The 2023 Stroke Services
Tracker data shows progress in stroke care planning and treatment
access, but persistent disparities demand urgent attention.
New data from the Stroke Action Plan for
Europe’s 2023 Stroke Service Tracker, launched today, show encouraging
progress in stroke care(NOT RECOVERY!) across Europe – but also highlight serious
inequalities that urgently need to be addressed.
A total of 47 countries contributed to the
latest dataset, providing the most comprehensive picture yet of stroke care(NOT RECOVERY!) across the continent. The findings show improvements in national
planning, emergency treatment and prevention. However, too many people
who have had a stroke still face major challenges in accessing the care(NOT RECOVERY!),
rehabilitation and follow-up they need.
Stronger national commitment to stroke care(NOT RECOVERY!)
There is growing political commitment to
tackling stroke. The number of countries with a national stroke plan has
risen from 16 in 2022 to 24 in 2023, with 16 more countries currently
developing one. Importantly, 30 countries now involve Stroke Support
Organisations in shaping national stroke strategies and guidelines,
ensuring people with lived experience have a voice in how care(NOT RECOVERY!) is
delivered. Lithuania, Poland and Slovakia have recently joined this
effort.
Programmes aimed at preventing stroke are
also becoming more common. Lithuania, Sweden, the Netherlands and
Germany are among the countries that have launched or expanded national
prevention efforts in the past year, bringing the total to 23.
Improved access to life-saving treatment – but too slowly
Access to key emergency treatments for
ischaemic stroke (which happens when a blood clot or blockage stops
blood flow to parts of the brain) is improving, but unevenly. On
average, 15.4% of eligible patients received clot-busting drugs
(intravenous thrombolysis), and 5.9% underwent mechanical thrombectomy –
a procedure to remove a clot directly from the brain.
Seven countries have now met the European
benchmark of giving thrombolysis to at least 20% of patients, and 14
have reached the target of delivering thrombectomy to over 7.5%, based
on high-quality data. Five more countries hit this goal using data of
lower quality.
However, delays in treatment remain a major
problem. Only seven countries managed to achieve the recommended
‘door-to-groin’ time – the time from arrival in hospital to starting
thrombectomy – of 60 minutes or less. In 12 countries, this delay was
over 90 minutes, reducing the chances of a good recovery.
Ongoing challenges in stroke unit care(NOT RECOVERY!), rehabilitation and follow-up
Despite some progress, the organisation of
stroke services and monitoring of quality still fall short in many
areas. The goal of admitting at least 90% of stroke patients to a
specialist stroke unit is only met in nine countries with reliable data.
In contrast, some countries admit fewer than one in four patients to
stroke units – and others don’t collect this data at all.
Only 22 countries monitor the quality of
stroke unit care(NOT RECOVERY!). The picture is even more concerning when it comes to
rehabilitation after hospital discharge. Just 11 countries have systems
in place to monitor the quality of rehabilitation services.
Early rehabilitation is available in stroke
units in 22 countries (although data quality is low in eight). However,
there has been little progress in ensuring patients have a
rehabilitation and care(NOT RECOVERY!) transition plan which are essential for
continued recovery. Just five countries systematically monitor whether
such plans are given, while 14 estimate that they are provided, but
without proper tracking.
Follow-up care(NOT RECOVERY!) after stroke also varies
widely. Only 11 countries report that at least 90% of patients receive
follow-up and just four countries offer structured follow-up that meets
recognised standards.
Prevention of further strokes and improving patient outcomes
Preventing another stroke is crucial –
nearly one in four strokes happens in someone who has already had one.
But across Europe, there is little data on how well countries are doing
in providing secondary prevention, or how many patients are getting the
medication and support they need. This makes it difficult for
policymakers to know where to act.
These inequalities in care(NOT RECOVERY!) are reflected in
outcomes. In some regions, death rates within 30 days of stroke remain
worryingly high, pointing to major differences in access to emergency
treatment, rehabilitation services and longer-term support.
Life after stroke: support remains limited
Only 13 countries report having a dedicated national programme for life
after stroke. While many address important aspects of recovery, support
remains inconsistent. Twelve countries include ongoing health management
in their programmes, while 10 focus on emotional adjustment and mental
wellbeing. Eleven countries offer support for everyday activities and
practical challenges, and an equal number provide information and
guidance for both stroke survivors and their carers.
A call to action: bridging the gap between potential and practice
“The 2023 Stroke Service Tracker data show
that while momentum is building in some areas – particularly in national
planning and access to acute therapies – major gaps in organisation,
delivery and equity of stroke care(NOT RECOVERY!) persist,” said Professor Hanne Christensen, Chair of the Stroke Action Plan for Europe.
“There is no room for complacency. Countries must take these insights
and act decisively to bring data collection and stroke care(NOT RECOVERY!) up to the
standards that every person affected by stroke deserves.”
Arlene Wilkie, Director General of the Stroke Alliance for Europe (SAFE),
added: “It is unacceptable that in 2023 we still see such wide
disparities in access to stroke unit care(NOT RECOVERY!), early rehabilitation and life
after stroke support. Stroke survivors need holistic and continuous care(NOT RECOVERY!). We call on all national governments and policy makers to do better
in providing the essential services required for all those affected by
stroke.”
Professor Simona Sacco, President of the European Stroke Organisation (ESO),
emphasised: “The Stroke Action Plan for Europe provides countries with
the framework they need to close the gap between aspiration and
delivery. These data are both a roadmap and a challenge – to work
smarter, faster and more equitably.”
Click for more information on your country’s data, the Stroke Action Plan for Europe and the Stroke Service Tracker
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About SAP-E and the Stroke Service Tracker
The Stroke Action Plan for Europe (SAP-E),
launched in 2018, provides a strategic blueprint to improve stroke
prevention, care(NOT RECOVERY!) and life after stroke support by 2030. The Stroke
Service Tracker (SST) was developed as a monitoring tool to evaluate
Europe’s progress against the SAP-E targets, providing valuable insights
for national stakeholders to drive improvements.
Europe faces over 1.1 million strokes each
year, causing nearly 460,000 deaths. Nearly 10 million people live with
stroke’s long-term effects. The economic burden is immense – €60 billion
in 2017 – and is projected to rise to €86 billion by 2040 without
urgent reform.
The SST continues to be a vital
instrument for mapping progress and exposing areas where countries fall
short. It is a call for action, innovation and investment to ensure
every stroke survivor in Europe has access to high-quality, timely and
equitable care(NOT RECOVERY!) – no matter where they live.
