WSC 2025 | The implementation of the European Stroke Action Plan: successes and areas for improvement

Stroke action plan for Europe 2018 to 2030 was started because we have previous experience that it was not enough just to have a declaration and put it forward. You needed also to have a strong implementation force linked to this. So this was the background of the stroke action plan that developed the declaration setting targets for the year 2030 and then the next phase to have implementation. And very crucial here is that we have the central part of the stroke action plan and then to have the delegation to national delegates who do their work in their individual countries. Because we have learned the lessons. It’s not enough just to have a European declaration. You need to come down to the country level because each country is autonomous when it comes to decisions on healthcare. We’re asking again here for national stroke plans, for work within the country, to approach the Minister of Health, to have a collaboration within the country. And then we have yearly meetings. We are discussing what was successful, what were barriers, and to demonstrate and learn from each other. And we created a stroke service tracker. And this is that the data from 47 of the 52 European countries are made public every year. So we can monitor the progress and we can see year by year for 12 key performance indicators what the progress is. And what we have seen so far during the last few years is that the implementation, the improvements are coming like an avalanche. It’s going so rapidly, more beyond expectations, that we can see that this works and we see a change from year to year. So also in a broader perspective, the European Stroke Action Plan is a format that can be used in other regions in the world. We have set up this format based on a declaration, implementation, science, national coordinators demonstrating the data and seeing the improvements and discussing barriers and facilitators. And we know this works. So we hope this will be used also in other parts of the world. In particular, the successful targets have been for the acute stroke services with a rapid increase in intravenous thrombolytic therapy and also on mechanical thrombectomy. We also see a rapid progress in the number of countries that have national stroke plans. And for the last year now, there were about half of the European countries that had a national stroke plan and we can clearly see if you have a national stroke plan you also have a much higher chance to reach those key performance indicators. What was less successful, though, was the creation of stroke units. Still, we need more stroke units, a higher percentage of patients that come to a stroke unit as the first level of care. This is one of the key areas for further improvement.

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