UK Stroke Forum 2025 | Improving and innovating stroke care across the four nations of the United Kingdom

We have a great opportunity at the moment to innovate stroke care from prevention all the way through to hyper-acute and rehabilitation and life after stroke. Within England, we’ve got a new modern service framework due to be delivered in April to May 2026. What we’re looking for is innovative practice which is going to shape stroke care for the future. We need to do more with the resources we have, both workforce and infrastructure, and therefore we’ll need novel techniques and using old practices in a new way to deliver the transformative care that we need to deliver excellence over the next 10 years. There are good examples of innovation that’s going on currently within England, Scotland, Northern Ireland and Wales. For example, in England, we’ve been piloting pre-hospital video triage for the last five years during the pandemic. This has seen the number of patients that are mimicking a stroke have their journeys transformed by either not coming to hospital at all or avoiding stroke services. We also see that the time taken from reaching a hospital to getting their scan, thrombolysis and also thrombectomy is reduced in those patients that come through the pre-hospital video triage process. Colleagues in Wales have also been introducing this across some of their health boards, and they’re using various platforms to undertake the video assessment. They’re looking to sustain that over the coming year. Other innovations that we’ve seen across the four nations include the clopidogrel testing, which has gone on in Dundee, Scotland, for the last two years, and they’re currently evaluating the benefit, but they predict that almost 1,000 patients may well have had a stroke avoided because they are now on the correct antiplatelet. Colleagues in Belfast, Northern Ireland, have been using a traffic light system to transform the way they perform mechanical thrombectomy. They found that there was not enough anaesthetists to provide general anaesthetics. And so they’ve used a physician-led model of conscious sedation to perform local anaesthetic to deliver mechanical thrombectomy. They have very similar results to the use of GA, but they found that we’ve been able to deliver this service without anaesthetists present on many occasions. That’s a really good example of innovative practice used to transform healthcare.

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