The estimate from the Stroke Association, is based on the latest survey of stroke treatment published yesterday, which shows that some hospitals continue to deliver “lamentable care”. Overall, the audit shows some improvements, with more stroke units and higher scores for most key indicators of care. But treatment for the third most common cause of death, and leading cause of disability, still lags behind other developed countries.

“There are huge problems in the delivery of stroke care,” said Dr Tony Rudd, president of the British Association of Stroke Physicians. “Even though 40 per cent of patients are now being treated in stroke units, they are still not being treated as a medical emergency. More than 40 per cent of patients who need an urgent scan aren’t getting it. Even in stroke units, a third of patients don’t have their swallowing reflex checked. Half the people who have a stroke will have lost the ability to swallow.

“If this isn’t checked and they are given their tea and cornflakes for breakfast, it’s going to end in pneumonia.”

The National Sentinal Audit for Stroke is funded by the Health Commission and carried out by the Royal College of Physicians. The first was in 1998, and this is the fourth, which is based on returns from all hospitals in England, Wales and Northern Ireland in April last year.

The audit found that 82 per cent of hospitals in England now had a stroke unit, compared with 74 per cent in 2001.

This is the first audit to cover every NHS trust. They were given a score, out of a maximum of 100, for their adherence to 12 basic standards such as time spent in a specialist stroke unit, access to emergency brain scans and rehabilitation services.

The best performing hospitals were North Wiltshire and Devizes Area Stroke Unit and London’s Royal Free Hampstead NHS Trust, which both scored 93 in the audit. Bottom were the Grantham and District Hospital, with 25, and the Royal Oldham Hospital at 27.

The audit found only marginal improvements in rehabilitation services since 2001. The percentage of patients receiving a physiotherapy assessment within 72 hours of admission to hospital increased from 59 per cent to 63 per cent.

Patient assessment by an occupational therapist within seven days increased from 51 per cent to 57 per cent.

Dr Rudd said: “Clearly the quality of care has been steadily increasing over the years.

But stroke still lags far behind heart disease and cancer. For every £1 spent on research focusing on stroke, £20 was spent on heart disease research and £50 for cancer.

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