Healthcare professionals and patient groups say Scotland is being left behind by its UK counterparts with the highest incidence of stroke across the four nations, the highest levels of disability amongst those affected, and access to a key intervention only available during working hours.
Today sees the launch of a campaign in the run-up to the Holyrood election to persuade political parties to promise to make the delivery of better stroke care a priority.
A year ago this week, colleagues working with 56-year-old Tracey Donaldson from Glasgow spotted that she had some of the classic signs of a stroke – her left side had collapsed and she was struggling to speak.
On arrival at Glasgow’s Queen Elizabeth University Hospital (QEUH), a CT scan confirmed a significant ischaemic stroke and, within two hours she had undergone a thrombectomy to remove blood clots from her brain.
Two days after being admitted, her speech having returned and suffering no issues with her mobility, she was discharged home.
Tracey says it wasn’t until she later went to a stroke support group that she realised how lucky she had been:
“Everyone was exceptionally welcoming, but I felt like an imposter as I had no visible effects of the stroke, noting that others around me had not been as fortunate.
“I strongly believe the recovery from my stroke has been miraculous due to having a thrombectomy quickly. I am forever grateful to the QEUH doctors for saving my life and letting me live life to the full.”
Around one in 10 people with stroke will benefit from thrombectomy which, if undertaken within six hours, can reduce the risk of long-term paralysis, blindness and speech problems.
The Stroke Association and Chest, Heart & Stroke Scotland (CHSS) say thrombectomy rates in Scotland are less than half of the rest of the UK, not least as only one service in Scotland operates 24/7.
The charities say that in 2024, more than 1000 patients should have had the procedure but only 212 did.
In a statement supporting the campaign, the British and Irish Association of Stroke Physicians called the situation in Scotland “worrying”:
‘Standards of stroke treatment and care are sliding, so we have joined forces with other stroke professionals in Scotland to outline what we believe are affordable, deliverable solutions to an increasingly frustrating position.
‘For example, thrombectomy is one of the most effective interventions in modern medicine, as it significantly reduces the risk of long-term disability when delivered promptly. Yet Scotland’s specialist thrombectomy units are hampered by limited operating hours, with only one currently performing the procedure seven days a week.
‘As stroke doctors, this puts us in a very difficult position. We want every patient who should have a thrombectomy to have access to this life-changing treatment, but we are thwarted by lack of resources, whether human or material.’
Clinicians’ five asks
Today, 200 health professionals and six health organisations– the British and Irish Association of Stroke Physicians, the Royal College of Speech and Language Therapists, the Royal College of Occupational Therapists, the Scottish Stroke Nurses Forum, the Royal College of Physicians of Edinburgh and the Royal College of Physicians & Surgeons of Glasgow – are putting their names to a Stroke Association and CHSS campaign for Scotland’s politicians to commit to investing in delivering a list of five key asks developed by doctors, nurses and allied health professionals:
- Deliver an equitable 24/7 national thrombectomy service;
- Increase inpatient and outpatient rehabilitation capacity, saving money in the long term as people recover from stroke and return to health;
- Give acute stroke care the same hospital status as other specialist units, with the same system of allocated beds, staff and resources as coronary care or trauma units.
- Develop an innovative long-term stroke specific workforce recruitment and retention plan to address the shortfall in stroke staff; and
- Require Healthcare Improvement Scotland to lead audits of every NHS board’s stroke care services.
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The Associate Director for the Stroke Association in Scotland, John Watson says the failure to invest in stroke treatment and care over years has taken a toll on lives, livelihoods and the NHS:
“A national thrombectomy service has been promised for years, but progress remains glacially slow. According to the latest figures, less than one in five Scots who needed this life-changing procedure, got it. It can be the difference between resuming life as normal and living with life-limiting disability.
“The stroke community’s other proposals not only put the best interests of patients at heart, but they have also thought about whole hospital systems and the immense pressure on the NHS and social care. Sorting stroke can help address the NHS crisis, not least in reducing the need for ongoing support for stroke survivors.”
Allan Cowie, Chief Operating Officer at CHSS says Scotland can and must do better for everyone affected by stroke, regardless of where they live:
“When only around half of patients receive the basic stroke care bundle that we know leads to better outcomes, and when life-changing procedures like thrombectomy are available to so few, it’s clear that Scotland is still failing people at the moments they need the NHS most.
“The five actions put forward by stroke professionals are practical, evidence-based and affordable – and they would transform the future for thousands of people every year.
“Investing in stroke care is not only the right thing to do for patients and families, it is one of the smartest ways we can relieve pressure on the NHS and social care.”
Read more: More younger Scots dying from stroke; Loneliness: a public health crisis for Scotland; Stroke patients ‘failed’ for 7th year in row
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