Diolch, Llywydd. Our motion today proposes that this Senedd notes that World Stroke Day is 29 October 2022, recognises the urgent response required to prevent danger to life for people suffering a stroke, and instructs the Senedd's Health and Social Care Committee to conduct a review into the benefits and challenges of recategorising strokes as red calls, immediately life-threatening, under the clinical response model.

World Stroke Day takes place on 29 October every year. It provides an opportunity to raise awareness of the serious nature and high rates of stroke, and to talk about ways in which we can reduce the burden of stroke through better public awareness of the risk factors and signs of stroke. It is also an opportunity to advocate for actions by decision makers at global, regional and national levels, which are essential to improve stroke prevention, access to acute treatment and support for survivors and care givers. For 2021 and 2022, the campaign is focused on raising awareness of the signs of stroke and the need for timely access to quality stroke treatment.

Across the UK, a stroke happens every five minutes. An estimated 7,400 people a year in Wales experience a stroke—the fourth leading cause of death in Wales. A further 70,000 stroke survivors live in Wales and, without early intervention and diagnosis, significant harm to the patient, or chance of death, subsequentially increases—this is substantially.

According to the Stroke Association, there are three different types of stroke: ischaemic, the most common type of stroke, found in about 85 per cent of cases, caused by a blockage cutting off the blood supply to the brain; haemorrhagic, caused by bleeding in or around the brain and apparent in 15 per cent of cases—this is the most severe type of stroke; and the transient ischaemic attack, also known as a mini stroke, where the symptoms only last for a short amount of time. 

Strokes are a conditions where the golden hour is vital. Certain acute conditions, including stroke, have 60 minutes to receive definitive care. Any later, and harm, including brain damage, physical disability and mortality, can increase significantly. Quality standards for strokes in adults, published by the National Institute for Health and Care Excellence, also highlight that patients with acute stroke should receive brain imaging within one hour of arrival at hospital should they meet any indicators for immediate imaging. NICE and the Stroke Association recommend the use of thrombolysis, or clot-busting medicine, within four and a half hours of an ischaemic stroke. According to NHS advice, alteplase, the medication used for treatment, is most effective if started as soon as possible after the stroke occurs, and certainly within four and a half hours. The NHS further notes that medication is not generally recommended if more than four and a half hours have passed, as it's not clear how beneficial it is when used after this time, and that it is vital that a brain scan is done to confirm diagnosis of an ischaemic stroke, as the medicine can make bleeding that occurs in haemorrhagic strokes worse.

Latest Sentinel Stroke National Audit Programme data, or SSNAP data, showing hospital performance on stroke management across England and Wales, highlights a decline in appropriate care for stroke patients. Once arrived in hospital, stroke patients must be scanned within an hour, according to NICE, yet three hospitals in Wales took longer than this target time to scan a patient.

The SSNAP data, which scores Welsh NHS responses to key indicators, such as time to scan, time to treatment and time to admission to stroke units, highlights some concerning trends in Welsh hospitals. Their scores range from A, or hospital meets the highest standards for almost all patients, to E, or hospital does not meet the highest standards for almost all patients. The latest overall scores for Welsh hospitals were D for all hospitals apart from Withybush, which scored a C, with, for example, all three district hospitals in north Wales scoring E for admission to stroke units in their latest disclosed figures.