More than half of Scotland’s adults have a close personal connection to stroke, amid poor health board performance in stroke

A YouGov poll for the Stroke Association has revealed just over half the adult population in Scotland (52%) have a close personal connection to stroke¹ – whether having had a stroke or seen a close friend or relative affected.

This comes as a new Stroke Association report highlights that Scotland’s health boards are not making enough progress against the Scottish Government’s Stroke Improvement Plan (SIP), which was published last summer. The SIP is a roadmap to help Scotland’s health boards to improve stroke services.

The ‘stroke care bundle’ is one of the main ways health board performance in stroke is measured. The Scotland quality standard is that 80% of patients should get four critical elements, but Scotland’s health boards collectively achieved a national average of 51.3% in 2023 - slightly up on the 49.9% of 2022 and well down on the 64% of 2019.

According to the Scottish Stroke Care Audit (SSCA) “the stroke care bundle is important because achieving it is associated with reduced risk of dying and increased likelihood of getting back home”.

The stroke bundle comprises prompt delivery of four elements:

a) admission to a stroke unit; b) brain imaging; c) screening for swallowing problems; and d) administering of aspirin.

Rapid testing for swallowing problems is a particularly good indication of whole hospital performance, but no health board is good at this. Performance against the swallow test standard (100% within four hours) is poor. The Scottish average (67.7%) is almost identical to 2022 (67.9%) and down from 73% in 2021.

John Watson, Associate Director for the Stroke Association in Scotland, comments: “The framework for improving is there, but not enough progress is being made for the thousands of people in Scotland affected by stroke.

“Stroke is one of Scotland’s biggest killers and the leading cause of complex adult disability, but this is not matched by an urgency to improve stroke services.

“Our report pulls out health board performance in both hyperacute care and rehabilitation and finds slow progress in things that could revolutionise stroke care and prevent lifelong disability.

“We argue that quicker improvements would not only save lives, but money too. We believe improving stroke care is part of the solution to the current NHS crisis. If you get stroke care right, you get many other things right too.”

Dr Matt Lambert, Scotland’s National Clinical Lead for Stroke, adds:

"We know that prompt delivery of hyperacute and acute stroke assessments and treatment can really make a difference in someone's chances of recovery from a stroke. However, there is still significant variation in provision and delivery both geographically and between different hours of the day or days of the week.

“I know that stroke teams across the country passionately want to deliver the best stroke care possible. But stroke improvement relies on giving stroke its proper place in health and social care planning and aligning whole systems to make the stroke pathway work.”

The new Stroke Association report shows slow progress in rehabilitation, using Red, Amber, Green (RAG) charts featured in the Scottish Stroke Improvement Programme 2024 annual report, and John Watson hopes this clear picture will provide government, health board decision-makers, MSPs and Stroke Association supporters with key insights to help make stroke a priority.

The new report – which shows local health board performance in some key areas – will be available at https://stroke.org.uk/scotland/campaigns from 00.01hrs on 11^th October.