STROKE campaigners say patients in Scotland must have access to centralised, specialist units as the latest figures show little improvement in the delivery of a vital clot-busting treatment.
The Stroke Association said evidence from England showed that more patients survived and were less disabled long-term if they were rushed to regional centres run by stroke experts, instead of relying on their local hospital.
Specialist centres are already up and running in London and Manchester, but currently there are none in Scotland.
The call comes as the latest annual Scottish Stroke Care Audit (SSCA) reveals little improvement in thrombolysis rates - a procedure used to dissolve the clots blocking blood flow to the brain.
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Of the 1,033 stroke patients admitted to hospital in 2018, only 60 per cent were thrombolysed within an hour of arrival compared to 59% in 2017 and still far short of the 80% target.
Delivery of the ‘stroke care bundle’ - the package of care every stroke patient should get in hospital - had improved from 65% in 2017 to 68% in 2018 but only NHS Ayrshire and Arran came close to achieving the 80% target.
The bundle includes admission to a stroke unit, brain scan, swallow screen, and aspirin.
The continuing absence of a thrombectomy service in Scotland - a procedure to remove a blood clot from a vessel - was also highlighted.
Andrea Cail, director of the Stroke Association in Scotland, said dramatic improvements would only be achieved through changes in how stroke care is delivered.
She said: “The report acknowledges that we have no comprehensive stroke centres in Scotland.
"But the evidence shows that re-shaping stroke services and creating hyper-acute stroke units (HASUs) with the best equipment and experts in one place can save lives, reduce disability and result in greater cost effectiveness for our health and social care services.
“The SSCA report states that our thrombolysis door to needle times have ‘stalled’, this means there are still people who would benefit from thrombolysis not getting timely access.
"We know in some areas this is because of the transfer times between hospitals, which could be negated.”
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NHS Tayside plans to introduce Scotland’s first hyper-acute care model for stroke, which would see all patients in the region admitted directly to Ninewells in Dundee for initial treatment, before being transferred back to their local hospital for follow-up care 48-72 hours later.
In London and Greater Manchester, this model has been credited with saving the lives of an estimated 96 and 69 patients a year respectively who would have died under standard hospital treatment.
Average hospital stays are shorter, and patients are more likely to receive the interventions they need in time.
Ms Cail added: “We will champion this model and want to see it being replicated in other parts of Scotland and especially in Greater Glasgow and Clyde.”
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Keith Muir, a consultant neurologist at Queen Elizabeth University Hospital in Glasgow and professor of clinical imaging at Glasgow University, said: “There is considerable scope for improvement in thrombolysis rates and thrombolysis effectiveness.
"More patients can be treated, and need to be treated more quickly.
"Service configuration needs to be reviewed to ensure that we deliver the greatest benefit to the greatest number.
"Stagnant treatment rates and slow door-to-needle times highlight major need to improve.”
Around 13,000 people suffer a stroke every year in Scotland, and some 4000 die.
A spokesman for the Scottish Government said: “Over the past 10 years, the number of people dying from stroke has decreased by 42%. This is significant progress but we want to go further.
"We continue to implement our Stroke Improvement Plan which sets out the priorities and actions to deliver improved prevention, treatment and care for all people living in Scotland who are affected by stroke."
He added that the Scottish Government "fully support" the development of thrombectomy services in Scotland. 
He said: “The Health Secretary has made clear that she expects this service to be made available in appropriate sites across Scotland and asked that a national planning framework is developed to ensure a high quality and clinically safe service can be implemented.”