Stroke rehabilitation: why 94% of patients get less than NICE recommends

Only 6.4% of stroke patients in England, Wales and Northern Ireland received NICE’s benchmark for stroke rehabilitation. The benchmark is at least 3 hours a day, on at least 5 days a week. The other 94% did not meet it. Not everyone needs or can manage that much therapy. But the figures show most patients get far less than the guidance aims for.

What the research found

The figures come from the latest periodic report of the Sentinel Stroke National Audit Programme (SSNAP), covering January to March 2026. This national audit collects stroke care data from hospitals in England, Wales and Northern Ireland. The findings were reported by The Guardian and Social Care Today on 9 November 2026.

• 6.4% of patients received 3 hours of therapy a day, at least 5 days a week, between January and March 2026. In October to December 2024, it was 7.5%.
• 40 minutes a day was the average amount of therapy patients received in hospital, six minutes less than in late 2024.
• 15.2 to 57.3 minutes a day was the range of figures reported, so even the highest was under an hour.
• 68% of patients carried on getting rehabilitation support after they left hospital. That means roughly 1 in 3 didn't.

How the Stroke Association responded

Juliet Bouverie, Chief Executive of the Stroke Association, called the figures “damning”. She said many survivors don't get the help they need, either soon after their stroke or later in their recovery.

She explained that a stroke needs urgent treatment, but its effects can last a lifetime. Too often, care stops at the emergency and overlooks recovery. She added that services for stroke survivors are already stretched to their limit.

In a new report, the charity estimates stroke costs the UK £25.7bn a year. By its estimate, more than half of that, £13.7bn, goes on social care. It puts the wider cost to society at another £6.7bn. This includes survivors who can no longer work and family members who leave their jobs to care for them.

The Department of Health and Social Care did not comment directly on the figures. A spokesperson said the NHS is working to support stroke patients quickly and help them recover in the long term. The department pointed to its pledge to cut early deaths from heart disease and stroke by a quarter within 10 years. It also mentioned its cardiovascular disease modern service framework for England, published in July 2026.

What NHS guidance says stroke rehabilitation should look like

The NICE guideline on stroke rehabilitation in adults (NG236) guides NHS practice in England and Wales, and is also followed in Northern Ireland. Updated in October 2023, it says people should be offered needs-based rehabilitation for at least 3 hours a day, on at least 5 days a week.

The 3 hours should cover a range of therapy, including:

• Physiotherapy to rebuild strength, balance and walking
• Occupational therapy to relearn everyday tasks like washing, dressing and cooking
• Speech and language therapy to help with communication and swallowing

The 3-hour total replaced the 2013 advice of at least 45 minutes of each relevant therapy. NICE raised it after reviewing evidence, especially for physiotherapy, that more intensive rehabilitation improves quality of life and daily activities.

If someone can't manage, or doesn't want, 3 hours a day, NICE's guideline says the therapy they need should still be offered on at least 5 days a week, in shorter sessions.

According to the NICE recommendations, support for stroke recovery and rehabilitation should carry on after someone leaves hospital:

1. Leaving hospital. People who can move from a bed to a chair, on their own or with help, should be offered early supported discharge. This means continuing rehabilitation at home, as long as the home is safe.
2. Within 72 hours of going home. A specialist stroke rehabilitation team should follow up to assess needs and plan ongoing therapy. This applies to people in care homes too.
3. The same standard at home. The 3-hour guidance applies whether someone is in hospital or recovering at home.
4. For as long as it helps. Therapy should continue for as long as it helps the person reach their goals, not stop after a set number of weeks.
5. Support for family. Family members and carers should have their own training and support needs reviewed, at least at the 6-month and annual reviews.

What actually happens

On average, patients in hospital got less than a quarter of the daily therapy in NICE’s benchmark. The gap between guidance and reality looks like this:

Source: SSNAP figures for January to March 2026, as reported by The Guardian and Social Care Today.

In practice, many people leave hospital still having trouble moving, speaking or swallowing. They then get little or no therapy to help them improve. Much of their daily recovery falls to family, and some relatives give up work to provide care.

If someone you love is coming home after a stroke, it helps to plan early. Ask the hospital team what stroke rehab is arranged after discharge and who to contact if it stops. Our guide to arranging care after a hospital discharge explains each step and the support you may be entitled to. For help with day-to-day life during recovery, read our guide to stroke care.