Five things stroke professionals believe can improve stroke care in Scotland to save lives and livelihoods
The Stroke Association and Chest, Heart & Stroke Scotland (CHSS) have today (23 February) revealed a bid to persuade political parties vying for power in May’s Scottish election to make stroke a priority for the next government.
Stroke is a huge health issue in Scotland. More than 10,000 Scottish residents have a stroke every year1 with about 150,000 people currently living in Scotland with the effects of the condition2. It’s the country’s third biggest killer3 and the leading cause of complex adult disability4, which can leave survivors unable to see, speak, move or even swallow.
Scotland is also being left behind by its UK counterparts on stroke. It has the highest incidence of stroke of the four UK nations and the largest proportion of people living with a disability because of stroke5.
More than 200 health professionals and six major health bodies – 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 proposing radical change.
The Stroke Association and CHSS are supporting stroke professionals in communicating five cost-effective, practical actions to politicians. These are changes developed by doctors, nurses and allied health professionals themselves. They are:
• Deliver an equitable 24/7 national thrombectomy service. Thrombectomy saves brains and money. It is a standard medical procedure in many countries and should no longer be a postcode lottery in Scotland.
• Increase inpatient and outpatient rehabilitation capacity. Front-loading spending on inpatient and outpatient rehabilitation will save money and promote recovery from stroke by reducing the need for ongoing support.
• Give acute stroke care the same hospital status as other specialist units. Stroke is designated a clinical priority and needs the same protection for beds, staff and other resources that is afforded to coronary care or trauma units.
• Develop an innovative long-term stroke specific workforce recruitment and retention plan. Measures to address the shortfall in stroke staff will include a biggerprofile for stroke in education syllabuses and increased opportunities for careerprogression.
• Ongoing failure to meet stroke standards to be escalated to Health Improvement Scotland. This will make the auditing process more robust and ensure NHS boardsplace greater emphasis on meeting the needs of stroke patients.
John Watson, Associate Director for the Stroke Association in Scotland, said: “Successive Scottish governments have not invested in stroke treatment and care to anything like the level it needs, and it’s taking a terrible 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.”
Chief Operating Officer at Chest, Heart & Stroke Scotland, Allan Cowie, said: “Stroke is devastating lives in every community in Scotland – this is impossible to ignore for any successive government. We are seeing more people of working age having strokes, and yet the standard of care they receive depends far too much on where they live and when they arrive at hospital. That is simply unacceptable.
“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.
“Scotland can and must do better. We are calling on all political parties to grasp this moment and commit to delivering stroke as a national priority. Lives, livelihoods and recovery depend on it.”
The latest Scottish Stroke Statistics published in January once again laid out the extent of stroke in Scotland. It devastates lives in all corners of society including increasing incidence of strokes in people of working age (under 65s) over the last 10 years6.
According to the Scottish Stroke Improvement Programme annual report 2025 just 52.9% of stroke patients received the stroke care bundle*, which is associated with better patient outcomesagainst a national quality standard of 80%. In 2019 it was 64%.7
The British and Irish Association of Stroke Physicians (BIASP), the professional body representing stroke physicians across the United Kingdom and Republic of Ireland, added: “We are fully supportive of addressing inequalities in patient access and outcomes across all five nations.
“The situation in Scotland is 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.
“We call on the Scottish Government to take action and support us in ensuring thrombectomy is available for all who need it.”
More than 200 doctors, nurses and allied health professionals have signed the Stroke Association and CHSS’s Scottish election campaign call to make their views known to political parties developing their manifestos for May. It is hoped that parties taking stroke seriously will commit to delivering stroke as a priority.
*The stroke care bundle comprises the prompt delivery of a) admission to a stroke unit; b) brain scanning; c) screening for swallow problems; d) administering aspirin (unless contraindicated).
About Thrombectomy
Thrombectomy is a treatment for ischaemic stroke, which removes large arterial blood clots from the brain and reduces the risk of patients having long-term disability such as paralysis, blindness and communication problems. About 1 in 10 peoplewith stroke could benefit from thrombectomy.8
It should be carried out on eligible patients as soon as possible after onset – and ideally within six hours9.
The thrombectomy rate in Scotland is less than half what it is in the rest of the UK – only 2.2% of the total number of patients who had an ischaemic stroke compared to 4.4% for the UK. In Scotland in 2024 this equated to 212 people10 of the more than 1,000 patients who should have had the procedure.
Case study – Tracey Donaldson
Tracey Donaldson, 56, from Glasgow credits thrombectomy for letting her have the retirement she’s worked hard for. Tracey had a stroke on Wednesday, 19th February 2025 – she thinks about 8.45am.
Tracey served as a school secretary for 19 years, taking early retirement in December last year and having previously worked in banking for 20 years.
Rewind to 19th February 2025 and a work colleague noticed Tracey was showing the classic signs of a stroke – her left-side collapsed and she was struggling to speak. School first aiders rushed to the scene and called an ambulance.
She arrived at Glasgow’s Queen Elizabeth University Hospital (QUEH) at about 10:30am and doctors quickly got to work. She had a CT scan confirming a significant ischemic stroke and was promptly prepared for a thrombectomy, she thinks about two hours after her stroke.
A matter of hours later, Tracey showed nurses that she could walk and her speech had returned.
Incredibly, Tracey passed all the tests set by physiotherapists to check her mobility and was discharged from hospital at 4.30pm on Friday, 21st February.
She said: “I was very tired that first week at home. I had lots of visitors, and it was quite overwhelming at times. But otherwise, it was like I hadn’t had a stroke.”
True to form, Tracey quickly resumed her busy life.
She adds: “I went along to a stroke support group when I retired. 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. So, I focused on getting back to normal my way – spending time with family and friends and trying new experiences.”
Tracey concludes: “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.”
Tracey returned to work in April ‘25, but anxiety brought on by the stroke prompted her to prioritise her health and take early retirement eight months later.
