Stroke Association response to December 2022 ambulance data

More than 36,000 patients waited over three and a half hours for an ambulance in England

Stroke Association: “These delays are causing severe disability and even death.”

More than 36,000 people who called 999 in December 2022 with emergencies including suspected stroke waited over three and a half hours (03:41:48) for an ambulance, today’s (12.01.23) figures show.

Today’s data release from NHS England shows that the average response time to category 2 emergencies, like stroke, was over an hour and a half (01:32:54) last month, more than five times the 18 minute response time target. The 90th centile (aka the longest 10% of calls) target of 40 minutes was also not met, as this took over three and a half hours (03:41:48), more than five and a half times the target.

There are 1.3 million stroke survivors in the UK, and more than 100,000 strokes annually. Most recent data show that stroke, a sudden brain attack, is fatal for one in eight (13.2%) patients. This is because for every minute a stroke goes untreated, 1.9 million brain cells die.

The Stroke Association is incredibly concerned that the deepening crisis in ambulance services and emergency care is putting many patients at risk of avoidable death or severe disability.

Around 87% of strokes are caused by a blood clot in the brain. The most widely used treatment is thrombolysis - ‘clot-busting’ drugs. For most people, thrombolysis must be administered within four and a half hours of stroke symptoms starting and gets less effective as time goes on. Other treatments, such as thrombectomy, rely on similarly specific time windows and are more effective the sooner they are performed.

Juliet Bouverie OBE, Chief Executive of the Stroke Association, said: “It's hard not to despair at the state of the health service. Over an hour and a half is an unacceptably long wait for an ambulance when you’re having a stroke. Every minute waited is a shortened chance of survival or weeks more rehabilitative therapies. These delays are causing severe disability and even death.

“I am incredibly worried that this is a chronic crisis situation for the ambulance service. This has life-threatening consequences for thousands of stroke patients. The government must recognise the severity of the situation, caused by their consistent lack of funding and resources to support patient flow through hospitals. The lack of resource and funding in the ambulance service and social care has clogged up the system, meaning people can’t get into hospital, receive quick treatment and then be discharged.

“The government and NHS leaders must urgently address staffing issues within ambulance services, hospitals and social care services. Ambulance leaders and NHS staff need to work together to prioritise addressing handover delays to make up for lost time. NHS England should address the wider system challenges in its upcoming Urgent & Emergency Care Recovery Plan, to mitigate ambulance pressures that prevent quick access to stroke treatments like thrombectomy.

“We’re hugely grateful to ambulance call handlers, paramedics and stroke clinicians who are working tirelessly under extreme pressure, which has been exacerbated by rising covid and flu numbers. But despite their best efforts, systemic challenges are severely compromising ambulance response and hospital treatment times.

“Long ambulance delays are a symptom of a failing health and social care system. There’s a perfect storm of pressures, with soaring demand for services, a shortfall of hospital and care home beds, and staff shortages, resulting in a failure to get people in, through and out of hospital into follow-up care.

“Despite these ongoing challenges our advice to the public remains the same. If you spot the signs of a stroke in you or someone else, it’s vital to call 999 straight away. The ambulance service will always be there for stroke, even on strike days. Always act FAST, always call 999. This lines up getting scanned and seen by a stroke specialist as soon as possible when you arrive at hospital.”