• National clinical director of stroke says she “wouldn’t go to Betfred” when asked about chance of meeting key national target
  • NHS long-term plan said 10 per cent of stroke patients would have access to mechanical thrombectomy
  • Deb Lowe says many stroke services unsustainable, but would not confirm number of units due to close

A new national clinical director has suggested it is unlikely a key long-term plan commitment over stroke care will be met, which could leave thousands of people severely disabled.

Deb Lowe, who has recently become national clinical director for stroke at NHS England and Improvement, told an event in London she “wouldn’t go to Betfred” when asked if there was any chance of meeting a commitment to increase the number of stroke patients who have access to specialist treatment.

The NHS long-term plan said that by 2022, the proportion of stroke patients accessing mechanical thrombectomy would rise from 1 per cent to 10 per cent.

Dr Lowe told HSJ’s inaugural national cardio forum the proportion had improved to roughly 2 per cent in 2019 (equating to around 2,000 patients). About 10,000 relevant patients would need to receive the treatment for the commitment to be met.

She added: “We may not be up to 10 per cent in two years, but I think we’ll be along the way there.”

The long-term plan pointed out mechanical thrombectomy can significantly reduce the severity of disability caused by a stroke, by quickly restoring blood flow.

The treatment physically removes a blood clot from the brain by introducing a clot retrieval device via an artery in a patient’s groin.

Dr Lowe said six units across England deliver 24/7 mechanical thrombectomies if required, which is an increase from one in the prior financial year. She said another 19 similar centres will open in the next 12 months.

Juliet Bouverie, chief executive of the Stroke Association said: “Thrombectomy is an incredibly cost effective and life-changing way of treating strokes, but requires changes to stroke service delivery and more specialist staff to be available to all who are eligible.

“NHS England should do everything it can to meet its own target, including training up enough specialists, so that all eligible patients can receive this treatment and have the best chance at rebuilding their lives after stroke.”

At the same conference, Dr Lowe also said although there will be a “reduction” in the number of stroke units, she didn’t expect it to be “down to 80”, as had previously been suggested. She said: “I’m not willing and I don’t believe at the moment that I can put a specific number on the number of units we need.”

The NHS long-term plan said it wanted “sustainability and transformation programmes and integrated care systems to reconfigure stroke services into specialist centres” within the next five years.

Although no figures were attached to this plan, HSJ had previously reported the Stroke Association charity as saying independent modelling suggested the number of stroke units should be cut from 126 to around 80 “hyper acute” and specialist units.

Dr Lowe said: “Having looked across the country, it’s very clear that many stroke services have already identified themselves as being non-sustainable in terms of workforce perspective.”

She also said stroke must be given the “same parity of esteem as other conditions” such as trauma, but “a lot of hospitals” are not giving priority to “time-critical conditions like stroke” when it comes to securing scanning slots.

Some local reconfiguration plans have already met public resistance, with plans in Kent and Medway STP potentially facing a judicial review.

Ms Bouverie said: “NHS England needs to do everything possible to ensure that stroke services are set up in the most efficient way, including taking modelling work into account”.