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London Ambulance Service

Working together with NHS Trusts for world-class care

Whilst the designation and preparation of the Hyper Acute Stroke Units (HASUs) and the Stroke Units (SUs) across London are an enormous achievement, the success of the stroke project is also dependent upon the collaboration of those who transport the patients - the London Ambulance Service.

Using ambulance staff's existing knowledge of the FAST test and other clinical assessments, the Service has ensured that crews are educated about the new pathway for stroke patients and the potential benefits of receiving thrombolysis within the appropriate timeframe. Through pre-alerts to the receiving HASU, the Service can ensure that required capacity and staff resources are seamlessly available to patients.

Since February 2010

Since February, the first phase of implementation of the stroke model, the Service has created new processes, ramped up staff training and worked together in support of the stroke project. They have introduced a clinical coordination desk in their emergency operations centre that provides clinical advice for crews, capacity monitoring and demand management.

The clear commitment to patient care is evident each and every time the Service responds to a call.
  • The percentage of FAST positive patients taken directly by ambulance to HASUs versus non HASUs has been continuously increasing. Since February, the Service has been taking patients within the 4.5-hour timeframe directly to HASUs and already 70 per cent of patients are benefitting from this care, up from 48 per cent in October 2009. From 19th July all stroke patients displaying stroke symptoms will be taken directly to a HASU.
  • The average journey time from scene to HASU was less than 15 minutes (as per April data).
  • The average journey time from original 999 call to arrival at a HASU was under an hour (as per April data).

Looking ahead

The Service is always exploring more tools and ways to increase the number of patients to benefit from being taken directly to a HASU. For example, the Service is currently running a study using the Recognition of Stroke in the Emergency Room (ROSIER) assessment method which identifies stroke patients with more subtle symptoms.

The London Stroke Strategy is a project that requires enormous levels of teamwork and collaboration. Working in partnership, the hospital trusts and the Service are providing all Londoners with rapid access to the best stroke care, at levels never before seen in the capital.

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ED to HASU transfer policy
Developed by the Service and the pan-London stroke networks


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New stroke services pathway