A Consensus Conference on Stroke in 1988 concluded that rehabilitation for stroke in the United Kingdom was poorly organised, was not based on evidence, and was associated with poor outcomes compared with similar health care systems. In addition, there were significant variations in the quality of services and outcome across different areas of the country. Efforts to improve care included increased investment into services and research, development of multidisciplinary national guidelines for all aspects of stroke care, and a regular national audit of stroke rehabilitation. The last 20 years have seen dramatic improvements in the development of a coherent policy for the management of stroke patients in the United Kingdom, underpinned by well-organised services within a framework of guidelines and performance review. However, further work is needed to increase the evidence base for the nature, duration, and effectiveness of complex rehabilitation interventions and to improve multidisciplinary interactions and communications with patients and their caregivers. Of the further work required, the leading priority is to increase therapy input to make the best use of time that patients spend in rehabilitation settings.