The British and Irish Association of Stroke Physicians (BIASP) surveyed 84 (out of 100) sites from the parent specialties of geriatrics (49%), neurology (21%), acute medicine (14%) and general internal medicine (10%).

The report found 96 vacant consultant positions across 53 sites, indicating a significant worsening in the workforce position.

The survey found huge geographical variation between teaching and non-teaching hospitals, including a higher reliance on locums in some regions, causing regional financial vulnerability due to the increased cost of locum staff.

In addition, the report identified a high level of regional variation in senior medical workforce numbers for each local NHS hospital trust.

The BIASP estimated an additional 127 new stroke consultant posts (currently unfunded) are required to meet the ongoing clinical needs of their services.

Several opportunities in the report are identified to boost recruitment, including:

•           the recently launched neurology training curriculum that mandates competencies in all aspects of stroke care that should increase the number of neurologists committing to a career in stroke medicine, although this is unlikely to have significant impact for at least several years
•           broadening the involvement of other specialties, with two recent pilots of a three-year clinical training programme in general internal medicine and stroke having received 220 applications and the first two cohorts completing training in 2027
•           diversification of the stroke workforce, with currently 15 nurse consultants in England, four of whom deliver thrombolysis independently, and five Allied Health Professional consultants.

The BIASP said it will continue to collaborate with key stakeholders, including the NIHR, on focussed solutions.

Dr Louise Shaw, president of the BIASP, said: ‘When someone suffers a stroke, there is a small window of potential opportunity to dramatically change their long-term outcome. For mechanical thrombectomy, one in every three patients treated benefits and we only need to treat five patients to return someone to being independent again three months later instead of dead or permanently disabled. This is of vital importance to people's lives and is also highly cost effective to society. In addition, there are very significant benefits from thrombolysis (clot-busting drugs), correct management of bleeding into the brain and of immediate stroke unit care. This is why having the correct stroke consultant workforce is absolutely essential. 

‘District general hospitals are at particularly high risk of being unable to recruit stroke consultants in the future and should take immediate action to fund training posts under the new accelerated three-year general internal medicine and stroke training pathway to secure the future of their service. Those responsible for commissioning and managing stroke services should pay very close attention to what is happening in their area and ensure stroke is prioritised and supported.'

A Department of Health and Social Care spokesperson said: ‘There are record numbers of doctors in the NHS – 7,000 more than this time last year – and our upcoming workforce plan will set out how we ensure the NHS has the right people, in the right places, with the right skills to care for patients when they need it.

‘With 20 regional networks already bringing together local NHS services to deliver seamless, joined-up care, our 10-Year Health Plan will go further by shifting the focus of healthcare out of hospitals and into the community, helping stroke survivors get vital support sooner.

‘We are committed to improving stroke prevention, treatment and recovery, including by setting new national standards for how cardiovascular disease care should be delivered across the NHS.'

The DHSC said a new cardiovascular disease Modern Service Framework will be published in 2026 to meet the goal of cutting premature heart disease and stroke deaths by 25% within a decade.

In addition, it said the NHS was working to provide access to 24/7 thrombectomy services across England. 

The latest data shows thrombolysis rates have risen to 13.9% (from 12.1% in 2024) and thrombectomy rates have risen to 4.8% (from 4.1% in 2024).