This report from the National Audit Office (NAO) formed the basis of a hearing of the Committee of Public Accounts, whose report in June 2006 concluded that “the human and economic costs of stroke could be reduced by re-organising services and using existing capacity more wisely.” The Committee made a number of recommendations for the Department of Health and NHS organisations, and asked the NAO to report back on progress. This report sets out how stroke care has changed over the last four years, the extent to which these changes have improved the value for money of stroke care provision nationally, and the risks and issues to be managed to ensure that stroke care services continue to improve in future.