PERFORMANCE: Paramedics at London Ambulance Service Trust need to be better trained to recognise the symptoms of stroke, a patient’s group has said.

The patients’ forum for London Ambulance Service said not all paramedics are able to accurately use the “Face Arms Speech Time” test to assess if someone has suffered a stroke.

The Mayor of London’s office has written to the trust to raise the forum’s concerns.


The trust said in 2014 there were times when crews ‘appeared to have

The Care Quality Commission inspected the service this month. The patients’ forum included its stroke concerns as part of the feedback to the regulator.

The forum has called for refresher training for paramedics “to ensure that the use of the FAST test is fully understood by all frontline clinicians”.

This follows an incident last year where a woman suffered a stroke. The woman’s partner, Courtney Grant, said the paramedics did not recognise she was having a stroke and only treated her for stroke symptoms more than an hour after arriving at the scene.

The woman now has no movement in her right arm, limited movement in her right leg and difficulty speaking.

The Parliamentary and Health Service Ombudsman is looking into Mr Grant’s complaint.

Mr Grant said he was told that the paramedics were unable to draw a conclusion from the FAST test because his partner could not speak. Inability to speak is one sign of a stroke.

He said: “As confirmed by the formal complaint response that I received, a FAST test was administered on three separate occasions, each of which was determined to be inconclusive on the grounds that she was still unable to speak, so her speech could not be assessed. As confirmed by the statement from the paramedic, they only decided to eventually treat the last FAST test as positive in order to ‘err on the side of caution’.”

In March last year the trust wrote to staff in its regular “clinical update” to say there had been a number of clinical incidents where crews “appeared to have ‘missed’ signs of a stroke”.

A trial at Northwick Park Hospital last year showed that 19 per cent of patients who received thrombolysis for stroke had not been identified as having a stroke by ambulance crews. Many of these patients failed on the speech element of the FAST test, the ambulance service said.

A spokeswoman for London Ambulance Service said: “Our crews are highly-skilled clinicians who are all trained to carry out the Face Arms Speech Test (FAST), and to take into account as much other information as is available.

“We work very closely with the London Stroke Network to ensure that our stroke pathway and teaching materials are appropriate for London.”