The NHS has failed to deliver universal, round-the-clock access to a “life-changing” stroke treatment across England, breaking repeated ministerial promises that the service would be in place.
Despite a clear expectation from the government that mechanical thrombectomy would be available 24/7 from the start of this month, seven of England’s 24 regional stroke centres have been unable to meet the deadline. The health service confirmed it had not fulfilled its ambition, though stated achieving it remained a priority.
A ‘game-changing’ intervention left to chance
At the heart of this failure is a procedure described by doctors as a game-changing intervention for severe stroke. Mechanical thrombectomy is a minimally invasive, non-surgical treatment used when a major artery in the brain is blocked.
It involves threading a catheter through an artery in the groin or wrist up to the brain to physically remove the clot, restoring blood flow. Speed is critical; it is most effective when performed within 6 to 24 hours of symptoms beginning, with earlier intervention leading to better outcomes.
The impact is profound. It can reduce the mortality risk in severe stroke patients from 50% to 17% and can cut long-term disability in two out of every five patients treated. The NHS spends over £100 million annually on the treatment, viewing it as key to reducing the 113,000 avoidable deaths that occur each year in England from major conditions like stroke and heart disease.
The postcode lottery in practice
Currently, 17 centres do offer thrombectomy all hours, all year. But the seven that cannot—located in Hull, Middlesbrough, Leeds, Sheffield, Newcastle, Brighton, and Coventry—have created a stark geographical divide.
“A patient presenting during normal working hours in a well-served area may receive rapid, life-changing treatment, whereas the same patient presenting at night or in a different region may not receive thrombectomy at all,” said Dr Sanjeev Nayak, a stroke specialist at Royal Stoke University Hospital. “This creates a real postcode lottery.”
The consequence, experts fear, is that patients who have a stroke overnight, in the evening, or at weekends in these underserved areas may become avoidably severely disabled or die because they cannot access the procedure.
Staff shortages and regional gaps
The primary reason for the shortfall is a critical shortage of specialist staff, including stroke doctors, specialist nurses, and the interventional neuroradiologists who perform the delicate procedure.
Some centres have established workarounds. University Hospital Coventry and the Royal Sussex County Hospital in Brighton transfer patients needing out-of-hours thrombectomy to Birmingham and University College London Hospital respectively. However, this leaves Yorkshire and the North-East as regions with no form of 24/7 service at all.
The operational realities vary by trust. Newcastle Hospitals NHS Foundation Trust, providing for the North East and Cumbria, currently runs its service seven days a week but only between 9 am and 5 pm, with a business plan submitted for more clinicians. Leeds Teaching Hospitals NHS Trust, serving West Yorkshire, has 24/7 stroke nurse cover but not round-the-clock thrombectomy. Meanwhile, Royal Stoke University Hospital stands out as one of only two UK sites with a dedicated 24/7 thrombectomy team, treating a record 200 patients in 2023.
NHS England has made extra funding available, confirming £14 million in targeted funding in February to support expansion and staff training. NHS Minister Karin Smyth had confirmed the 1 April target as recently as 23 March.
A national challenge amid rising demand
The failure to achieve universal coverage comes against a backdrop of ambitious national targets and increasing need. The NHS Long Term Plan aims to increase the proportion of patients receiving thrombectomy tenfold, enabling an extra 1,600 people a year to be independent after their stroke. The goal is for 10% of stroke patients to receive the procedure by 2027-28.
Current performance is far short. The Sentinel Stroke National Audit Programme (SSNAP) shows only 3.9% of stroke patients received thrombectomy last year, a figure that rises to just 3.3% nationally as of April 2025. This compares poorly to over 10% in other advanced healthcare systems, with the UK average stuck at around 4.2%.
The Stroke Association has labelled the situation “deeply troubling.” Alexis Kolodziej, the charity’s deputy chief executive, welcomed investment but said implementation in parts of the country was “woefully slow,” leaving patients at a significant disadvantage.
The challenge is set to grow. The number of stroke patients is expected to double by 2035, with a concerning rise in cases among adults under 55. In response, some trusts are turning to innovation; Royal Stoke and Newcastle are among those using AI-powered software to expedite stroke diagnosis and triage, while NHS England is working with regulators to credential more neuroradiologists to perform the procedure.
With over 100,000 people suffering a stroke in the UK each year—38,000 of them fatal—the urgency to resolve the postcode lottery in this life-saving treatment has never been clearer.