Stroke Association comment: Scottish Stroke Improvement Programme 2022 National report

John Watson, Associate Director Scotland of the Stroke Association said:

“We are deeply concerned at the performance of stroke services in Scotland over the last year.

“Whilst we acknowledge that the Covid-19 pandemic caused significant disruption to service delivery, the report clearly shows too many stroke patients did not get the care they needed. Healthcare staff have performed heriocally, but they are exhausted – the system is letting them down too.

“We recognise where there have been improvements. We also recognise and warmly welcome the much more detailed contribution from the Scottish Ambulance Service but overall the report makes a clear argument for change.

The national figures for stroke care bundle performance and door to needle time for thrombolysis - key measures of the health of our stroke systems - were flatlining well below the standards required, pre-pandemic. Improving those was always going to be challenging whilst dealing with the impact of Covid-19. However, the latest national figures show a significant decline in stroke care bundle performance. They show that thrombolysis figures nationally have pretty much stayed static, but only at already unhappy levels.

There also remains significant variation in performance against the standards amongst health boards – so that the stroke care you receive is too heavily dependent upon where you live.

Stroke is Scotland’s biggest single cause of disability. Two out of three patients who have a stroke leave hospital with disabilities. These can be life-changing. Delays to treatment mean people are potentially being denied access to life-saving and disability-avoiding treatments they may be eligible for.

Front line stroke teams across the stroke pathway have our thanks and respect. Stroke teams largely do an incredible job in difficult circumstances with limited resources but we cannot continue like this.

Stroke is designated a “clinical priority” in Scotland. We need the Scottish Government and health boards to now spell out what prioritising stroke actually looks like and to direct and enable our health and social care services to deliver on this.”

The Scottish Government gets credit for the progress so far towards its Programme for Government stroke improvement commitments. As a result of those, we had the blueprint for a progressive stroke service for Scotland published in March this year. We await a revised stroke Action plan based on its recommendations – and offering much-needed, real change - later this year.