National Clinical Guidelines for Stroke - fourth edition

The fourth edition of the National Clinical Guideline for Stroke (PDF 2MB), was published in September 2012.  It was prepared by the Royal College of Physicians Intercollegiate Stroke Working Party chaired by Professor Tony Rudd, this working party also oversees the National Audit Programme for Stroke.

The fourth edition of this world-renowned stroke guideline provides the reader with the most comprehensive coverage of stroke care to date, encompassing the whole of the stroke pathway from acute care through to longer-term rehabilitation, including secondary prevention. It informs healthcare professionals about what should be delivered to stroke patients and how this should be organised, with the aim of improving the quality of care for everyone who has a stroke, regardless of age, gender, type of stroke, or location.

It also has a detailed section on commissioning of stroke care, which will be useful for clinical commission groups in the changing healthcare landscape.

The recommendations have been completely revised to include the most up-to-date evidence published since the previous edition in 2008.

The guideline is written in a clear and holistic way.

It is an essential resource for everyone involved in stroke care, prevention and rehabilitation, as well as commissioners of stroke services, patients and carers.


  • Commissioning
  • Systems underlying stroke
  • Acute-phase care
  • Secondary prevention
  • Recovery phase – rehabilitation
  • Late Phase

Additional features included in the fourth edition of the guidelines:

  • evidence to recommendations sections, detailing the links between the evidence available and the recommendations in areas which may require more explanation
  • a section on public awareness of stroke
  • new guidance on risk assessment for falls
  • a new section on unusual causes of stroke
  • incorporation of the stepped care model for psychological care after stroke
  • updated sections, on acute care, rehabilitation, longer-term care, and secondary prevention
  • an updated guideline for patients and carers
  • guidance on the new oral anticoagulants.


How to access the 4th Edition of the National Clinical Guideline for Stroke

Download the PDF of the National Clinical Guideline for Stroke - fourth edition (PDF 2MB)

Download a patient version of the guideline (Care after stroke or transient ischaemic attack - information for patients and their carers)

Download an App of the Guideline for mobile devices

Purchase the print edition of the National Clinical Guideline for Stroke -fourth edition at the RCP shop

Purchase 'Care after stroke or transient ischaemic attack - Information for patients and their carers' at the RCP shop

 National clinical guideline for stroke – fifth edition

The RCP stroke programme are currently developing the next version of the National Clinical Guideline for Stroke, which will be published in 2016.

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Cover of National clinical guidelines for stroke - fourth edition
Clinical resources, Clinical guidelines