Our survey of almost 2,000 stroke survivors and their carers across the UK found that the Covid-19 pandemic has affected every aspect of stroke treatment and care.

This includes delays to calling 999 and going to hospital with stroke symptoms and hospital care and discharge. It’s also impacted access to rehabilitation and ongoing support, causing significant challenges for stroke survivors trying to rebuilding their lives, no matter when they had their stroke. Unsurprisingly, survey respondents have also reported feeling more anxious and concerned about the future, and carers have felt the significant pressures of lockdown. 

National stroke priorities

Delaying national progress – The disruption to health and care services caused by Covid-19 meant national stroke initiatives across the UK were paused or slowed. This is putting the progress made in stroke care over recent years at significant risk.  

Treatment

Delays accessing stroke treatment – 30% of those who had a stroke during the pandemic delayed seeking emergency medical attention due to Covid-19. In England, Wales and Northern Ireland the number of stroke admissions fell by around 13% in April, with fewer people experiencing milder stroke presenting at hospital. In England and Wales, stroke deaths in private homes were 52% higher than usual during the Covid-19 surge.

Treating strokes in hospital – 76% of stroke survivors who had a stroke this year felt satisfied with the care they received in hospital, and stroke professionals reported innovations and improvements to stroke care. However, only 20% of surveyed stroke physicians reported no impact on stroke care in April, with the majority saying thrombolysis and thrombectomy treatments were affected. In April, the overall risk of stroke patients dying in hospital increased by 12%, with Covid-positive stroke patients especially at risk (41% – SSNAP 2020).

Being discharged from hospital – 69% of people who had a stroke during the pandemic were satisfied with their discharge from hospital, but 21% were dissatisfied. Around 1 in 3 people (38%) also felt they hadn’t received enough support from health and care services since leaving hospital.

Rehabilitation

Problems accessing rehabilitation and support – 39% of stroke survivors who had a stroke this year felt they had not received enough rehabilitation therapies, including physiotherapy. 34% of those who had their stroke in 2019 or before said the support they received from health and care services had been worse than before the pandemic. Around half of all stroke survivors had therapy appointments cancelled or postponed, and 56% have not felt safe to go to scheduled appointments – demonstrating the significant disruption to rehabilitation and support that Covid-19 has caused.  

  • “Everything was cancelled due to Covid-19 and lockdown. It all fell apart.” Read Colyn's story

Using virtual rehab and healthcare – Some stroke survivors have had appointments (45%) and therapy (28%) online or over the phone, but many others have gone without their usual rehabilitation and support. This could be because they were not offered virtual appointments, or didn’t accept them. Satisfaction with telehealth was high among 52% of stroke survivors. Yet 17% reported negatively on the experience, and virtual appointments are clearly not suitable for everyone. 

Life after stroke

Declining mental health and wellbeing – The pandemic and lockdown have taken their toll on stroke survivors’ mental health, exacerbating a significant and pre-existing unmet need. 7 in 10 (69%) stroke survivors have felt more anxious and depressed lately, with 68% saying they feel more worried about their health and 69% more worried about what the future holds. 

Caring during lockdown – The pandemic has had a stark mental health impact on informal carers, many of whom say they need more wellbeing support and respite care. 77% of carers and family members have been providing more care during lockdown. Worryingly, over half (56%) feel overwhelmed and unable to cope, particularly those caring for someone who had a stroke this year (72%).  

  • “When the visits stopped, I had to take over that responsibility.” Read Lee's story

Finances and employment – 4 in 10 (41%) stroke survivors have worried more about their finances and employment during the pandemic, particularly those of working age. The Stroke Association has awarded more hardship grants than usual, as individuals turn to our charity to fund vital home or personal equipment to cope with the effects of their stroke. 

Staying safe during lockdown – Nearly one-fifth of stroke survivors (20%) were advised by the NHS or government that they were in the shielding category. Over a third (37%) followed shielding guidance by choice, despite not being officially advised to shield. Stroke survivors reported uncertainty and confusion over whether they were more at risk if they contracted Covid-19, which increased their levels of anxiety. 

Stroke research

Impacting stroke research – The majority of stroke research stopped completely due to Covid-19. 3 in 4 Stroke Association funded researchers have had their research paused. Although some studies have restarted, including recruitment, it may take substantial resource to restart or replan others. Stroke research is historically underfunded, and Covid-19 threatens the funding available to drive much-needed improvements in stroke care and treatment. 

Next steps

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