Millions of people in the UK are suffering poor health because they miss out on vital rehabilitation after strokes, heart attacks and cancer, which in turn is also heaping further pressure on the NHS, a damning report warns. Physiotherapists say some groups of patients are particularly badly affected. Without access to these services, many patients desperately trying to recover from illness became “stuck in a downward spiral”, they said, with some developing other health conditions as a result. The new report by the Chartered Society of Physiotherapy (CSP) says millions of people in marginalised communities, including those from ethnic minorities, are not only more likely to live shorter lives, but also spend a greater proportion of their lives struggling with health difficulties. Vital services that could tackle those inequities are either unavailable or poorly equipped to meet their needs, the report warns, adding that “some communities face particular barriers”. Prof Karen Middleton, the chief executive of the CSP, said: “Rehabilitation services have been under-resourced for decades and were not designed coherently in the first place. This has exacerbated poor health outcomes, particularly for people from marginalised groups. “It’s not only the individual who suffers. Without adequate access to rehabilitation, health conditions worsen to the point where more and more pressure is eventually piled on struggling local health systems and other public services. “We desperately need a modernised recovery and rehabilitation service that adequately supports patients following a health crisis and prevents other conditions developing.” People who face “systemic discrimination and marginalisation” and those who live in poor communities are more likely to miss out on rehab, the report says. The CSP said access to high-quality rehabilitation services must be improved to avoid “further entrenching health inequalities faced by millions”. People are living longer with long-term conditions and after cancer, stroke or heart disease. When people are dealing with a long-term condition, their future health and wellbeing “makes a significant difference”, according to the report. However, the authors warned: “It should be universally available as an unmissable part of treatment. But currently millions miss out. “Without rehabilitation people can be stuck in a downward spiral where having one long-term condition leads to other health conditions, including further long-term conditions, with loss of mobility and poor mental health and multiple medication regimes. “Ensuring everyone who needs rehabilitation can access it can reverse this downward spiral.” It emerged on Tuesday that thousands of physiotherapy staff in England and Wales would vote on industrial action after overwhelmingly rejecting this year’s NHS pay award. The CSP said almost 80% of those voting in England said they were prepared to take industrial action, with 83% in Wales. The CSP council recommended members voted in support of action. A decision has already been taken to ballot in Scotland.