Stroke is one of the leading causes of death in Scotland. And for those who survive it is the largest cause of adult disability.

The impact can be devastating, taking away a person’s ability to talk, to walk, and be the person they were. Stroke comes at a huge cost, not just to thousands of Scots families every year, but to the public purse as well.

On current trends, by 2035, the annual cost of stroke, to Scotland’s health and social care system, will be £4.5 billion. We cannot afford to let that happen.

Getting life after stroke support right has never been more vital.

All stroke survivors who need it should receive rehabilitation in hospital, which may include physiotherapy, occupational therapy, or speech and language therapy. But ongoing support when returning home after hospital needs to be better.

Many survivors tell us they feel abandoned when they get sent home, not knowing what is going to happen next, or where to turn. Going home to a completely new life is a scary prospect.

Every stroke survivor deserves to receive the rehabilitation they need, for as long as they need it, and the goals and aspirations of the stroke survivor should be at the heart of rehab plans. It used to be thought that rehab was only beneficial in the first few weeks post-stroke, but the clinical consensus is now that gains can be made even years after stroke. The National Clinical Guideline for Stroke (2023) supports this, and we are clear, in our new Thriving after stroke campaign briefing of the importance of adequate levels of rehabilitation and life after stroke support. We need to see health boards ensuring they deliver personal rehab plans for every stroke survivor so that more people are thriving after stroke, not just surviving.

We know getting life after stroke support can make an enormous difference to people’s lives. It can help them to regain independence, return to work or be more active in their community.

To help people thrive after stroke, every stroke survivor should have an ongoing point of contact to monitor stroke recovery and a six-month review to assess their progress and needs. This helps people to recover, and to spot problems before they turn into crises. This is already national policy. We need to see policy make its way off the page and onto the bedside/into people’s lives.

This is currently not happening equitably across Scotland: delivery of rehabilitation and life after stroke support is seen, by many, as a postcode lottery. It is vital that those who allocate resources to health boards across Scotland recognise the value of life after stroke support, and meet guideline levels of support.

Some areas are already implementing national policy for life after stroke support and providing support that is literally getting people back on their feet. The expected level of life after stroke support across the whole of Scotland would benefit thousands of people every year.

The gains aren't just personal. Stoke is preventable, treatable, and recoverable. Getting stroke right can reduce the increasing demands on the NHS, saving hundreds of admissions and millions of pounds and allowing stroke survivors to have the best possible chance of recovery after stroke.

No stroke survivor should feel like they are falling off a cliff, worried about what the future holds. It is the duty of leaders working in stroke to ensure resourcing and support is there to meet their commitments in the Stroke Improvement Plan, and in so doing, make life better for stroke survivors in Scotland.

For more information go to or call: 0303 3033 100.

John Watson is Associate Director Scotland, The Stroke Association

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