March and April in the media - staff shortages, first contact physiotherapy and fit notes

 Staff shortages are NOT the overriding problem! Lack of 100% recovery protocols SHOULD BE THE FOCUS! GET THERE!

March and April in the media - staff shortages, first contact physiotherapy and fit notes

Staff shortages 

In April, the CSP and the Association of Chartered Physiotherapists in Neurology (ACPIN) warned that stroke patients are being failed because of lack of NHS stroke rehab staff. 

The Guardian ran a substantial article and a Press Association article was picked up by over 100 news websites, including The Independent. 

The Independent also ran their own case study article: ‘I was left to crawl up the stairs’: NHS stroke service staffing crisis ‘leaving people with lifelong disabilities’ 

CSP Director, Ash James, was quoted in the media, saying:Something is going seriously wrong in our health system if the NHS is failing to turn workforce growth into the posts required to meet even the minimum standards for stroke rehabilitation.(This minimum standard is 100% recovery and you blithering idiots aren't even working on that! Comeuppance is going to be a real bitch for you when you are the 1 in 4 per WHO that has a stroke! )

 

‘It is deeply concerning that our members are going above and beyond to advocate for their patients and secure the staffing they need, only to have their concerns dismissed.’ 

Sara Hazzard, CSP assistant director and co chair of the Community Rehabilitation Alliance, was interviewed by LBC News alongside a patient, David, who spoke about his own experience of stroke rehabilitation. You can listen to that interview here. 

And later in April, the press team secured a broadcast package with ITV Meridien news - to further highlight stroke staffing shortfalls, which again featured stroke patient David. The piece included an interview with CSP’s  Sara Hazzard. 

NHS rehabilitation care staff shortage fails stroke patients, say health leaders

 If all you are delivering is 'care'; THEN YOU ARE COMPLETELY FUCKING INCOMPETENT!

You do realize survivors want 100% recovery and YOU BLITHERING IDIOTS ARE FAILING AT THAT!

NHS rehabilitation care staff shortage fails stroke patients, say health leaders

People receive rehab only three to four days a week in hospital – and one to two days once they are discharged, data suggests

The NHS is failing stroke patients and limiting their chances of recovery because of a shortage of rehabilitation care staff, health leaders have said.

More people are surviving strokes than ever before in the UK. But their hopes of getting better are being dashed because of a lack of physiotherapists and other specialist staff, according to the Chartered Society of Physiotherapy and the Association of Chartered Physiotherapists in Neurology.

National guidelines say people who have had a stroke should receive therapy-based rehabilitation for three hours a day, five days a week. But data suggests that, on average, people only receive rehab three to four days a week in hospital, and one to two days once they are discharged, the CSP and Acpin said.

Ash James, the director of practice and development at the CSP, said despite record numbers of registered physiotherapists, stroke services were unable to provide the care patients needed because they were chronically understaffed.(The understaffing is not the main problem! The main problem is you have nothing for 100% recovery! That is a fireable offense!)

He said: “Something is going seriously wrong in our health system if the NHS is failing to turn workforce growth into the posts required to meet even the minimum standards for stroke rehabilitation.

“It is deeply concerning that our members are going above and beyond to advocate for their patients and secure the staffing they need, only to have their concerns dismissed.”

Recreational drugs can more than double risk of stroke, study suggests

Read more

A national survey of stroke physiotherapists working in 159 NHS services across the UK found workforce shortages across different aspects of stroke care. These included community stroke services, acute stroke teams and community rehabilitation support.

Findings from the 2025 stroke physiotherapy workforce survey suggested there were 26% fewer physiotherapists than national guidance recommends in community stroke services. Acute stroke teams were also operating with 15% fewer physiotherapists than recommended, and community rehabilitation support workers were 36% below guidance levels.

The Acpin chair, Adine Adonis, said: “More people are surviving strokes in the UK than ever before, but survival must be matched with the chance to recover well. These findings highlight a stark and urgent gap in the number of physiotherapists and support staff available to provide the specialist rehabilitation that stroke survivors rely on. This is not good enough.

“It is failing people every day and limiting their potential for recovery. We need immediate action to ensure every stroke survivor receives the physiotherapy support they deserve.”

Juliet Bouverie, the chief executive of the Stroke Association, said about 240 people in the UK had their lives “potentially destroyed” by stroke every day. She said: “Stroke survivors are at risk of being unable to see, speak, move or even swallow, which has a huge impact on their ability to enjoy a full and independent way of life.

Professor Sir Stephen Powis: Fighting back against stroke - Healthcare Today

 WOW! Survivors don't want stroke 'managed'! You're not smart enough to understand stroke needs? They want RECOVERY! People like this are why we can never get stroke solved to 100% recovery.

Leaders solve the BHAG(Big Hairy Audacious or (Assed) Goals in stroke! The only goal in stroke is 100% recovery. GET THERE!

Professor Sir Stephen Powis: Fighting back against stroke - Healthcare Today

The former National Medical Director of NHS England and current Maulin Group Advisory Board Member and Clinical Ambassador for the Stroke Association, talks about prevention, rehabilitation and unfinished business.

Having run NHS England between 2018 and 2025 as National Medical Director, and as the former executive lead for the NHS national cardiovascular disease, respiratory disease, stroke and prevention programmes, Professor Sir Stephen Powis has seen public health battle one health crisis after another. Now retired, he’s set his sights on effecting real change in stroke management.

Here, the Maulin Group Advisory Board Member and Clinical Ambassador for the Stroke Association talks about prevention, rehabilitation and unfinished business…

 

What drew you to stepping up as Clinical Ambassador for the Stroke Association after stepping down from your national post?

The National Stroke programme was part of my portfolio at NHS England when I arrived as National Medical Director in early 2018. 

In the acute stroke area, we set a particular ambition around mechanical thrombectomy – that’s the procedure where, for around 10% of patients, a radiologist can remove the clot causing the stroke. It’s one of the most effective procedures in the NHS.

We settled on a model with 24 major neuroscience locations in England as comprehensive stroke centres to deliver this service. The task was to get them running 24 hours a day, seven days a week, to hit that 10% target, and, while we have made some progress, the efforts were not enough. Workforce issues and a lack of interventional radiologists are constraints. As are financial issues and kit issues. 

The figure we’re currently at is around 5%, so we’re almost halfway towards our target. 

When I stepped down from NHS England last summer, I said to the Stroke Association that I would be happy to continue with this work. For me, it’s unfinished business. 

It also means I can do some work in Scotland, Northern Ireland and Wales. And I can give advice on a range of other issues, including prevention and rehabilitation. 

 

How well are integrated stroke delivery networks functioning in practice? Are they delivering the improvements that policymakers want?

The networks work well by bringing people together to collaborate and by having that system-level view. That’s really important in strokes. That entire pathway from ambulance to local stroke unit to thrombectomy centre has to work well and involves not just one organisation. 

A delivery programme that can bring all those constituent parts together into a single forum for optimising that pathway is really important, and that’s what networks do. 

Everywhere I go, people point out the value of having a network to take on that role. They’re relatively small teams performing a key role and I’m a big supporter of them.

 

“I’m a proponent of doing our best to support people in what are often relatively small teams.”

 

 

Given your experience at NHS England, is the NHS’s current approach to prevention of strokes, particularly around hypertension, atrial fibrillation, obesity and smoking, going far enough?

We have done pretty well on atrial fibrillation and we have met the ambition we had back in 2019. On high blood pressure, we’re part of the way there. In absolute numbers, they have been increasing because the number of people with potentially high blood pressure has been changing. On other risk factors like smoking, we have smoking cessation programmes. 

There’s a major conditions framework plan for cardiovascular disease, which will be the opportunity to look at how we’re doing on these risk factors. The key thing is that the risk factors are well known. It’s all around how you set up your health services to target those. 

I’m a proponent of doing our best to support people in what are often relatively small teams and I hope that they continue to be part of the overall way in which we improve.

 

Stroke Association research shows dramatic geographical and socioeconomic disparities; how do we shift the dial on that inequality? 

If you look back at where we were, we have made great advances. We have seen a steady reduction in smoking and a lot of the improvement has come from a sustained effort. 

We need to think of more innovative ways. If you use very targeted approaches, you can deal with the health inequalities issue. 

Through the determination of a practice and using a bunch of methodologies, you can make a difference in areas you think might be quite hard. With the right targeting and the right support, you can do it.

Rehabilitation remains a significant pressure point for stroke survivors. Where is the system failing? How could rehabilitation pathways be redesigned?

There is quite a variation in rehabilitation services. Sometimes we see excellent services; sometimes the services are struggling. The Stroke Association has been supporting improvement work in this latter area. 

Everybody’s rehabilitation needs are different. One of the things to think about is how you get that balance between a standard offering and a bespoke offering. There is some overlap with other rehabilitation services, and we are able to bring the rehabilitation teams from various speciality teams together. 

We have to make sure that we’re not working in silos on rehabilitation. And make sure that we are making the best use of a rehabilitation community. 

There’s an opportunity for innovation in how to get individual rehabilitation aligned with the standardised approaches that you inevitably end up with when you organise and commission these things. 

 

Is thrombolysis the answer to better treatment?

Thrombolysis is definitely effective and needs to be used where appropriate. That is something we focused on. Our message has been that none of these things should be used in isolation. 

If you are looking at improving thrombectomy, you need to be looking at improving your thrombolysis rates as well. All of this comes down to a really effective pathway. What we want is when somebody has symptoms of stroke, getting people to call early and ensuring the ambulance service gets there quickly. 

An innovation we are rolling out is video triage. We’re now using AI-supported software so stroke clinicians can see the CT scans and have AI-driven interpretation for decision support. That means that the clinician can be phoning the thrombectomy centre within seconds. All of these incremental changes are cumulatively making a difference. It’s not just about getting somebody to a thrombectomy centre. It’s about getting there quickly. 

 

“My role now is to be a critical friend with the Stroke Association.”

 

 

Looking back at your time as National Medical Director, what do you wish you could have achieved in stroke care(NOT RECOVERY!) but didn’t?

I wish we could have been further ahead. We did have the pandemic to deal with, and that put a dent in our progress, but I’m also proud of everything the NHS did to manage the pandemic. 

 

As Clinical Ambassador, where do you think the Stroke Association can most effectively influence national policy?

I’m keen that we involve our charity partners in policy development and implementation. The Stroke Programme board is co-chaired by the chief executive of the Stroke Association, and we need them to be our critical friends. 

My role now is to be a critical friend with the Stroke Association. The Stroke Association does this by supporting policy where it needs to, calling out where it thinks it needs to be different, recognising challenges, and helping when it can in overcoming those challenges. 

They do wonderful things supporting leadership development. It’s also around the Stroke Association, helping local services to overcome local challenges to deliver national policy. 

I’m confident that the government and NHS England will continue to involve the charity sector. Why wouldn’t you? There’s a huge amount of expertise and patient experience.

NHS stroke specialist shortage leaving thousands dead or severely disabled, doctors say

 The specialist shortage is not the problem! LACK OF 100% RECOVERY PROTOCOLS IS THE PROBLEM! Are you that blitheringly stupid? These specialists have nothing that will get survivors 100% recovered! That is the only goal in stroke for survivors! 

GET THERE!

NHS stroke specialist shortage leaving thousands dead or severely disabled, doctors say

Thousands of people in the UK are at risk death or severe disability due to a lack of NHS stroke specialists, senior doctors have warned.

A chronic shortage of stroke consultants means patients face delays to clot-busting drugs and surgery, with horrendous consequences, they said.

Prof David Werring, past president of the British and Irish Association of Stroke Physicians (BIASP), 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.”

About 100,000 people across the UK have a stroke each year.

Between 10,000 and 20,000 of them died or sustained a serious disability because of treatment delays linked to staff shortages, said Dr Sanjeev Nayak, a senior stroke specialist at Royal Stoke hospital.

“It is heartbreaking to see the real and avoidable impact that workforce shortages have on patient outcomes.

In my experience workforce shortages directly lead to avoidable disability and, in some cases, avoidable death,” said Nayak, a consultant interventional radiologist.

“It is reasonable to estimate that around 10-20 per cent of stroke patients each year are left avoidably dead or more disabled than they otherwise would have been because of delays in the system.

“Those delays are multifactorial, but workforce shortages are a major, repeatedly identified contributor.”

The most recent Sentinel Stroke national audit programme report found it took four hours and 11 minutes to get someone who had had a stroke to hospital in 2024-25, more than 90 minutes longer than a decade ago.

Just 46.5 per cent of stroke patients last year were admitted to a specialist stroke unit within four hours of arrival, down more than 10 percentage points on a decade ago.

New research by BIASP surveyed 100 hospitals in England providing acute stroke care and found:

• 70 per cent of stroke units are short of at least one consultant, and many are two down
• 53 of 84 hospitals that responded had vacancies for a total of 96 consultants
• 10 per cent of the NHS’s 423 permanent consultants are due to retire in the next five years

Dr Louise Shaw, BIASP’s current president, said some smaller hospitals did not have a senior specialist on duty around the clock.

“That’s very unacceptable,” Shaw said.

“All patients admitted to a hospital with an acute stroke should have access to an immediate stroke consultant opinion and advice on their care. And at the moment that’s not available.”

Key treatments such as thrombolysis, which uses drugs to dissolve a clot, and mechanical thrombectomy, surgery to remove a blood clot from the brain, are extremely time-critical.

Nayak said: “When services are understaffed, patients miss treatment windows altogether or are treated too late, resulting in far worse neurological outcomes that could have been prevented.

“Delays in specialist assessment or transfer to a thrombectomy centre can mean the difference between independent recovery and devastating, lifelong disability, or not surviving at all.”

The Stroke Association said patients were being denied “time-critical, life-changing” treatment because of staff shortages.

The situation threatens Labour’s pledge to cut deaths from heart disease and stroke by 25 per cent by 2035.

A Department of Health and Social Care spokesperson said the NHS had 7,000 more doctors than the same 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.”

The number of people in the UK who have a stroke is expected to rise from 100,000 to 151,000 a year by 2035, according to Stroke Association analysis.

NHS repeatedly failing in care of stroke patients, watchdog says

 Any talk of 'care' is COMPLETE FUCKING FAILURE! Survivors want recovery; or don't you ever talk to survivors without dumbing down their goals with your tyranny of low expectations?

NHS repeatedly failing in care of stroke patients, watchdog says

Health ombudsman says number of last-resort investigations into care(NOT RECOVERY!) in England up two-thirds in four years Health and social affairs correspondent Tue 1 Jul 2025 00.00 EDT

The NHS has repeatedly failed in its diagnosis and (NOT RECOVERY!) of stroke patients, England’s health ombudsman has said.

According to the World Stroke Association, more than 12 million people worldwide will have their first stroke this year and 6.5 million will die as a result. Strokes are one of the UK’s biggest killers, causing about 34,000 deaths a year, and the single biggest cause of severe disability.

NHS Fast campaign aims to raise awareness of the most common symptoms of stroke – facial drooping, arm weakness and slurred speech – and the need for prompt treatment, including transfer to a specialist stroke unit within four hours. Without it, a stroke can result in death or long-term disabilities such as paralysis, memory loss and communication problems.Sentinel stroke national audit programme (SSNAP), which assesses the quality of stroke care(NOT RECOVERY!) in England, Wales and Northern Ireland, show that just 46.6% of patients are directly admitted to a specialist stroke unit within four hours of symptoms starting.The ombudsman looks into cases where a patient or family has complained to an NHS care(NOT RECOVERY!) provider but been dissatisfied with the outcome. It is seen as a last resort once other complaints procedures have been exhausted.The ombudsman said the number of investigations it had conducted over poor stroke care(NOT RECOVERY!), including not spotting symptoms and delays to diagnosis, rose by two-thirds in the four financial years to March 2025, from 17 to 28. The number of complaints also rose over this period from 318 to 396. Rebecca Hilsenrath, the chief executive of England’s health ombudsman service, said these included repeated failings in diagnosis, nursing care(NOT RECOVERY!), communication, and treatment of patients with strokes.“Over the past four years we have seen a significant rise in the number of complaints and investigations related to people who have suffered a stroke, including typical and atypical presentations. This is particularly concerning as early diagnosis is crucial in giving patients the best opportunity for successful treatment and recovery,” she said.

“These investigations all represent instances where organisations involved have not identified a failing. It is important that the NHS operates in a learning culture and that when things go wrong clinicians recognise what has happened and put it right for those involved, as well as improve care(NOT RECOVERY!) and treatment for future patients.”

The ombudsman said clinicians needed to act more quickly when they suspect a stroke, even if the patient presents with atypical symptoms. They also should improve communication and collaboration to make treatment more joined up.

Juliet Bouverie, the chief executive of the Stroke Association, said the findings were “deeply concerning”.

She said: “Whilst dedicated stroke professionals provide compassionate care(NOT RECOVERY!), without urgent investment and action, stroke patients will continue to face unacceptable variations in treatment and support. We’re also calling for a wider cardiovascular plan, with a focus on stroke, to ensure stroke survivors have the best chance of making a good recovery.”

Prof Martin James, the SSNAP clinical director, said: “In the national stroke audit we have seen a significant fall in the proportion of patients with acute stroke who are getting specialist care(NOT RECOVERY!) and treatment in a timely fashion on a stroke unit.

“We know that this reflects a whole range of acute pressures on hospitals that are not unique to stroke, but we also know how important that timely specialist care(NOT RECOVERY!) can be for reducing complications and disability after stroke, so it must be a priority for all hospitals to provide access to a specialist stroke unit within four hours of arrival for all their patients.”