Yorkshire Ambulance Service medical director Alison Walker is a Health Foundation Leadership Fellow. She has been working on a project to redesign ambulance services to deliver faster and higher-quality care for people who have had a heart attack, resulting in increased survival rates.

The UK has one of the worst heart attack rates in the world, accounting for one in four deaths in men and one in six in women. Yet most people who survive the first month after a heart attack are alive five years later, so prompt and appropriate care is essential.

Alison's project aimed to increase the number of heart attack patients in Yorkshire who receive an angioplasty, which recent evidence shows can often be the best treatment. Alison explains: "A balloon is fed through a vessel in your groin into your heart, where it dilates the vessel that's causing the obstruction to blood flow."

Unlike traditional clot busting drugs, there are no side effects, such as strokes or bleeds. Moreover, angioplasty increases survival rates and has a better effect on the heart.

Specialist centres in Middlesbrough and Leeds can perform an angioplasty. Alison's team set out guidelines for paramedics that allow them to take patients straight to one of these centres in certain circumstances.

The project has been an enormous success and local hospitals are showing increased survival rates from heart attacks. The learning will be used to inform an upcoming stroke management initiative in Yorkshire.

For more information, see www.health.org.uk

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