Many Scots miss out on key stroke care

‘Inequality of provision’ for key thrombectomy treatment ‘disappointing’, says Edinburgh’s Royal College of Physicians

Tuesday 9th July 2019

Health boards in Scotland are routinely falling short of a set of stroke care standards that are linked to reduced mortality and increased likelihood of speedy discharge home after a stroke, according to figures released today.

Despite an improvement from 65% of patients receiving the appropriate treatment in 2017 to 68% in 2018, performance against a ‘bundle’ of key stroke care standards is still short of the 80% target.

The latest Scottish stroke improvement programme report details care related to the 9,641 stroke patients admitted to Scottish hospitals in 2018, as well as the 1,085 seen at neurovascular clinics.

Stroke is the third most common cause of death in Scotland and the most common cause of severe physical disability amongst adults.

It is estimated that around 15,000 people in Scotland have a stroke each year. Hospital care for these patients accounts for 7% of all NHS beds and 5% of the entire NHS budget.

An appropriate care bundle includes admission to hospital within one day; a brain scan within 24 hours; screening tests within four hours; and aspirin being provided within one day.

“This report shows continuing improvement in the delivery of many aspects of stroke care in Scotland,” says Professor Derek Bell, president of the Royal College of Physicians of Edinburgh.

“However, we believe that a full range of effective treatments should be available to Scottish patients. It is therefore disappointing that a key treatment – mechanical thrombectomy – is still not available in Scotland.

“Mechanical thrombectomy is an emergency treatment which can prevent significant life-changing disability in selected patients with severe strokes. There is inequality of provision of this service between Scotland and other countries worldwide - and even between England and Scotland.”

“We are pleased that the Scottish Government have started the process of planning a thrombectomy service. However, we would urge that resources are made available to ensure there are no avoidable delays in its implementation.”


The Scottish Liberal Democrat health spokesperson, Alex Cole-Hamilton, has criticised the Government for failing to meet the 80% target by a ‘giant margin’, as no health boards in Scotland achieved the standard in 2018.

The poorest performing health boards were NHS Highland at 48%, NHS Dumfries & Galloway at 63% and NHS Lothian at 64%.

But Tayside and Dumfries & Galloway health boards were able to make significant gains.