Small hospitals must stop treating stroke emergencies in order to save thousands of lives, England’s top doctor will today say.

The national medical director will say NHS trusts across the country must centralise services, so that victims get the right help sooner.

Professor Stephen Powis will say hospitals should follow a controversial model pioneered in London and Manchester, which is now saving around 170 lives a year.

In both cities, local stroke wards were closed, with ambulances instead taking victims not to nearest hospital, but to larger centres with access to brain scans, clot-busting drugs and specialist procedures.

As a result, the numbers dying or suffering long-term disability have fallen significantly.

Now health chiefs want to introduce the same changes across towns and cities in England, in the hope of saving more than 800 lives a year.

Professor Stephen Powis, NHS national medical director, said rolling out expert stroke teams will ensure thousands more people “survive and thrive”.

Speaking at the NHS Confederation conference in Manchester, he will say: “Introducing quicker access to better treatment for stroke in London and here in Manchester has saved hundreds of lives and we now want to see them rolled out across the whole of the country.

“As clinicians and as leaders we have a responsibility to drive this forward and to make the case for change, because we know that the prize is so great: thousands more people surviving and thriving after stroke.”

F.A.S.T. | Can you recognise the signs of stroke?

The main signs of stroke can be remembered with the mnemonic “F.A.S.T”.


The face may have dropped on one side, the person may not be able to smile, or their mouth or eye may have dropped.


The person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in one arm.


Their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.


It’s time to dial 999 immediately if you see any of these signs or symptoms.

Such changes can prove controversial because they mean local hospitals lose major services, which can stoke political rows.

But charities said the measures were crucial to save lives, urging NHS leaders not to delay making such changes.

Juliet Bouverie, chief executive of the Stroke Association, warned “time lost is brain lost”.

She said: “When stroke strikes, part of your brain shuts down. And so does a part of you.

“That’s because a stroke happens in the brain, the control centre for who we are and what we can do.

“The evidence shows that reorganising stroke services to create stroke centres of excellence saves more lives and enables survivors to leave hospital sooner to start their recoveries at home.

A stroke happens when the blood supply to the brain is cut off, caused by a clot or internal bleeding.

Every year more than 150,000 Britons have a stroke – and it is the leading cause of complex disability.

The units have operated in London since 2010 and Manchester since 2015.

Before their introduction, patients were taken to the nearest hospital A&E department in the capital to receive immediate care, followed by treatment on a general ward.

An independent analysis into the change showed that patients are now more likely to receive the right treatment sooner, and are therefore more likely to survive and recover faster.

The study from University College London, funded by the National Institute for Health Research, reviewed data from 500,000 hospital admissions for patients between 2008 and 2016 and compared the rate of stroke survival and the time patients spent in hospitals in London and Greater Manchester compared with other urban areas in England.

Chief investigator Professor Naomi Fulop said: “Our research provides robust evidence for centralising acute stroke services in urban areas. This may mean that patients are taken by ambulance past their local hospital to a specialist centre in order to save lives.”

More than three in five strokes could be prevented if major triggers were treated, such as reducing high blood pressure and raised cholesterol.

Professor Powis also wants the NHS to prevent more strokes, by providing lifestyle advice and medication sooner.

NHS England has launched a £9m programme to support 20,000 people with heart problems in 23 areas with the highest rates of stroke.

The scheme will see specialist nurses and clinical pharmacists identify sufferers from the heart condition atrial fibrillation but aren’t receiving treatment, so that they can be offered lifestyle advice and help to get them on the right treatment.

Health chiefs hope it will prevent around 700 strokes, saving an estimated 200 lives.

More than three in five strokes could be prevented if major triggers were treated, such as reducing high blood pressure and raised cholesterol.

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