The NHS has come under renewed scrutiny after England’s health ombudsman exposed repeated shortcomings in the diagnosis and treatment of stroke patients across the country.
Strokes remain one of the UK’s leading causes of death, claiming around 34,000 lives annually, and are the primary cause of long-term disability.
Globally, the World Stroke Association estimates over 12 million people will suffer their first stroke this year, with 6.5 million fatalities.
The NHS’s FAST campaign continues to stress the importance of recognising key stroke symptoms—facial drooping, arm weakness and slurred speech—and the urgent need for transfer to a specialist stroke unit within four hours.
Delays in treatment can result in death or debilitating conditions such as paralysis, memory loss and speech difficulties.
However, recent figures from the Sentinel Stroke National Audit Programme (SSNAP) reveal that only 46.6% of patients in England, Wales and Northern Ireland are admitted to a specialist stroke unit within the critical four-hour window—far short of acceptable standards.
The Parliamentary and Health Service Ombudsman (PHSO), which intervenes when NHS complaints have been exhausted without resolution, reported a 66% rise in formal investigations into poor stroke care over four years, rising from 17 cases in 2020 to 28 in 2024. Total complaints also increased, from 318 to 396.
Rebecca Hilsenrath, chief executive of the ombudsman service, said investigations revealed systemic failings in diagnosis, nursing care, communication and stroke treatment.
“We’ve seen a worrying increase in complaints involving both typical and atypical stroke presentations. Early and accurate diagnosis is absolutely critical to improving outcomes for stroke patients,” she said.
“These cases highlight how NHS providers failed to recognise errors in care. A culture of learning must be embedded, where clinicians acknowledge when things go wrong and use those insights to improve future treatment.”
The ombudsman urged clinicians to act swiftly, even when stroke symptoms are less obvious, and to strengthen communication and coordination across departments to provide seamless, effective stroke care.
Juliet Bouverie, Chief Executive of the Stroke Association, called the findings “deeply concerning”. She warned that, without urgent investment and a national strategy focused on cardiovascular health and stroke recovery, patients would continue to face unacceptable disparities in treatment and rehabilitation support.
Meanwhile, Professor Martin James, SSNAP’s clinical director, confirmed that fewer stroke patients are receiving timely care on dedicated stroke units.
“While this reflects broader pressures within hospitals, access to specialist stroke care within four hours is vital to prevent complications and long-term disability. Ensuring this should be a priority for every hospital,” he added.
