New emergency ambulance category for stroke patients introduced in Wales
In a landmark move to improve emergency care, Wales is introducing a new 'orange' ambulance category specifically for people suspected of suffering a stroke. This change, in effect from this winter, marks a significant shift in how emergency services prioritise and respond to one of the most time-critical medical emergencies.
Currently, stroke patients tend to be grouped under the broad 'amber' category, which accounts for around 70 per cent of all 999 calls. This category lacks a specific response time target and includes a wide range of conditions, meaning stroke cases can face delays in receiving the urgent care they need.
The new orange category aims to change that by identifying stroke and STEMI (a severe type of heart attack) cases earlier and ensuring they receive faster, more specialised pre-hospital treatment – and make it to hospital more quickly.
In stroke care, every minute counts. Around two million brain cells are lost for each minute a stroke goes untreated. Rapid intervention can mean the difference between a full recovery and a lifetime of disability, or even death.
The orange category will be supported by specialist screening of 999 calls by trained nurses and paramedics to ensure stroke symptoms are recognised quickly and accurately, allowing for faster dispatch of appropriate help.
Importantly, while the new category won’t have a fixed response time target, data on average and longest response times—as well as the quality of care provided before hospital arrival—will be recorded.
A pilot 'video triage' scheme is also underway, enabling paramedics to consult stroke specialists in real time before the patient even arrives at hospital.
At Fieldfisher, we regularly see the devastating consequences of delayed stroke diagnosis and treatment. I currently act for a man in England who collapsed and called an ambulance, but it took them 1.5 hours to arrive, even after multiple calls to 999. The ambulance crew then took 30 minutes to assess him at home before taking him to hospital.
The client had informed 999 that he was suffering a stroke as he had slow slurred speech and his tone was abnormal. The response time for a category 2 ambulance and average response time should be 18 minutes.
My client was eventually transported to Charing Cross Hospital’s stroke unit. But by the time he received a scan, the window for thrombolytic medication, which dissolves clots, had closed. There was a clot blocking half his artery, but medical staff chose not to operate due to the risks. My client now lives with life-changing injuries that could well have been prevented with faster response and treatment.
This new category coming in Wales has the potential to reduce those delays and improve survival and recovery rates and could well become a model for other parts of the UK.
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