SAFE call to action

From “The Burden of Stroke In Europe” and “The Un-met Needs of Stroke Survivors” reports

Healthcare planning:

  • The number of people having a stroke and the number of people living with the long- term effects of stroke will rise in the coming decades. Effective healthcare planning and adequate resource allocation across Europe is needed to deal with this, taking into account that the financial burden of stroke is to a large extent borne by stroke survivors themselves and their families.

Prevention, hypertension & atrial fibrillation

  • Across Europe we need rapid and concerted action to prevent stroke and, especially, improvement in the detection and treatment of high blood pressure (hypertension) and atrial fibrillation (an abnormal heart rhythm with rapid and irregular beating).
  • A more systematic, evidence-based approach to public education across the EU is required to improve knowledge of the modifiable risk factors for stroke, i.e. an awareness that these factors significantly increase a person’s risk of having a stroke, but can be treated in most cases. Joining forces with public education efforts in relation to other cardiovascular diseases could create a more powerful message and greater impact.

Stroke as an emergency

  • We need to reduce delays in people getting emergency stroke care by carrying out continuous education of the public and health professionals to recognise stroke and always treat it as an emergency; and by improving emergency care pathways. There should be enough trained stroke specialists available and acute and emergency stroke services should be organised to maximise fast patient access to emergency care.

Life after stroke support

  • Across Europe there is very little provision for the long-term needs of stroke survivors. SAFE calls on all European countries to consider implementing frameworks for support after stroke, ensuring a holistic approach to tackling “life after stroke” issues and recognising the roles of carers and families.
  • Recognising the value of emotional, practical and financial support for stroke survivors and their families, SAFE believes that stroke support organisations can play an important role in the overall stroke pathway. Health authorities and Governments should provide funding and support to help build their capacity.

Acute stroke care

  • Stroke units save lives and improve outcomes so improving stroke unit provision is a priority. Currently only 30% of people who have a stroke get treated in a stroke unit. Everyone who has a stroke should be treated in a stroke unit that meets Europe-wide agreed organisational and quality standards.
  • Thrombolysis and thrombectomy are still under-performed across all of Europe. Structural changes to acute stroke care within the respective national and local context could help to improve thrombolysis rates and patient outcomes.
  • Medical and technological advances leading to new treatment options, such as for restoring blood flow and improving brain function, must be made available to all patients across Europe, for example by creating hospital networks.


  • We need a step change in the provision of rehabilitation and long-term support for stroke survivors and their families. All stroke survivors should get an early assessment for rehabilitation in hospital and receive appropriate levels of therapy both in hospital and following discharge. Post-hospital reviews should be available to all stroke survivors, wherever they live in Europe, and they should be able to get therapy (including for their psychological and non-physical needs) for as long as they need it.

Un-met needs

  • Governments and research bodies should provide funding to investigate the medium and long-term needs of stroke survivors and the improvements in service provision to meet those needs.
  • Health and social care systems should be designed to provide high-quality information and support for stroke survivors and their carers that is easily accessible over the long-term.
  • All stroke survivors should be followed up, at least annually, by a stroke specialist to have their physical, mental and societal needs assessed and to be referred to relevant services.
  • National and local health and social care systems must improve access to rehabilitation therapies for stroke survivors for as long as they continue to show benefit.
  • National and local health and social care systems must improve the provision of and access to secondary prevention services and support.
  • More specialist support is needed post stroke to help stroke survivors cope with ongoing issues such as chronic fatigue, concentration problems and mental health support.
  • People supporting and caring for stroke survivors should have timely access to information and support, including meeting their needs to self-care.
  • Stroke specialists and health planners should develop a European-wide model of care or set of principles (with an agreed definition of un-met need) to guide the provision of services to meet the long-term needs of stroke survivors.