Charities have lambasted the Scottish government for letting down stroke patients, after only half received the acceptable level of care – and too few underwent a key intervention that can prevent long term injury. 

Figures released today by Public Health Scotland show the country has fallen short of its target of 80% of stroke patients receiving the care they are entitled to for the 7^th straight year.

The stroke care bundle, which includes being prescribed aspirin, access to a stroke unit, brain imaging and swallow screening, was given to just 52.9% of Scotland’s 11,341 new stroke patients in 2024.

The country’s two leading stroke charities say the failure to provide best stroke care is most striking in the delivery of thrombectomy – a potentially life-saving procedure to remove blood clots from the brain.

Just 2.2% of suitable stroke patients in Scotland received

a thrombectomy in 2024 – slightly higher than the 1.6% who received one in 2023, but still far below the country’s 10% target.

John Watson, Associate Director for the Stroke Association in Scotland said a Scotland-wide, round-the-clock thrombectomy service was promised years ago, but Scotland has now fallen behind other comparable nations:

“The thrombectomy rate elsewhere in the UK is more than double that in Scotland.

“We work closely with stroke teams and recognise the tremendous efforts made by staff on the ground. But they can’t sort this on their own. It is political decisions, from the Scottish government and health board leadership, that determine the resources, equipment and staff available to them.”

 

Two tales of thrombectomy

The experiences of two men at different sides of the country show the power of place and time in accessing the life-changing treatment and its role in recovery from stroke.

Graham McGowan, from Aboyne in Aberdeenshire, was unable to access the treatment after his stroke in 2022 in what the Stroke Association says was ‘the wrong place at the wrong time’.

After being rushed to Aberdeen Royal Infirmary, a brain scan revealed a blood clot which doctors advised should be treated with thrombectomy.

However, Graham was unable to have the procedure because he arrived at hospital at around 9pm. He was instead treated with a drug used to try and disperse clots, followed by intensive physiotherapy.

The former trail runner and skier now lives with left-side paralysis, due, he believes, to restricted availability of thrombectomy.

“I don’t want to dwell too much on the ‘what ifs’ and the cost of me not getting a thrombectomy,” he said, “as it doesn’t help me mentally.

“But if you take me as an example, I was working and had an active, healthy lifestyle before I had a stroke. Now, I can’t live independently. I can’t work. I can’t drive, ski, run or mountain bike. My wife is now also my carer and there has been a dramatic change in our circumstances.”

Graham’s experience is in sharp contrast to two-time stroke survivor Michael MacDonald.

At age 33, Newton Mearns-based Michael received a thrombectomy after his first stroke.

Through quick treatment and intensive rehabilitation, Michael told national charity Chest Heart & Stroke Scotland he was able to make a good recovery and feels “lucky” to have had the procedure:

“I didn’t realise this procedure is only available 9-5, Monday to Friday. I got to hospital at 4.30 in the afternoon, and I was lucky that the stroke team decided I needed to be treated right away, and they all stayed to do that. 

“Now, knowing the difference thrombectomy can make in recovery, I think it’s essential that this procedure is available to everyone, no matter where you live or what time you are admitted to hospital. It’s a gamechanger where stroke recovery is concerned.”

 

A working day only service

Thrombectomy is currently available during daytime hours at three specialist hubs in Glasgow, Edinburgh and Dundee. A total of 212 procedures were delivered in 2024.

Thrombectomy is estimated in one study to save the health and care system £47,000 per patient over five years.

Chest Heart & Stroke Scotland’s Chief Operating Officer, Allan Cowie, said the government is failing both stroke survivors and NHS staff who are “doing the absolute best they can with the inadequate resources” they’re being given:

“While we recognise the financial constraints facing the government, the continued underinvestment in stroke care is resulting in significantly higher long-term costs – both through prolonged hospital stays and the extensive support required for individuals living with stroke-related disabilities.

“This ongoing shortfall is not only economically unsustainable but is also costing lives. Immediate action is imperative."

The Stroke Association’s John Watson added:

“Small sums of money, such as investing in new operating suites to perform thrombectomies, would remove an existing bottleneck, save lives and quickly pay for themselves.

“But more than anything this requires political leadership. Oversight of the thrombectomy programme has now been passed to the NHS Planning and Delivery Board - it needs to own this problem and make it the priority it should have been all along.”

Public Health Minister Jenni Minto confirmed earlier this month that work to develop a plan for thrombectomy service expansion is continuing “at pace”.

The Scottish government has been approached for comment.

 

Read more: Government plans risk ‘diluting’ focus on stroke; Scots from poorer areas less likely to survive stroke; 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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