Thousands left dead or disabled due to shortage of stroke specialists, medics warn

Thousands of people have been left dead or disabled due to a shortage of stroke consultants in the NHS, senior medics have warned.

Experts said there is only a “small window” of potential opportunity in which to dramatically change the outcome of stroke patients – but that their ability to act within it is being strained by a dwindling workforce, leaving patients with terrible consequences.

Speaking to The Independent, president of the British and Irish Association of Stroke Physicians (BIASP) Dr Louise Shaw, said having the correct stroke workforce is “absolutely essential” to patient outcomes.

She said the timely administration of a treatment such as a thrombectomy – a procedure which should be delivered within 4.5 hours of a stroke, and removes the blood clot and restores normal blood flow – can prevent someone from dying or becoming seriously disabled.

But a recent BIASP survey of 100 hospitals in England that provide acute stroke care found 70 per cent of stroke units are short of at least one consultant in stroke care, and many are short of two.

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It also found that 53 of 84 hospitals that responded had vacancies for a total of 96 consultants, and that the NHS relies heavily on locum doctors to fill holes in the workforce.

Additionally, BIASP reports that 10 per cent of the stroke consultant workforce are close to retirement age, further worsening the position over the next five years.

Speaking to The Guardian, survey lead and former president of BIASP Professor David Werring said people are either “dying or living with disability unnecessarily because they’re not getting the correct evaluation and treatment by the right expert at the right time”.

He added the results showed “a significant worsening in the workforce position in the NHS in England”, with more unfilled vacancies than previously understood.

“The shortage means that when people have an acute stroke, they cannot be sure of receiving an expert consultant opinion to get the right diagnosis and the right treatment at the right time,” he added.

It comes as data from the NHS shows the number of people being admitted to hospital following a stroke has risen by 28 per cent in the last 20 years. It attributed the rise to “an ageing population and the impacts of lifestyle factors on the nation’s cardiovascular health”.

Of the 100,000 people in the UK who have a stroke each year, between 10,000 and 20,000 die or sustain a serious disability that could have been prevented if they were treated earlier, Dr Sanjeev Nayak, a senior stroke specialist at Royal Stoke hospital, told The Guardian.

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“It is heartbreaking to see the real and avoidable impact that workforce shortages have on patient outcomes,” he said. “In my experience workforce shortages directly lead to avoidable disability and, in some cases, avoidable death.”

In its national audit last year, the Stroke Association said stroke care is in a “dire state” in England, with too few patients receiving timely treatment and only a third getting the recommended aftercare.

It also warned that patients are also facing a “postcode lottery” when it comes to getting a clot-busting treatment, which can significantly reduce the likelihood of long-term disability.

Data from the audit revealed that less than half of eligible patients are getting a thrombectomy.

Juliet Bouverie, chief executive of the Stroke Association, said: “Stroke changes a person’s life in an instant with far-reaching repercussions for many. It requires treatments including physiotherapy, speech and language therapy, and mental health support.

“The fact that 65 per cent of stroke survivors don’t get this is truly shocking and demonstrates the dire state stroke treatment and ongoing care is in.”

A Department of Health and Social Care spokesperson said: “There are record numbers of doctors in the NHS – 7,000 more than this time last year – and our upcoming workforce plan will set out how we ensure the NHS has the right people, in the right places, with the right skills to care for patients when they need it.

“With 20 regional networks already bringing together local NHS services to deliver seamless, joined-up care, our 10 Year Health Plan will go further by shifting the focus of healthcare out of hospitals and into the community, helping stroke survivors get vital support sooner.

“We are committed to improving stroke prevention, treatment and recovery, including by setting new national standards for how cardiovascular disease care should be delivered across the NHS.”