Complaints and investigations into poor stroke care in the NHS have risen significantly, with the health ombudsman reporting a two-thirds increase in formal investigations over four years.
Between March 2021 and March 2025, the number of investigations into stroke-related care rose from 17 to 28, according to the Parliamentary and Health Service Ombudsman.
The watchdog reviews cases where patients remain dissatisfied after complaining directly to NHS providers.
The ombudsman’s office identified repeated failings in stroke diagnosis, nursing care, communication and treatment. Complaints also rose from 318 to 396 over the same period.
Rebecca Hilsenrath, chief executive of the ombudsman service, said: “Over the past four years we have seen a significant rise in the number of complaints and investigations related to people who have suffered a stroke, including typical and atypical presentations.
“This is particularly concerning as early diagnosis is crucial in giving patients the best opportunity for successful treatment and recovery.
“These investigations all represent instances where organisations involved have not identified a failing.
“It is important that the NHS operates in a learning culture and that when things go wrong clinicians recognise what has happened and put it right for those involved, as well as improve care and treatment for future patients.”
Data from the Sentinel stroke national audit programme (SSNAP), which monitors stroke care in England, Wales and Northern Ireland, shows only 46.6 per cent of patients reach a specialist stroke unit within four hours of symptom onset—a critical timeframe for effective treatment.
The NHS Fast campaign continues to highlight the urgency of recognising stroke symptoms—such as facial drooping, arm weakness and slurred speech—and acting quickly to get patients to stroke units for assessment and treatment.
The ombudsman has called for quicker clinical action, even when symptoms are not typical, and for improved communication between services to provide better-coordinated care.
Juliet Bouverie, chief executive of the Stroke Association, described the findings as “deeply concerning”.
She said: “Whilst dedicated stroke professionals provide compassionate care, without urgent investment and action, stroke patients will continue to face unacceptable variations in treatment and support.
“We’re also calling for a wider cardiovascular plan, with a focus on stroke, to ensure stroke survivors have the best chance of making a good recovery.”
Professor Martin James, clinical director of SSNAP, acknowledged the decline in timely access to specialist care.
He said: “In the national stroke audit we have seen a significant fall in the proportion of patients with acute stroke who are getting specialist care and treatment in a timely fashion on a stroke unit.
“We know that this reflects a whole range of acute pressures on hospitals that are not unique to stroke, but we also know how important that timely specialist care can be for reducing complications and disability after stroke, so it must be a priority for all hospitals to provide access to a specialist stroke unit within four hours of arrival for all their patients.”
