Stroke survivors are "being put at extreme risk by ambulance delays", a health charity warned.
Phil Woodford, originally from Hoylake, was "terrified" when he realised why "water was coming out my mouth out one side". After stumbling inside, slurring his words and blinking to clear a sensation like someone shining a torch in his eye, he called North West Ambulance Service (NWAS).
Their response six years ago was fast. Within 15 minutes, paramedics arrived at his home near Preston, Lancashire, and took him to Royal Preston Hospital, despite his symptoms having cleared. Doctors diagnosed the dad of two with a transient ischaemic attack (TIA) - also called a mini-stroke - at the age of 45.
READ MORE: As corridors fill with patients, hundreds are unable to leave our crisis-hit hospitals
He was still there the next day when he "slammed down on the floor" in the shower with another, more serious stroke. Phil, who works as a director at an NHS Trust, told the ECHO: "After about 10 minutes I was found. I couldn't talk so the shouting was really difficult asking for help. I was able to reach the bin and bang the bin against the wall until someone could hear me."
The clock was already ticking. There's a narrow window for administering the most effective treatments that reduce the long-term effects of stroke, one of the biggest causes of death and disability in the UK. Nearly 2m brain cells die every minute a stroke isn't treated. As Phil put it: "The longer you go without treatment, the more of the brain you lose if you've had a stroke."
He was given thrombolysis, a clot-busting injection which must be given within four and a half hours of stroke symptoms starting. Another treatment - mechanical thrombectomy, described by the Stroke Association as a "miracle treatment" - reduces the risk of disability from a stroke by removing blood clots from blocked arteries, restoring the flow of oxygen to the brain.
There's a 24-hour window for administering thrombectomy, the first six of which are when it's most effective. But Phil "was selfish enough to have a stroke at the weekend" when the necessary staff weren't working, so he couldn't have the treatment despite being eligible for it.
He ended up spending months in hospital and, even after rehab, he still suffers permanent pain, bladder issues and problems with his joints caused by weakness down one side of his body. Phil, now 52, said: "After spending nearly five months as an inpatient in hospital, and then another six months going through rehabilitation so I could learn to walk again, I know how hard everybody's working.
"They did a great job putting me back together, the doctors, nurses and the therapists, but I'm really bitter on the other hand, but those they work for didn't see sense to plan for night time or weekend working. People don't have strokes to o'clock, so that I'm a bit bitter about. I think it's really short sighted.
"Whatever the costs would have been are probably outweighed by the costs of domiciliary care coming my home for a couple of months when I needed it, or lifelong medication and therapy. For many people, they never return to work."
The NHS has made efforts to extend access to life-changing stroke treatments like thrombectomy, but last year, the Stroke Association warned 47,000 people could be left disabled over the next seven years due to a "postcode lottery" and a lack of 24/7 services.
Now the charity is "extremely worried" that "stroke survivors' lives and recoveries are being put at extreme risk by ambulance delays". NWAS aims to respond to category two calls - which includes strokes - within 18 minutes. It achieved that for Phil in 2016, but last December - "the second busiest month of the year in terms of calls", according to NWAS - the average response time for category two was one hour 13 minutes in the North West.
Janice Taylor, an NWAS emergency medical advisor who spoke to the ECHO on a picket line this week, said she feels helpless when telling people they'll wait hours for paramedics to attend a suspected stroke or heart attack. The 40-year-old said: "You come off and you go, 'Oh, that's great, I've just had to tell her two and a half hours', she's having a stroke, she was having a stroke two hours ago.
"Four hours critical, irreparable damage. And we can't do anything because we haven't got enough staff. We've got staff who are on long-term stress because it's hard. It's having an effect on everyone."
The ambulance service told the ECHO it "performs better than other parts of the country" but "remains under extreme pressure" and is "working with NHS partners to ease handover delays" at A&E. Phil described the delays he hears about as "frightening", saying: "I feel angry. I don't feel angry at the ambulance service, I really support them and I guess I'm biased because I once worked there. I support them with everything they're going through trying to do their very best, but the investment needs to be there."
Juliet Bouverie, chief executive of the Stroke Association, said: "Stroke is a medical emergency and every minute is critical. Treatment for stroke is time sensitive, so getting the best treatment in the quickest time is key to survival. Every minute stroke goes untreated 1.9 million brain cells die.
"It's vital that suspected stroke patients call 999 as soon as they see the signs of stroke, are sent ambulances rapidly and are quickly admitted to the right specialist stroke units. This way so they can receive time-sensitive, life-saving treatments.
"We're extremely worried at the Stroke Association that stroke survivors' lives and recoveries are being put at extreme risk by ambulance delays. Every minute waited is a shortened chance of survival or weeks more rehabilitative therapies. These delays are causing severe disability and even death. This has life-threatening consequences for thousands of stroke patients across the country.
"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. This Government must act now to address immediate issues – including ambulance delays and transfers, handover at A&E, in hospital care and patient discharge – and provide resources and funding to create sustainable emergency care for the future."
An NWAS spokesperson said: "The ambulance service remains under extreme pressure, and December was the second busiest month of the year in terms of calls. However, our staff work hard every day to ensure everyone who needs an ambulance gets one, and we continue to perform better than other parts of the country.
"While patients suffering from life-threatening conditions do receive the next available ambulance, some patients are waiting longer than we would like. Improvements to our call centres mean we are now offering health advice to more patients over the phone without the need to send an ambulance.
"Consequently, well under 50% of our patients actually go to the hospital. We also continue working with NHS partners to ease handover delays. We are grateful to patients for considering alternatives for non-urgent health concerns, including NHS 111 online, GP or local pharmacy, which helps us keep our ambulances available for emergencies."
Receive newsletters with the latest news, sport and what's on updates from the Liverpool ECHO by signing up here
READ NEXT
