Stroke Association highlights how stroke survivors with communication problems are left without support

Less than a quarter of stroke survivors get timely help and support for speech and language difficulties, according to new statistics released ahead of Stroke Awareness Month in May.

The latest figures from the Sentinel Stroke National Audit Programme (SSNAP),1 which cover October – December 2024, reveal less than a quarter of stroke patients (24.8%) are receiving a speech and language therapy (SLT) assessment within 24 hours of arrival at hospital. In addition, less than half of patients (46.8%) are having an SLT assessment within 72 hours of hospital admission, as set out in in NHS guidelines.2

The amount of time spent delivering speech and language therapy in hospital has also decreased by 10.4% over the last five years – despite growing need.3 The National Institute of Health and Care Excellence (NICE) guidelines4 state that rehabilitation, which also includes physiotherapy and occupational therapy, should be provided for a minimum of three hours a day, five times a week - the intensity of which varies depends on the stroke survivor’s individual needs. Yet SSNAP data shows that only 35.4% of patients are getting these recommended levels of support.5

Of those who didn’t receive an SLT assessment, 7.6% were due to ‘organisational reasons’ which is largely due to staffing issues. This equates to 1,708 patients who missed out on this vital assessment in a timely manner at the end of last year.1 This leaves thousands of people every year navigating the unknown in the aftermath of their stroke with new and frightening communication difficulties, which could have significant repercussions for their long-term recovery and mental health.

The Stroke Association is calling on the Government to support hospitals across England and the devolved nations to ensure stroke patients receive crucial SLT assessments within these nationally specified timeframes. This needs to be part of a host of measures to tackle the woeful lack of rehabilitation support – both in hospital and in the community - to give stroke survivors the best possible chance of making a good recovery.

Around 240 people a day wake up to the reality of life after stroke and about a third of stroke survivors have aphasia - a language and communication disability which leaves people struggling to speak, read, write or understand the written and spoken word. Stroke survivors can also experience problems with swallowing making it difficult to eat and drink. This is assessed separately but can also be addressed with SLT support.

Ahead of Stroke Awareness Month (May), the Stroke Association surveyed6 2,000 members of the public and found that more than a quarter (28%) were unaware that communication difficulties are a common effect of stroke. In addition, almost three quarters (71%) didn’t know that stroke can lead to mental health issues.

The survey also asked 1,000 stroke survivors and found that:

• Three in five stroke survivors surveyed (59%) experienced anxiety

• Over half of survivors (56%) experienced low mood

• Over half of survivors (52%) had reduced confidence

• Two in five (40%) said they felt socially isolated after their stroke.

As part of a full support programme, the Stroke Association also wants every stroke survivor to have a six-month review. This assesses a stroke survivor’s physical and mental health to identify what support is needed going forward. However, SSNAP data also shows that, in 2023-24, only 39% of eligible stroke survivors had this vital review.7

In addition, only 17% of community-based services have appropriate access to each core therapy including speech and language therapy as well as physiotherapy and occupational therapy.8

Juliet Bouverie OBE, CEO of the Stroke Association, said: “It is unacceptable that vital speech and language therapy assessments for stroke survivors have declined in recent years. Losing the ability to communicate after a stroke can be one of the scariest and most unsettling aspects in the early stages after a stroke. In the long-term, speech and language therapy plays a huge part in boosting a stroke survivor’s overall quality of life to support good mental health by helping to ensure they can enjoy the simple pleasure of communication.

“Whilst the skill, effort and true dedication of the NHS workforce cannot be questioned, there is a real and urgent need to recruit, train and retain more staff who can provide rehabilitation tailored to the needs of individual stroke survivors for as long as they need it.

“Our recently released report, Unlocking potential: a bold vision for stroke care in England, sets out key actions across the stroke pathway which we want the Government’s upcoming 10 Year Health Plan to address. All stroke patients must get effective treatment and care catered to their individual and specific requirements. Only when this is achieved will stroke survivors be properly supported to recover, rehabilitate and live well.”