Tens of thousands of stroke patients in England are being denied access to a “miracle treatment” that pulls them back from “near death”, putting lives at risk and leaving many unnecessarily disabled, a report warns.
More than 47,000 patients will miss out on mechanical thrombectomy on the NHS over the next seven years unless NHS England and ministers take immediate action, according to the new study by the Stroke Association.
The treatment uses a stent to manually remove large stroke-causing blood clots from the brain via a catheter inserted into the patient’s groin. It can be performed up to 24 hours after a stroke, but is most effective in the first six hours.
But the report warns that NHS England has missed its target to make mechanical thrombectomy available to all the patients it could benefit – only delivering to 28% of all suitable patients by December 2021.
The procedure can reduce hospital stays by months. Some patients have been able to leave hospital the next day, instead of spending months in rehabilitation units.
Stroke specialists say a 24/7 service would save £73m a year due to the reduced costs of looking after people with stroke. But just 25% of thrombectomy centres operate as such, while 42% are only open from Monday to Friday during office hours, the report says, in part due to a lack of biplane suites, which contain specific radiology equipment.
Juliet Bouverie, the chief executive of the Stroke Association, said: “Thrombectomy is a miracle treatment that pulls patients back from near death and alleviates the worst effects of stroke.
“It’s shocking that so many patients are missing out and being saddled with unnecessary disability. Tens of thousands will miss out if rates stay the same as in 2020/21.
“There are hard-working clinicians across the stroke pathway facing an uphill struggle to provide this treatment and it’s time they got the support they need to make this happen. It really is simple.”
The procedure is one of the most effective ever discovered for stroke and is suitable for about 10% of all patients, the Stroke Association said. There are 75,000 strokes in England every year.
The report also revealed an “unacceptable postcode lottery” in care, with almost 8% of stroke patients receiving thrombectomy in London, compared with 0% to 3% in other parts of England.
Treatment rates are also kept low by ambulance delays and slow handovers of patients to A&E.
Prof Martin James, a consultant stroke physician at the Royal Devon and Exeter NHS foundation trust and a clinical trustee of the Stroke Association, said: “Thrombectomy really is a gamechanging treatment, yet the number of people receiving the treatment in the UK remains much lower than elsewhere in Europe, and has been only slowly increasing over recent years.
“At this rate, it won’t be available to all those who could benefit for many years to come.”
An NHS England spokesperson said: “By bringing services together through newly created stroke networks, we are supporting local clinicians to deliver 24/7 access to thrombectomy, clot-busting drugs and other lifesaving specialist stroke services in every part of the country, so if you experience stroke symptoms, it’s vital that you call 999 immediately.”
A government spokesperson said: “We are growing the health and social care workforce, with over 4,000 more doctors and 9,600 more nurses compared to last year, and over 1,400 more doctors in general practice compared to March 2019.”
