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Updated: Sep 14, 2025
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
17.3K
Breaking Barriers: Achieving Equity in Acute Stroke Care
Ranvir S P Cheema1, Philip M White2,3, Nasar Ahmad4
1Department of Anaesthesia and Critical Care Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Summary
Access to acute stroke care, including mechanical thrombectomy (MT), is unequal across the UK. Rural patients face poorer outcomes due to delays and limited access to specialized stroke centers and neurointerventionists.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Stroke is a major global health burden, with significant disparities in acute care access, particularly within the UK.
- Reperfusion therapies like mechanical thrombectomy (MT) are standard for acute ischemic stroke but availability is uneven.
- Inequalities persist due to geographical variations in access to acute stroke centres (ASCs) and comprehensive stroke centres (CSCs).
Discussion:
- Delayed ambulance transfers (primary and secondary) impact treatment timelines.
- Mechanical thrombectomy (MT) is restricted to comprehensive stroke centres (CSCs), leading to geographical concentration of neurointerventionists.
- Suboptimal imaging facilities and variable consultant stroke physician staffing in ASCs delay critical decision-making.
Key Insights:
- Patients in rural areas face worse outcomes due to limited access to advanced stroke care.
- Uneven distribution of neurointerventionists and comprehensive stroke centres exacerbates care inequalities.
- Lack of investment outside major urban centres hinders equitable access to timely stroke interventions.
Outlook:
- Expansion of the neurointerventionist workforce is underway but requires further investment.
- Addressing geographical disparities is crucial for ensuring equitable access to acute stroke care globally.
- Strategic investment in stroke care infrastructure and staffing across all regions is essential.
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