Stroke is the second biggest killer in London and the most common cause of disability. More than 11,000 people having a stroke are admitted to London hospitals each year – that’s about one every hour.

The UK has a higher proportion of deaths due to stroke compared with Australia, Germany, Sweden and the US, and almost double the number of deaths that occur in France. The first three hours after a stroke are the most crucial but Londoners were not receiving fast enough access to life-saving care, as reported in A Framework for Action.

In 2007, a review into stroke services was launched and these proposals were subject to a formal, pan-London consultation over the summer of 2009. Proposals saw the introduction of dedicated, high-quality hyper-acute stroke units across the capital, manned by specialist teams with rapid access to high-quality equipment 24 hours a day, seven days a week. Dedicated stroke units will continue to deliver specialist treatment and intensive rehabilitation after patients have spent 72 hours in the hyper-acute stroke unit.

People having a mini-stroke (transient ischaemic attack) will also receive the highest-quality care. Patients who have a mini-stroke will be seen by an expert who will do further investigations, reducing the chance of patients going on to have a full stroke.

As part of the work to develop London’s stroke services, there were changes made to the structure of the London stroke tariff.

Since 2007, the stroke project has looked at the entire stroke pathway, including prevention, acute care and hospital services, rehabilitation and life after stroke. The agreed service changes were formally handed over to the London cardiovascular and stroke networks in 2010 to implement. Service changes to rehabilitation have been made subsequently in 2011.