Only 4.3% of stroke patients in England have access to life-saving treatment

Most stroke patients in England who are eligible for treatment that could save them from serious disability or even death are unable to access it, new figures show.

It is estimated that at least 10% of stroke patients may benefit from a treatment known as mechanical thrombectomy. During the procedure, a wire and stent are maneuvered into the brain to pull out the clot blocking blood flow. The treatment reduces the adverse effects of a stroke and with the best results, a patient can leave the hospital the next day.

But figures from the Sentinel Stroke National Audit Program (SSNAP), based at King’s College London for the first three months of this year, show that only 4.3% of stroke patients in England are receiving the procedures.

Peter Hooper, 64, said of the procedure after suffering a stroke in June 2020: “I find it terrifying that there are people who can have a thrombectomy and be back on their feet within days who don’t have access to the treatment.” He said it was crucial that treatment was given to eligible patients and that they were treated quickly because around two million brain cells die every minute until blood flow is restored.

Speaking at a mechanical thrombectomy awareness day in Stoke-on-Trent last Thursday, NHS England medical director Prof Sir Stephen Powis said the national rollout of mechanical thrombectomy had been hampered by the pandemic, but the NHS was committed had committed to guarantee wider access.

Powis said: “It is one of the most effective clinical interventions we have in medicine and it is transformative for those who have had a stroke. To see someone with a severe disability come in and then be able to leave the hospital shortly after the procedure – as often happens – a day or two later is truly remarkable.”

Powis said he visited all 24 mechanical thrombectomy centers in England this year to support the treatment, but there were problems with staff and equipment. He said North Midlands University Hospitals, where Hooper was treated, had already exceeded its target of providing mechanical thrombectomy to 10% of stroke patients and were “one of the best services, if not the best services in the country”. .

Dr. Sanjeev Nayak, a consultant interventional neuroradiologist at the University Hospitals of North Midlands, said mechanical thrombectomy was effective but more resources were needed to ensure wider access. He said: “You can prevent a patient from becoming permanently disabled or dying if you act quickly. Especially for patients with a large occlusion of one of the large blood vessels, the treatment is like a light switch. The patient’s brain comes back to life and can recover very quickly.”

The 2019 NHS Long Term Plan set a target to treat 10% of stroke patients with mechanical thrombectomy by 2022, but this target was not met and availability depends on where the patient lives. The Observer reported in October last year how a primary school teaching assistant died of a stroke after her family were told the life-saving treatment was unavailable at the weekend.
SSNAP data for England for the period April 2023 to March 2024 shows that patient thrombectomy rates range from 1.7% in West Yorkshire and Harrogate to 8.7% in Thames Valley. The total number of procedures in England increased from 2,684 in 2022/23 to 3,501 in 2023/24, an increase of around 30%.

Speaking at the mechanical thrombectomy event, Maeva May, from the Stroke Association, said mechanical thrombectomy was cost-effective and could save the NHS an estimated £73 million a year. She said there had been a significant increase in the number of patients receiving the procedure, but improvements were still needed.
She said everyone was aware of the pressure on ambulance services, but it was vital that patients arrived at hospital as quickly as possible, with every minute counting. She said: “The sooner we can get (these patients) to the thrombectomy center, the better the chance of a full recovery.”