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Organisation and quality of stroke services

Stroke is a devastating disease affecting many people as well as being an area of substantial health and care spend. It represents around 5% of total NHS costs and is the fourth largest cause of death in the UK. Recent years have seen huge improvements in the clinical management of people with stroke with early assessment, use of thrombolysis and better organisation of services into acute stroke units. Over the last twenty years, stroke mortality rates have halved.

Yet providing the right care over many years to those living with stroke and their families remains a challenge. Roads to Recovery brings together recent NIHR evidence relevant to those planning and delivering stroke services, those delivering treatments to people with stroke and to those living with stroke.

DOI: 10.3310/themedreview-001685 

Roads to recovery

Roads to Recovery - Organisation and quality of stroke services

This themed review looks at the configuration of stroke services, identifying stroke and acute management, recovery and rehabilitation, and life after stroke. 

It features:

  • 44 published studies
  • 29 ongoing studies
  • Questions to ask about your stroke services
  • Quotes from commissioners, clinicians and service users

A two side summary of the report is also available.


Over 100,000

people every year in the UK have a stroke

£1.7 billion

direct cost to the NHS in England every year

1.2 million

people in the UK live with a disability after stroke

  • Through working to improve stroke services in our region, we’ve often found it difficult to get the right evidence to make strategic recommendations and to support quality improvement initiatives. Now the NIHR stroke themed review provides some of that evidence, easily accessible and thoroughly reviewed.

    Stephen T Webb,

    Eastern Academic Health Science Network Patient Safety Collaborative Clinical Lead,

    East of England Clinical Senate Council Member

  • The themed review is informative, easy to read and would be of use to anyone working in field of stroke - from primary care to acute services and particularly for those who are developing a stroke pathway locally. The role of nurses is highlighted in many parts of the booklet. I urge you to read it and share it with colleagues.

    Amanda Cheesley,

    Professional Lead for Long-term Conditions and End of Life Care,

    Royal College of Nursing

  • I applaud NIHR for creating these Themed Reviews. They bring into sharp focus the underlying evidence base and provide an invaluable and accessible tool for commissioners and clinicians. This review is very timely and will help to maintain momentum in stroke at national and local level.

    Dale Webb,

    Director of Research and Information,

    The Stroke Association



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