Shortage of NHS stroke specialists leaving thousands dead or disabled, say doctors | Stroke

Thousands of people who have had strokes have suffered severe disabilities or died because there are few specialists on the NHS who can treat them quickly enough, senior doctors say.

They said a lack of chronic stroke consultants on the NHS meant patients were facing dire outcomes due to delays in clot-busting drugs and surgery.

Prof David Werring, former president of the British and Irish Association of Stroke Doctors (BIASP), told the Guardian: “People are either dying needlessly or living with disability because they are not getting the right assessment and treatment by the right specialist at the right time.”

Werring said many hospitals can’t make immediate diagnoses for stroke patients and provide them with time-critical treatment to maximize their chances of a full recovery because “we don’t have enough consultants.” “This gap means that when people have an acute stroke, they cannot be sure they will receive specialist consultant advice to get the right diagnosis and the right treatment at the right time.”

Around 100,000 people have a stroke in the UK every year. Senior stroke specialist at the Royal Stoke Hospital, Dr. Sanjeev Nayak said 10,000 to 20,000 people died or suffered serious disability due to treatment delays due to staff shortages.

“It is heartbreaking to see the real and preventable impact of workforce shortages on patient outcomes. In my experience, workforce shortages lead directly to preventable disability and, in some cases, preventable death,” said Nayak, a consultant interventional radiologist.

“It is reasonable to estimate that around 10-20% of stroke patients inevitably die or become further disabled each year due to delays in the system. These delays are multifactorial, but there is a workforce shortage of stroke doctors and nurses.” [and other staff] – are a key contributor identified over and over again.

“Given that stroke affects around 100,000 people a year in the UK, this equates to thousands of patients each year whose outcomes could be materially better with timely access to adequately staffed stroke teams.”

Nayak pointed to annual reports prepared by the Sentinel Stroke national audit program team based at King’s College London, which assess the NHS’s performance in England, Wales and Northern Ireland against official guidelines for stroke care.

His latest report It found that it took four hours and 11 minutes for someone who had a stroke to be admitted to hospital in 2024-25, longer than in 2023-24 and more than 90 minutes than a decade ago.

And last year just 46.5% of stroke patients were admitted to a specialist stroke unit within four hours of arriving at hospital; This is about the same level as the previous year, but down more than 10 percent from a decade ago.

New research from BIASP has shown that long-standing gaps in the stroke medical workforce are worsening despite an aging population and the disappearance of unhealthy lifestyles. more people need hospital treatment after stroke.

The following results were obtained in the study covering 100 hospitals providing acute stroke care in England:

• 70% of stroke units are short of at least one consultant on stroke care, and many are short of two consultants.

• Of the 84 hospitals that responded, 53 had vacancies for a total of 96 consultants.

• The NHS relies heavily on local doctors to fill gaps in its workforce created by the difficulty of recruiting new consultants.

• 10% of the NHS’s 423 primary (permanent) consultants are expected to retire in the next five years, exacerbating the current shortage.

Werring said the results together revealed a “significant deterioration in the workforce position in the NHS in England”, with more unfilled vacancies than previously thought.

The current president of BIASP is Dr. Louise Shaw said a shortage of consultants meant some smaller hospitals did not have a senior specialist on duty 24 hours a day to decide on the care of stroke patients arriving in the evenings, at night or at the weekend.

“This is completely unacceptable,” Shaw said. “All patients admitted to hospital with an acute stroke need access to the views and advice of an urgent stroke consultant regarding their care. And this is not currently available.”

Major stroke treatments such as thrombolysis (using clot-dissolving drugs) and mechanical thrombectomy Surgery to remove a blood clot in the brain is extremely time critical, Nayak said. “When services are understaffed, patients miss treatment windows altogether or are treated too late, leading to much worse neurological outcomes that could have been prevented… Delays in specialist assessment or transfer to a thrombectomy center can mean the difference between independent recovery and devastating, life-long disability or no survival.”

Hospitals in rural, coastal and poorer areas will likely face a shortage of stroke consultants, Werring said.

The Stroke Association said patients were being denied “time-critical, life-changing” treatments due to staff shortages. “We know harm is happening because there are not enough stroke specialist staff.”

BIASP audit reveals threat to Labour’s election chances fulfilling his promise Reduce deaths from heart disease and stroke by 25% by 2035. Labor Party change plan he said last year: “We want to see a reduction in deaths caused by the biggest killers such as cancer, cardiovascular disease, stroke and suicide. This means patients are diagnosed and treated earlier.”

The Department of Health and Social Care (DHSC) is preparing a plan to be published this year to meet the 25% target. England-wide guidelines say stroke patients should receive “uninterrupted, joined-up care at all stages” of NHS treatment.

DHSC did not respond directly to BIASP’s findings. The NHS has 7,000 more doctors than the same period last year, a spokesman said. “And our upcoming workforce plan will set out how we ensure the NHS puts the right people in the right places, with the right skills, to deliver care to patients when they need it.

“We are committed to improving stroke prevention, treatment and recovery, including setting new national standards for how cardiovascular disease care should be delivered across the NHS.”

The Stroke Association’s analysis found that the number of people suffering a stroke in the UK is expected to rise from 100,000 to 151,000 a year by 2035.