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Telestroke - the stroke consultant, on video, in minutes.

A stroke physician assessing you over encrypted video while the CT is still warming up - thrombolysis and thrombectomy decisions made in the window that decides how much brain you keep.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private telestroke costs in the UK.

Indicative ranges across our partner hyperacute stroke units. Acute episodes are almost always covered by insurance where eligible.

In short

A single video consultation: £450–£900, hyperacute episode with thrombolysis usually insurer-covered.

Service Indicative range
Telestroke consultant assessment (per episode) £450–£900
Hyperacute admission with thrombolysis (private cover) £12,000–£25,000
Mechanical thrombectomy episode £28,000–£55,000
TIA rapid-access clinic £450–£950
Post-stroke second-opinion video review £350–£650
Home video follow-up (weeks 2, 6, 12) £220–£380

On the NHS, telestroke and thrombolysis are free at the point of care. Private telestroke exists for second opinions, rural access, and expedited TIA clinics - not to replace 999.

The problem

Stroke consultants are scarce. Minutes are not.

Telestroke fixes the geography problem - a stroke consultant on video, doing the same NIHSS assessment, in the same window, at the smaller hospital.

  • Not every hospital has a stroke consultant on site

    Especially overnight and at weekends. Telestroke closes the gap in real time.

  • Thrombolysis has a 4.5-hour ceiling

    And thrombectomy up to 24 hours in selected cases. Telestroke exists so those windows are not lost to a phone tag.

  • TIA is a warning, not a discharge

    Video makes that possible from your front room.

The journey

From call to rehab - what happens, in order.

One team from FAST call through hyperacute treatment, secondary prevention and the 6-week review.

  1. 01

    Before

    You call, we listen for FAST

    Face, arms, speech, time. Suspected acute stroke is 999 first, then us - never the other way round.

  2. 02

    Before

    Route to the right hyperacute unit

    Same working day: a stroke unit with a 24/7 telestroke rota, a CT/CTA scanner ready, and thrombectomy on site or transfer arranged.

  3. 03

    Before

    Pre-arrival imaging plan

    CT head, CT angiogram from arch to vertex, and CT perfusion where extended-window thrombectomy is being considered.

  4. 04

    On the day

    Video assessment on arrival

    A stroke consultant on video runs a NIHSS score with the bedside team, reviews imaging live, and decides on thrombolysis within minutes.

  5. 05

    On the day

    Thrombolysis or thrombectomy

    Alteplase or tenecteplase given at the receiving unit; large-vessel occlusions are transferred to a neuro-interventional centre for mechanical thrombectomy up to 24 hours in selected cases.

  6. 06

    After

    Hyperacute stroke unit admission

    Neuro-observations, swallow screen, aspiration precautions, dysphagia and physio input from day one. Repeat imaging at 24 hours before starting antiplatelets or anticoagulation.

  7. 07

    After

    Rehab, secondary prevention, follow-up

    Early supported discharge or inpatient rehab, blood-pressure and lipid optimisation, atrial-fibrillation screening, and a stroke-clinic review at 6 weeks.

When it helps

When telestroke is the right call.

The situations where video-led stroke care changes the outcome - plus the one that means 999, not a form.

  • Sudden facial droop or one-sided weakness

    The classic FAST signs. Call 999 first - the telestroke pathway starts when the paramedics pre-alert the receiving unit.

  • Sudden slurred speech or word-finding trouble

    Aphasia and dysarthria are stroke until proven otherwise, especially with any motor sign.

  • Sudden loss of vision in one eye or one field

    Amaurosis fugax or homonymous hemianopia - either can be an emergency and needs urgent carotid imaging.

  • Sudden severe headache with neurology

    A thunderclap headache with focal deficit needs same-day CT to rule out haemorrhage before any clot-busting drug is even considered.

  • TIA within the last 7 days

  • Post-stroke review or second opinion

    Not sure the workup was complete? A telestroke consultant can review the notes, imaging and secondary-prevention plan on video.

  • Rural or offshore residence

    Telestroke was designed for exactly this - a district general with no on-site stroke consultant, connected to a tertiary neurology team on video.

  • Red flag: fluctuating symptoms in the last hour

    A stuttering or waxing–waning deficit within the last 60 minutes is a possible stroke-in-evolution - 999, not a booking form.

Telestroke options

Not one model - several.

The right model depends on where you are, what phase you are in, and whether the deficit is still there.

  • Hub-and-spoke telestroke

    A tertiary hyperacute stroke unit runs a 24/7 rota of stroke consultants who cover several spoke hospitals via encrypted video. The spoke does the scan and gives the drug; the hub decides.

  • Mobile stroke unit (MSU)

    A CT-equipped ambulance where thrombolysis can start at the roadside. Rare in the UK but expanding in London and the West Midlands.

  • In-hospital telestroke consult

    Used inside the same hospital when the stroke consultant is off site - nights, weekends, or during theatre. Same video kit, same NIHSS, same decision speed.

  • Telestroke for TIA and mimics

    Rapid-access TIA clinics are increasingly video-led - ECG, blood pressure and carotid Doppler done locally, reviewed remotely by a stroke specialist.

  • Thrombectomy triage

    Telestroke reads the CTA and decides whether to transfer to a neuro-interventional centre for mechanical clot retrieval - up to 24 hours in DAWN/DEFUSE-3 eligible patients.

  • Post-discharge video follow-up

    A stroke consultant on video for the 6-week review - blood pressure, statin, antiplatelet, mood, driving and return-to-work decisions.

  • Second-opinion video review

    The notes and imaging are couriered to us, and a stroke consultant reviews the case with you on video - useful after an unclear diagnosis or an unusual stroke in a young adult.

  • Family video briefing

    A separate video session for family members abroad - because stroke decisions are made in hours, and family are rarely in the room.

Safety and recovery

What to expect - honestly.

Telestroke is safe, evidence-based and NICE-endorsed. The risks belong to the treatments it enables, not to the video call.

  • Time is brain

    For every minute a large-vessel stroke goes untreated, roughly 1.9 million neurons die. Telestroke is designed to trim minutes off the decision - nothing else.

  • Thrombolysis bleeding risk

    Alteplase carries roughly a 6 percent risk of symptomatic intracranial haemorrhage. The consent conversation happens on video with you or a next of kin, then and there.

  • Thrombectomy vascular risk

    Groin haematoma, vessel dissection and distal embolisation are the main risks - small, but real. A neuro-interventional radiologist explains before the procedure.

  • Wrong-window drug

    Give thrombolysis outside the 4.5-hour window or into a haemorrhage and harm outweighs benefit. Telestroke insists on the timings before it agrees.

  • Aspiration and swallow

    A bedside swallow screen before the first sip of anything is standard. Aspiration pneumonia is one of the commonest early complications.

  • Blood-pressure targets

    Too high before thrombolysis and it is unsafe; too low after and the penumbra suffers. Continuous monitoring on the hyperacute unit is not optional.

  • AF, PFO and carotid workup

    A cause is chased for every stroke - 72-hour tape or implantable loop for occult AF, bubble echo for PFO in young adults, carotid Doppler for anterior-circulation strokes.

  • Driving and DVLA

    One month off driving for a Group 1 licence after stroke or TIA, longer for HGV. We put this in writing at discharge.

  • Red flags in the first 90 days

    A new deficit, worsening headache, sudden vision loss or a second TIA within 90 days is same-day A&E - not a routine follow-up call.

Reading your discharge summary

Your stroke summary in four parts. Read the last one first.

Whatever the pathway, the discharge summary keeps to the same shape.

  1. 01 NIHSS

    Severity score at arrival and after treatment

    The National Institutes of Health Stroke Scale - a 0 to 42 score. The number at arrival predicts outcome; the number after thrombolysis or thrombectomy proves the drug or clot retrieval worked.

  2. 02 Imaging

    CT, CT angiogram, CT perfusion

    Whether there is haemorrhage, an established infarct, a large-vessel occlusion, and how much salvageable brain (penumbra) is left. This decides thrombolysis vs thrombectomy vs neither.

  3. 03 Aetiology

    Cause: TOAST classification

    Large-artery atherothrombosis, cardioembolism (usually AF), small-vessel disease, other determined cause, or undetermined. Cause dictates prevention - antiplatelet vs anticoagulant.

  4. 04 Plan

    Secondary prevention and rehab

    Read this first: blood pressure, statin, antiplatelet or anticoagulant, AF workup, carotid decision, and the rehab plan for the next 6 weeks.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Frequently asked

Everything we get asked about telestroke.

  • Is telestroke the same as a telephone triage nurse?

    No. Telestroke is a consultant stroke physician on encrypted video, running a full NIHSS assessment with the bedside team and reviewing the CT and CT angiogram live. It is designed to replicate a bedside stroke consultant - not to screen calls.

  • How fast is it, honestly?

    A well-run telestroke pathway aims for a door-to-needle time under 45 minutes and door-to-groin (for thrombectomy) under 90 minutes - often faster than an ambulance transfer to a distant hyperacute unit would allow.

  • Does telestroke work for TIAs, not just full strokes?

    Yes. NICE recommends this timeframe for anyone with a resolved deficit in the past week.

  • What if I am abroad or offshore?

    Telestroke was built for exactly this - remote and rural sites that need a stroke consultant fast. In the UK, that means Scottish islands, Cornwall and Devon, mid-Wales and Northern Ireland via NHS pathways, or private international telestroke where appropriate.

  • Can I get a second opinion after a stroke?

    Yes. A stroke consultant on video will review your notes, imaging and secondary-prevention plan - helpful after an unclear diagnosis, a young-adult stroke, or a decision you would like to talk through with your family.

  • How much does a private telestroke consultation cost?

    A single video consultation with a stroke consultant runs £450–£900. A rapid-access TIA clinic runs £450–£950.

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