POOR ambulance response times have been blamed for some stroke victims in Powys missing out on a vital emergency treatment.

People who have had a stroke in Powys have been among those least likely in all of Wales or England to receive thrombolysis.

Patients whose stroke has been caused by a blood clot can receive thrombolysis - treatment using a clot-busting drug to return blood supply to the brain. Thrombolysis must normally be given within four and a half hours of stroke symptoms starting.

But a report for Powys teaching Health Board identified during 2014 people who had a stroke in Powys were less likely to receive thrombolysis than most other places in England and Wales. The figure improved during the first quarter of 2015.

During that period, of 163 stroke cases the health board was able examine only 17 people were thrombolysed with the other 146 ineligible for some reason.

Crucially of 81 people who knew when their symptoms started 45 people had arrived at hospital outside of the time window for thrombolysis including 30 who’d been brought to hospital by ambulance.

The report also showed disparities in thrombolysis rates between the different district general hospitals which accept patients from Powys.

Nevill Hall Hospital in Abergavenny administered thrombolysis to just under 5% of stoke patients during the period, expect for the second quarter of 2014 when its thrombolysis rate was 10%.

The rate at Prince Charles Hospital in Merthyr Tydfil halved, from 20%, from the first quarter to the second quarter of 2014 and continued to decline for the following two quarters.

Hereford County Hospital’s thrombolysis rate only dipped below 5% once, during the third quarter of 2014. Morriston Hospital in Swansea achieved consistently high rates, including above 20% in the third quarter of 2014.

Morriston’s rate only dropped below 15% in the first quarter of 2015 - when the overall rates improved to above the national average of just over 10%.

During the period there was also a steady improvement in thrombolysis rates at Aberystwyth’s Bronglais Hospital.

A spokesman for Powys teaching Health Board said all eligible patients who arrive at hospital within the time window are given thrombolysis and it is hoped work with the ambulance service will increase the figure.

The spokesman said: "We are working to understand why some patients do not reach hospital within the window and will be taking steps to both help increase awareness of how to identify a person having a stroke and are working with the Welsh Ambulance Service Trust (WAST) to improve response rates.

"WAST has recently started a new model for prioritising emergency calls and has improved its response rates as a result. We hope to see an increase in the number of patients receiving thrombolysis as a result."

The health board is also part of the National Stroke Implementation Group which is looking to improve thrombolysis rates across Wales and looking at evidence that may increase the eligibility criteria for receiving the drug.

The health board has reminded people that facial weakness, arm weakness such as being unable to raise both arms and keep them up, and speech problems are warnings of a stoke.

It’s spokesman said: "If you see any one of these three signs, it’s time to call 999. Stroke is always a medical emergency that requires immediate medical attention."

A spokeswoman for the Welsh Ambulance Service said it treats strokes as a medical emergency and works with hospitals across Wales to ensure suspected stroke patients are seen as quickly as possible.

She said: "We will continue to work closely with Powys teaching Health Board to ensure improvements are continually made that benefit our patients.

"Whenever a stroke is suspected by ambulance crews, the hospital is contacted to alert them of the patient’s condition and the estimated time of arrival, with the aim of ensuring the patient receives the right care quickly, including a CT scan.

"Critically ill patients – like stroke patients – are handed over as quickly and as safely as possible to hospital staff."

The ambulance service also reminded the public of the ’The FAST’ (Face, Arm, Speech, Time) test to help people recognise the tell-tale signs of a stroke.

"It involves checking a person’s face for signs of weakness or facial droop, their arms for weakness, and their speech for slurring, or difficulty speaking.

"Time is of the essence, so if any or all of these signs are present, it is important to dial 999," said the spokeswoman.