Posted: 21/11/2025
A stroke is a leading cause of death and disability in the UK with around 100,000 people affected annually. Timely intervention is critical and mechanical thrombectomy - a surgical procedure to remove a clot from a large brain vessel - can dramatically improve survival and recovery. Thrombectomy is very good at restoring blood flow to a blocked artery, with an up to 85% success rate.
However, access to this life-saving treatment often depends on the time of hospital admission. There may be a rota in place between different hospitals in terms of which hospital is receiving stroke patients on any day or night. While ambulance paramedic teams will be aware of that, hospital admissions depend upon availability of specialist centres.
The procedure must be carried out by a trained radiologist in such a specialist centre and, in some places, may only be available within 'working hours' as there may only be one competent radiologist available in the organisation. Patients admitted overnight or at weekends can therefore face surgery delays which can result in severe disability or death.
The NHS Long Term Plan aims to increase thrombectomy provision tenfold to ensure that 1,600 more people each year regain independence after stroke. However, current access remains uneven and only around 50% of eligible patients receive thrombectomy and many hospitals cannot provide the service 24/7. NHS England’s service specification states that thrombectomy should be available within a structured network model, with trained neuro interventionists and 24-hour imaging capability at designated centres. Despite this, most hospitals still operate with reduced specialist coverage during off-peak hours, leading to transfers and treatment delays.
These gaps in service are critical as the consequences of delayed treatment are stark. Research shows that patients treated within six hours of onset of stroke symptoms have significantly better outcomes and, with some types of strokes, thrombectomy performed up to 10 hours from stroke onset can be beneficial, yet weekend and overnight admissions often miss this window.
The Royal College of Physicians’ 2023 stroke guidelines emphasise the urgent access to thrombectomy for eligible patients and highlight the need for consistent standards across the UK. However, the reality is a postcode lottery where timing and location determine survival chances. Studies have linked weekend admissions to higher mortality rates, underscoring the urgency of addressing this disparity.
Systemic changes are essential. The NHS Long Term Plan calls for integrated stroke delivery networks to ensure equitable access, alongside investment in specialist workforce and imaging infrastructure. Expanding 24/7 thrombectomy services is a priority, supported by evidence that such services dramatically improve outcomes and reduce long-term care costs.
The Penningtons Manches Cooper's clinical negligence team has significant experience in investigating claims arising out of substandard medical care for stroke victims. Partner Alison Johnson comments: "Ultimately, the timing of a stroke should never determine a patient’s chance of survival. As the NHS strives to meet its Long Term Plan commitments, achieving 24-hour access to thrombectomy is vital. Lives depend on it and the cost of inaction is measured tragically in irreversible brain damage and preventable deaths."
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