New analysis of NHS data shows that for 2023-24 of 41,327 patients with a recorded time of symptom onset, the average time between first symptom and a 999 call being made was 88 minutes.
The figures come as the NHS today launches the first major update to the ‘Act FAST’ campaign since 2009, urging the public to call 999 immediately if anyone experiences one of the three common symptoms including struggling to smile (Face) or raise an arm (Arms), or slurring their words (Speech).
England’s top doctor today urged the public to call 999 even if the first sign of stroke doesn’t seem like an emergency, and said immediate action at the first sign of a stroke “could help save and protect many more lives”.
The analysis has been published today by the Sentinel Stroke National Audit Programme at King’s College London and comes as new polling of 2,001 adults in England found that 57% of respondents believed you should have 2-3 symptoms of a stroke before calling 999, despite just one being a sign of a medical emergency.
Nearly two thirds of respondents (64%) said they would not call 999 as their first course of action if they noticed someone was suddenly struggling to smile.
The NHS campaign launches with a brand new TV advert showing example symptoms – a man recognising his partner is struggling to smile while watching TV (Face), a decorator suddenly unable to lift their paint roller (Arm), and a grandmother struggling to read their grandchild a bedtime story (Speech) – which will run across TV, TV on demand and radio in England until mid-December.
As part of the campaign launch, a powerful new film has also been released which features stroke survivors listening back to audio recordings of the real 999 calls that saved their lives.
Professor Sir Stephen Powis said: “These figures highlight very clearly that we must do more to support people to recognise the symptoms of stroke in themselves and others and take action to call 999 at the earliest opportunity. Stroke symptoms can be less obvious or dramatic than you might expect, but even if it doesn’t seem like it, any sign of stroke is always an emergency and it’s vital you call 999 immediately.
“This campaign is so important – greater awareness of the need to act fast and dial 999 could help save and protect many more lives, as we know that earlier recognition of symptoms and immediate action to call 999 can enable faster access to specialist treatment and the best chance of reducing long-term effects of a stroke.”
Around 100,000 people have a stroke each year in the UK, which occurs when the blood supply to part of the brain is cut off. Without prompt treatment a stroke can result in death or long-term disabilities such as paralysis, memory loss and communication problems.
While more people are now surviving a stroke than ever before thanks to advances in NHS care, strokes remain the fourth single leading cause of death in the UK, with 38,000 stroke-related deaths each year.
A stroke can happen to anyone at any age, but those at increased risk include people aged over 50 years old, people from a Black or South Asian background, or those living with existing conditions such as high blood pressure, diabetes or sickle cell disease.
Dr David Hargroves, NHS national clinical director for stroke and consultant stroke physician, said: “When someone has a stroke, it’s estimated they may lose around two million brain cells a minute, which is why rapid diagnosis and treatment is critical – the first sign of a stroke might not seem like much, but face or arm or speech, at the first sign it’s time to call 999.
“Thanks to greater awareness of the symptoms and advances in NHS care, more people are now surviving a stroke than ever before, but there is much more to do help save lives and reduce the long-term impact of strokes. Acting FAST remains vital – whether it is a friend, loved one or even a passer-by, dialling 999 quickly saves lives.”
NHS ambulance teams are trained to recognise the symptoms of a stroke, ensuring anyone having one receives emergency medical care and specialist treatment.
One of the survivors involved in the campaign, Dionne Hudson, 58 from Surrey, had an ischaemic stroke in July 2024. When her arm went numb one evening and she couldn’t grip her phone, she assumed it had been from lying on it on the sofa.
While she couldn’t raise her arm, her face and speech were unaffected, so she assumed that it couldn’t be a stroke and went to sleep. When she woke, her symptoms had worsened and her leg also felt weak, so Dionne called 999. Within 25 minutes of making the call, she was in hospital having a CT scan. Dionne had experienced an ischaemic stroke and was partially paralysed on the left side of her body. Doctors told her that it was a miracle she had survived the stroke but warned her that recovery could take up to a year.
Following treatment, Dionne returned home after eight days in hospital, where she now continues her rehabilitation. While she is still in the very early stages of recovery, Dionne is feeling positive about the future and is already able to do a number of tasks that she was unable to do following her stroke.
Dionne said: “The doctors were amazed that I had survived my stroke, as it had actually occurred the night before I called 999. Looking back, I was very lucky as the weakness in my arm was a clear sign of a stroke, but because I didn’t have a dramatic symptom affecting my face or speech, I didn’t consider that I should get help sooner. I’m so grateful for the quick response from the ambulance and hospital staff, as their care has meant I’m now at home with my husband and daughter and working hard on the road to recovery.”
Juliet Bouverie OBE, CEO of the Stroke Association, said: “Over 88,000 people survive a stroke every year in the UK, but surviving a stroke is just the start of a long and traumatic battle to finding their way back to life. Mums, dads, grandparents, young people, even children can be stroke survivors, and the impact of stroke on them and their loved ones can be catastrophic.
“This new NHS campaign is so important to help raise awareness that stroke is always a medical emergency. If you spot any of the three common signs of a stroke in someone, the first thing you should do is call 999. The quicker many stroke treatments are given, the better. As we say, “time is brain”, so it’s important to recognise any of the signs of a stroke and act immediately. Acting FAST is vital for stroke survival and to help improve the journey to recovery.”
Media medic and GP, Dr Amir Khan said: “A stroke strikes every five minutes in the UK, so it’s crucial everyone is aware of the most common symptoms of a stroke and acts FAST by calling 999. The first sign of a stroke actually might not seem like much, but every minute is vital – getting quick access to specialist treatment can be lifesaving and can reduce long-term disability. Whether someone is unable to raise their arm, struggling to smile or slurring when they speak – any sign is always an emergency and you need to call 999 immediately.”
Chef Brian Turner said: “I’m so lucky my agent Louise recognised that I was experiencing a sign of a stroke. She noticed that I couldn’t speak properly and immediately called 999, ensuring that I could get lifesaving treatment from the NHS. Without her, I wouldn’t be where I am now. I’m proudly supporting NHS England in urging the public to act FAST and call 999 at the first sign of a stroke.”
Jaqualine Lindridge, Chief Paramedic for South East Coast Ambulance Service, which handled stroke survivor Dionne’s 999 call, said: “We’re absolutely here to help. Getting to a definitive place of treatment is so crucial for people suffering from stroke. The sooner a person receives treatment, the better their chances of recovery and reducing long-term damage.
“We would really urge people not to wait for multiple symptoms and if in any doubt make the call as our staff are equipped with the knowledge and tools to help determine whether you are likely to be suffering a stroke.”
In the last few years, NHS teams have rolled out innovative new ways to find and treat more people with the major risk factors for cardiovascular health issues, including rolling out blood pressure checks in high-street pharmacies for people over 40, making free blood pressure monitors available to 220,000 people at increased risk, and rapidly rolling out blood-thinning drugs to help save thousands of lives.
Andrew Gwynne, Minister for Public Health, said: “It is important to treat a stroke quickly and raising awareness of symptoms is vital to saving lives.
“It is not just about recognising when a stroke is happening – we know that many of the causes of strokes are preventable, and this government is taking action to tackle the biggest killers such as heart disease and stroke.
“The NHS Health Check Programme aims to prevent cardiovascular disease, including stroke, in people aged 40-74 years through assessing risk factors such as blood pressure and referring people to behavioural support and clinical treatment to reduce their risk. Each year the programme engages over 1.3 million people and prevents around 500 heart attacks and strokes a year.
“We are currently developing a new digital NHS health check enabling people to complete this life saving check in their own home”.
Jessica Cunningham, Executive Director of Operations at South Western Ambulance Service NHS Foundation Trust, said: “We are proud to support the NHS England stroke campaign to raise awareness of stroke symptoms and the importance of acting fast.
“Every second counts in a stroke emergency, and our call takers and clinicians within our emergency operations centres are highly trained to recognise the signs and provide life-saving guidance to those calling 999.
“This campaign shines a spotlight on their essential role and the critical first step of dialling 999. We hope this initiative encourages the public to recognise stroke symptoms quickly and not hesitate to call for help”.
