Stroke Association response to England December 2021 ambulance response times

Tens of thousands of emergency patients waited nearly two hours for ambulances

More than 40,000 who called 999 in December 2021 waited nearly two hours for an ambulance with an emergency condition such as stroke, today’s figures show.

Today’s data release from NHS England shows that the 10% of category 2 (90th centile corresponding to 40,995 incidents) calls to 999 (which include strokes) took over 1 hour and 59 minutes (01:59:12) to arrive in December 2021. The average response time is 53 minutes (00:53:12), over two and a half times the 18 minute response time target.

In the UK there are over 100,000 strokes per year and 1.3 million stroke survivors. Most recent data shows 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 extra time taken for an ambulance to arrive increases the probability of death or unnecessarily severe disability as a consequence of stroke. The Stroke Association expects stroke mortality to increase this winter with delays in treatment and a possible increase in stroke patients co-presenting with Covid-19; both of which significantly affect chances of patient morbidity.

Around 87% of strokes are caused by a blood clot in the brain. The most widely used treatment, thrombolysis - ‘clot-busting’ drugs - can only be administered within four and a half hours of stroke symptoms starting. Other treatments, such as mechanical thrombectomy rely on access within a similarly narrow timescale from onset of symptoms.

Juliet Bouverie OBE, Chief Executive of the Stroke Association, said: “I am seriously concerned that this crisis situation for the ambulance service could have severe adverse consequences for stroke survivors. We know that time lost is brain lost, because when you’re having a stroke, over 1.9 million brain cells die every minute.

“Over the past few years, ambulance delays have slowly increased and the times taken for stroke patients to get appropriate treatments has crept up too. This has been a slowly increasing danger for many years, but now we see an unprecedented leap in ambulance response times. I am worried that this severely threatens the lives and recoveries of stroke patients. Ambulance delays means delays or missed chances for treatment which cause avoidable disability and even death for some stroke patients.

“We recognise and applaud the hard work of ambulance call handlers, paramedics and stroke clinicians. They've made great progress in reducing time to emergency treatment when a stroke patient arrives at hospital. But these gains are being squandered by systemic challenges that mean ambulances are not getting some patients to hospital in the window that allows for life-saving and life-changing treatment. We're also concerned that some patients are being advised to make their own way to hospital which is scary and often not appropriate.

“Long ambulance delays are a symptom of a system which is failing. This is a problem across the whole health and social care system, which fails to get people in, through and out of hospital.

“This cannot be solved overnight and won’t recover this winter.

“The best thing you can do to help you or a loved one have the best chance of survival and recovery from stroke is to raise the alarm as soon as possible. This year, the FAST message is more important than ever. Make sure everyone you know and love calls 999 as soon as they see any of the signs of stroke. Calling 999 quickly is still important because it lines up getting scanned and seen by a stroke specialist as soon as possible when you arrive at hospital. We worry that scary stories about Omicron and ambulance delays are putting people off calling 999 like they did in the first lockdown.”

Ambulance response data for December 2021 (Published January 2022)