CompletedInterventional

Specialist pre-hospital redirection for ischaemic stroke thrombectomy (SPEEDY)

When someone has a stroke caused by a blood clot, every minute counts. Around 1 in 10 stroke patients can benefit from an emergency procedure called a thrombectomy, which mechanically removes the clot from the brain. However, this procedure is only available at specialist regional hospitals. Most patients are first taken to their nearest local hospital and then transferred, which can delay treatment by more than an hour and a half. The SPEEDY trial is finding out whether ambulance crews can speed this up. Participating ambulance teams are randomly assigned to either continue standard care or use a new system. Under the new system, paramedics speak directly with hospital specialists to decide if the patient should skip the local hospital and travel straight to the specialist centre. The study will see if this new approach improves recovery times and overall care for stroke patients.

At a glance

Status

Completed

Sponsor

Newcastle upon Tyne Hospitals NHS Foundation Trust

Enrolment target

80,000

Start

01 Sep 2022

Estimated completion

31 Dec 2025

Suspected and confirmed acute stroke

What is this study about?

A stroke is a serious medical emergency that happens when the blood supply to part of the brain is cut off. For many people, this is caused by a blood clot blocking an artery. An emergency procedure called a thrombectomy can pull the clot out of the brain using a tiny wire tool. When done quickly, it dramatically improves a person's chances of walking, talking, and living independently again.

The challenge is that thrombectomy is a complex procedure only offered at large, specialist regional hospitals. At the moment, ambulance crews usually take suspected stroke patients to the nearest local hospital first. If doctors there decide a thrombectomy is needed, the patient must be transferred by ambulance to the specialist centre. This extra journey can delay treatment by 90 minutes or more, reducing the chances of a full recovery.

The SPEEDY study is testing a new care pathway to see if patients can safely skip that middle step. In participating areas, ambulance teams will phone specialist stroke doctors from the patient's home or ambulance. Together, they will decide whether the patient should be taken straight to the specialist regional hospital. Researchers will compare patients treated this way with those receiving standard emergency care to see which approach works best.

Key takeaways

SPEEDY is testing whether taking stroke patients directly to specialist hospitals speeds up clot-removal treatment.
The study compares a direct-transfer pathway against standard emergency hospital care.
Paramedics and hospital specialists discuss the patient's symptoms by phone before deciding where to travel.
Participation happens automatically during emergency 999 calls in participating UK ambulance regions.
The ultimate goal is to reduce long-term disability by cutting out hospital transfer delays.

Who may be eligible?

This trial is open to people of any age and gender who call 999 with a suspected or confirmed acute stroke in participating areas of the UK. You do not need to sign up in advance to be included.

To be part of the study, you must be attended by an ambulance team that is taking part in the research. Your ambulance must be heading either to a local hospital that refers patients for thrombectomy, or directly to the specialist regional hospital providing the treatment.

You will not be included if your ambulance crew is not part of the trial or if your emergency transport is to a hospital outside the study network.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

You have suffered a suspected or confirmed sudden stroke.
An emergency 999 call was made within a participating UK region.
The attending ambulance crew is part of the SPEEDY trial.
Transport is arranged to a participating local or specialist regional hospital.

Answer every question to see your result.

What does participation involve?

Because stroke is an emergency, patients do not take part in planned research visits, appointments, or extra medical tests. Instead, whole ambulance stations or paramedic teams are randomly selected to provide either the new pathway or normal standard care. If your ambulance team is using the new pathway, they will carry out a quick assessment and call the specialist stroke hospital to discuss your care. If appropriate, they will drive you directly to that specialist hospital instead of your local one. You will receive all standard emergency stroke medications and treatments as normal. Researchers will follow your medical journey by collecting routine information from hospital records, comparing treatment speeds and recovery outcomes over the course of the study, which runs until March 2027.

Potential risks and benefits

The main potential benefit is that patients who need an emergency thrombectomy might receive it much faster, which could lead to better brain recovery and less long-term disability. However, there is a risk that a patient could be taken on a longer journey to a specialist hospital when they might have been treated just as well at their local hospital. The direct phone consultation is designed to minimise this risk. Because this is an emergency care study using routine health data, you do not have to do anything extra, but you or your family always have the right to ask questions or request that your health data is not used in the research.

Locations (10)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

North East Ambulance Service NHS Ft
City only
Newcastle upon Tyne, England
The Newcastle upon Tyne Hospitals NHS Foundation Trust
City only
Newcastle upon Tyne, England
North West Ambulance Service NHS Trust
City only
Bolton, England
Lancashire Teaching Hospitals NHS Foundation Trust
City only
Preston, England
Salford Royal NHS Foundation Trust
City only
Manchester, England
West Midlands Ambulance Service University NHS Foundation Trust
Unverified
Brierley Hill, England
University Hospitals of North Midlands NHS Trust
Unverified
Stoke-on-trent, England
University Hospitals Birmingham NHS Foundation Trust
Unverified
Birmingham, England
South Western Ambulance Service NHS Foundation Trust
Unverified
Exeter, England
North Bristol NHS Trust
Unverified
Bristol, England

Common questions

What is a thrombectomy?

A thrombectomy is an emergency procedure where doctors insert a thin tube into an artery to physically pull out a blood clot that is blocking blood flow to the brain.

Do I or my family need to give consent before ambulance travel?

Because a stroke is a life-threatening emergency where every second matters, the ambulance team will follow their allocated pathway immediately. Information about the study and how your data is used will be provided once you are safe in hospital.

Will taking part delay my emergency care?

No. The phone call between paramedics and specialists is very quick, and the goal of the study is to speed up treatment, never to delay it.

What happens if I go to the specialist hospital but do not need a thrombectomy?

The specialist hospital has fully equipped stroke units that can provide all other standard stroke treatments, such as clot-busting medicines. Once you are stable, you can be transferred back closer to home if needed.

Can I opt out of having my data used?

Yes. You or your family can speak to the hospital research team at any time to request that your medical records are excluded from the study analysis.

How to find out more

Lisa Shaw

lisa.shaw@newcastle.ac.uk +44 (0)191283826 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.