Stroke Rehabilitation Gaps and Access to Timely Treatment in Northern Ireland

Northern Ireland faces significant challenges in providing adequate stroke care, particularly in rehabilitation services and access to life-saving treatments like thrombectomy. Delays in care and staffing shortages are impacting patient recovery and outcomes, prompting calls for urgent action from healthcare professionals and patient advocates.

Rehabilitation Shortfalls Impact Recovery

Experts warn that stroke victims in Northern Ireland are being “failed every day” due to gaps in rehabilitation care stemming from a shortage of staff. National guidelines recommend therapy-based rehabilitation for three hours a day, five days a week for stroke patients. However, data indicates that patients typically receive rehab on only three to four days a week in hospital and one to two days once discharged home.

A national survey of stroke physiotherapists working in 159 NHS services across the UK revealed concerning workforce shortages. The 2025 Stroke Physiotherapy Workforce Survey found:

• 26% fewer physiotherapists than recommended in community stroke services.
• 15% fewer physiotherapists than recommended in acute stroke teams.
• 36% fewer community rehabilitation support workers than guidance levels.

Ash James, director of practice and development at the Chartered Society of Physiotherapy (CSP), stated, “This data shows that despite record numbers of registered physiotherapists, stroke services in hospitals and the community are unable to deliver the care patients need because they are chronically understaffed.”

Delays in Thrombectomy Treatment

Access to thrombectomy, a potentially life-saving treatment that removes blood clots after a stroke, remains limited in Northern Ireland. Currently, thrombectomy is only available between 8 am and 5 pm. This means patients admitted outside these hours must wait until the following morning to receive treatment, significantly impacting their chances of a good recovery.

Approximately 140 patients each year in Northern Ireland are missing out on this crucial treatment due to these time restrictions. Paul McLean, a stroke survivor from County Armagh, is among those advocating for 24/7 thrombectomy services. 1.9 million brain cells are lost every minute during a stroke, highlighting the critical importance of rapid treatment.

Patients Opting for Self-Transport to Hospital

Concerns over long ambulance wait times are driving a significant number of stroke victims to develop their own way to the hospital. Over 40% of stroke patients in Northern Ireland are choosing to self-transport to A&E, potentially putting themselves at further risk. The Stroke Association emphasizes that patients who access help via 999 have a better chance of receiving specialist care.

Looking Ahead

MLAs are scheduled to debate the issue of 24/7 thrombectomy services in the Northern Ireland Assembly. The Stroke Association NI continues to campaign for improved access to this life-saving treatment. Addressing the staffing shortages in rehabilitation services and expanding the availability of thrombectomy are crucial steps towards improving stroke care and outcomes for patients in Northern Ireland.