Contracts for Innovation Cymru - Ending Abandonment After Stroke

Stroke is one of the leading causes of disability in Wales and affects around 7,000 people each year. While survival rates continue to improve, many people experience a significant reduction in support once they leave hospital at a stage when rehabilitation remains critical to recovery and long-term independence. Around 45% of stroke survivors report feeling abandoned following discharge because they do not receive the support they need to recover well.

The impact extends far beyond the individual. Variations in access to rehabilitation, follow-up support and community services can lead to poorer outcomes, increased carer burden, avoidable demand on health and care services, and significant societal and economic costs. Stroke currently costs NHS Wales approximately £220 million per year and the wider Welsh economy approximately £1.63 billion annually. Without intervention, these costs are expected to increase significantly.

The challenge has been developed following extensive investigation across Wales involving clinicians, health boards, national leaders, stroke survivors, carers and the Stroke Association. This work has helped define the challenge, identify unmet needs, understand existing service variation and explore the current market landscape. The conclusion is clear: Wales requires innovative, scalable approaches that can strengthen recovery, improve experience, reduce feelings of abandonment and support more equitable outcomes beyond hospital discharge.

The challenge aligns with the Welsh Government Quality Statement for Stroke, which places renewed emphasis on rehabilitation, recovery, person-centred care and ensuring that stroke survivors do not feel abandoned during their recovery journey.

The Challenge

We are seeking innovative solutions that can improve rehabilitation, recovery and long-term support for stroke survivors.

Access to rehabilitation and follow-up support varies across Wales. As a result, outcomes can depend too heavily on where a person lives rather than on their clinical need. This challenge seeks innovative approaches that can improve equity of access and help ensure people can receive high-quality rehabilitation and recovery support regardless of geography, including those living in rural, remote, underserved and seldom heard communities across Wales.

The challenge is outcome-focused and does not prescribe a specific technology, product type or delivery model.

Applicants are encouraged to propose the approach they believe will best address the challenge and demonstrate how their solution could be adapted, developed or enhanced to meet the needs of NHS Wales and stroke survivors.

We are not seeking to specify a single solution in advance. The purpose of this challenge is to support the development, demonstration and evaluation of innovative approaches that can improve recovery, reduce feelings of abandonment and create foundations for sustainable improvement across Wales.

Particular consideration should be given to how solutions can improve access to rehabilitation and recovery support for people who may face barriers associated with geography, transport, service availability, digital exclusion, workforce capacity or being within a seldom-heard group.

The challenge is not simply about providing more therapy. We are interested in approaches that enable personalised, continuous and motivating rehabilitation and self-management support across home, community and outpatient settings whilst supporting better experiences and outcomes for stroke survivors.

This challenge is being delivered as a Phase 2 Contracts for Innovation competition. In contrast to a Phase 1 competition, focusing on feasibility, we are seeking organisations with existing technologies, products, platforms, services or rehabilitation approaches that require adaptation, enhancement, configuration or further development to address the identified needs of stroke survivors, carers and rehabilitation services across Wales.

This challenge follows significant investigation and engagement to understand the problem, review evidence, define requirements and explore potential market solutions. We are therefore seeking solutions with an established foundation. Early-stage concepts requiring fundamental research or proof-of-concept development are unlikely to be supported

Projects should support the development, adaptation and real-world demonstration of innovative approaches capable of improving rehabilitation, recovery and life after stroke.

Successful projects are expected to generate practical evidence relating to:

• Patient and carer outcomes.
• Rehabilitation outcomes.
• User experience.
• Service and workforce impact.
• Affordability and sustainability.
• Adoption readiness.
• Future scalability.

Applicants should describe in-detail:

• What they propose to deliver.
• How it will be tested and evaluated.
• How impact will be measured.
• How the solution could evolve in future.
• A core delivery plan to 31 March 2027, including activities, milestones, deliverables and costs.

Applicants should describe in outline:

• A separate proposal for a potential further stage beyond April 2027, including the additional activities, deliverables, outcomes, milestones, timescales and costs.
• How the further stage would build on the evidence and learning generated during the core project.
• What additional value the further stage would deliver for stroke survivors, services and the wider recovery pathway.
• How the core project would remain viable and deliver meaningful outputs if further funding does not become available.

Funding Allocation and Project Details

Competition Type: Phase 2 Development and Real-World Demonstration

Funding Available: £300,000 Total budget to support a portfolio of projects

The total funding available for the competition can change and the funders reserve the right to adjust the provisional funding allocations, i.e., should additional funding become available.

Number of Projects: Current funding is available to support a portfolio of projects, dependent upon the number/quality of submissions received.

Portfolio Approach

Funding decisions may be made using a portfolio approach, recognising that improving recovery and reducing abandonment after stroke is a complex challenge that may benefit from multiple complementary solutions rather than a single intervention.

Consideration may be given to the overall balance of projects supported, the evidence generated, opportunities for collaboration between projects and the potential for wider adoption and learning across Wales.

Solutions may address different aspects of rehabilitation, self-management, recovery, service coordination, family support, accessibility, digital capability, assistive technology, data, analytics or outcomes measurement. Collectively, these may contribute towards the wider ambition of improving life after stroke across Wales.

Potential further funding: Additional funding may become available to support a further stage of development or demonstration beyond April 2027. This funding is not currently confirmed and should not be assumed as part of the initial project award. Any decision to provide further funding would be subject to funding availability, project performance, evidence of value and the priorities of the challenge partners.