A national charity has warned Scottish government plans to bring together all long term conditions under a single policy framework could risk sidelining urgent, lifesaving treatment for stroke patients.

The Stroke Association has raised its concerns in response to a consultation on a proposed Long Term Conditions Framework, which aims to improve early identification and care through a unified strategy for chronic condition management.

While welcoming the ambition to improve care coordination, the charity cautions a ‘one-size-fits-all’ approach could ‘dilute’ hard-won progress in stroke policy and put at risk the delivery of improvements to stroke care the government committed to as recently as 2023.

A key concern for the charity is a potential loss of momentum in the national rollout of thrombectomy, a lifesaving treatment to remove blood clots which reduces the chances of long-term disability after a stroke.

Just one in seven eligible people underwent the procedure in 2023. The Scottish government has said it is “determined” to expand and increase access to thrombectomy services.

John Watson, Associate Director of the Stroke Association in Scotland, told healthandcare.scot the unique nature of stroke care merits targeted attention:

“Stroke is a medical emergency, with specific characteristics and clear differences from other chronic conditions, including the need for time-critical treatment to save lives and prevent disability.

“We are concerned that urgent procedures, such as thrombectomy, would get lost under a generalised Long Term Conditions Framework. As stroke can leave people unable to move, see, speak or even swallow, rehabilitation also has specific traits and needs that are different to other kinds of support.

“Stroke policy has been a focus for the Scottish government in recent years. Any combined framework must take care not to undermine this commendable progress.”

Stroke affects more than 10,000 people a year in Scotland and it remains a leading cause of death and disability.

It is currently designated by the Scottish government as a ‘clinical priority’ – a status it shares with other conditions including diabetes, heart disease and cancer.

Under the classification, stroke care improvements receive focused planning, dedicated civil servant support and ring-fenced funding.

In its consultation response, the Stroke Association says this hard-fought status must be protected and it will ‘vehemently oppose’ any attempt to remove it.

The charity also highlights ongoing issues with care quality, stating many stroke patients still do not receive the standard of care they are entitled to – making the case for more prioritisation, not less.

While the Stroke Association acknowledges a Long Term Conditions Framework could foster greater collaboration, it says current proposals lack the necessary detail to reassure them stroke-specific commitments made in the 2023 dedicated stroke improvement plan will be maintained.

This includes increasing access to rehabilitation and psychological care for people after they have a stroke, as well as making sure healthcare staff involved in stroke care have received the most up-to-date training.

A Scottish government spokesperson said the consultation process is ongoing and all views are being carefully considered, adding:

“The framework aims to encourage fairer care across all long term health conditions, better recognising that many people need the same type of support regardless of their circumstances.

“It will also still allow for specific care and help where appropriate to build on progress through the stroke improvement plan.”

 

Read more: Views sought on unified long term conditions approach; Stroke care only reaches half of Scots patients; Right to rehab: The first step to recovery; Shining the spotlight on aphasia

 

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