Dozens of stroke units lose ‘A’ ratings

Close to 80% of stroke units are falling well short against a swathe of new standards introduced to the high-profile national audit, according to HSJ analysis.

In the latest figures from the Sentinel Stroke National Audit Programme just one unit, at Sandwell and West Birmingham Hospitals Trust, achieved an ‘A’ rating.

This compared with 30 trusts rated ‘A’ in July-September 2024 data – the final results before major methodology changes.

The changes included significant new indicators – such as on thrombectomy – and increasing the performance bar on several existing measures, like those covering the standard and intensity of rehab care.

In the most recent data – October-December 2025 – of 99 routinely admitting stroke teams nationally, 22 achieved the lowest possible overall rating of ‘E’, while 57 were ranked the second lowest of ‘D’. Five received a ‘B’ and 14 a ‘C.

A substantial overhaul of the method, including introducing new measures – such as thrombectomy accesss – and raising the bar on others, for example standards and intensity of rehabilitation.

The Stroke Association is calling for the government to use its upcoming modern service framework guidance on cardiovascular disease – expected in coming weeks – to drive up rehab standards.

The charity said the new audit ratings revealed “significant gaps” in treatment standards – although it accepted the falls in ratings were “very much about recalibration” rather than declining quality.

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Source: HSJ, 20 May 2026