The future of stroke care in Wales

Thursday 19th and Friday 20th June saw the Welsh Stroke Conference take place in Cardiff. Katie Chappelle, the Stroke Association’s Associate Director in Wales, reflects on the event and our ambitions for the future of stroke care in Wales. 

Now in its 23rd year, the Welsh Stroke Conference is Wales’s largest multidisciplinary conference for stroke healthcare and other professionals. We heard from a mixture of inspiring stroke survivors and passionate professionals working in all aspects of stroke, all of whom were there to provide opportunities to share learning and ideas; with the ultimate aim of improving standards of care for stroke survivors.  

Standards desperately need to see progress in Wales. According to a report from Healthcare Inspectorate Wales, the treatment and care of people who experience a stroke in Wales has been declining since 2019. When it comes to stroke outcomes, i.e. how well people will recover from their stroke, Wales is towards the bottom of the table; currently ranking 21 out of 26 the highest income countries in the world, according to the Global Burden of Disease. England is positioned at 12.  

The Welsh Government’s Quality Statement for Stroke (published in 2021) commits to the transformation of stroke services via a regional model, to improve stroke services and address variations in care. Yet, we have seen very little meaningful progress on these plans.  

However, the Welsh Stroke Conference, which was this year attended by around 250 delegates, proved that the passion and drive to improve our stroke services exists in abundance. 

Critical time for change 

If we are going to make change in Wales, now is a critical time. 2026 is a Senedd Cymru election year. Our key message to all candidates ahead of the election is the crucial need to prioritise stroke care in Wales.  

The transformation of stroke services must be committed to in the Programme for Government because, while decisions are devolved to health boards in Wales, they are under significant budget pressures. Without clear prioritisation and funding from the Welsh Government, this critical work may not be completed due to competing demands and financial constraints.   

Ahead of the election we are strongly urging all political parties to embrace the recommendations in our manifesto, making sure Wales does not fall behind the rest of the world and ensuring people affected by stroke receive the support they need. One of our key messages is that, by transforming stroke services, we can drive improvements in prevention, treatment and recovery across all health conditions.

 The challenges and opportunities 

As sponsors of the Welsh Stroke Conference, we delivered the Symposium Speech. Professor Deb Lowe, the Stroke Association’s Medical Director and the former National Clinical Director for Stroke - NHS England, talked about the challenges and opportunities in transforming and improving stroke services in Wales. 

Deb reflected on the successes seen in Wales so far; the introduction of AI to support brain scanning has been implemented across Wales, pilots for Pre-Hospital Video Triage (PVT) have been introduced in a number of Health Boards, and we’re about to see publication of the Welsh Optimal Stroke Imaging Pathway (WOSIP) and acute service standards. However, there is still a long way to go if we are to provide stroke services that are truly Safe, Timely, Effective, Person-Centered, Efficient and Equitable. We cannot be comfortable with the fact that if you have a stroke in Wales, you are more likely to die earlier or have to live with a disability.  

Next steps 

We want to see the transformation of stroke services committed to as a Programme for Government. Learning from work already carried out in other parts of the UK, Deb pointed out that dedicated resources and strategic support are essential for change to be successful.  

Moving to a regional network model will include developing comprehensive stroke centres and a new set of dedicated stroke service standards. This will provide resilient, high quality and sustainable healthcare by enhancing recovery and quality of life for stroke survivors, while maximising NHS resources from the hospital through to life after stroke support in the community. 

New service standards for stroke in Wales must include a commitment to improved thrombectomy and thrombolysis rates, increased early supported discharge and improved six-month reviews, with associated measures that are regularly reviewed. Life after stroke services should be integrated into the pathway and service standards through cross-sector collaboration, ensuring holistic support for all stroke survivors.  

Our healthcare workforce is critical for our success. By investing in workforce development and ensuring the transformation of stroke services, we can make Wales an attractive place for healthcare professionals to work, thereby ensuring the high-quality services and positive outcomes our communities need.  

Wales cannot and should not stay at the bottom of the rankings for stroke outcomes. Neglecting investment in stroke will have significant consequences.  

Thanks to the Welsh Stroke Conference and other events, we know this passion exists. We now need political support to help us move forward together, to improve the treatment and care for everyone experiencing a stroke in Wales. 

Katie Chappelle can can be contacted by email (katie.chappelle@stroke.org.uk) if you’d like to get in touch.