West Midlands Ambulance Service University NHS Foundation Trust serves 5.6 million people across 5,000 square miles. It has the UK’s second city, yet over 80% of the region is rural.

WMAS is the pilot ambulance service for the SPEEDY (Specialist pre-hospital redirection for ischaemic stroke thrombectomy) study, which is testing a new pathway for direct admission to thrombectomy centres. Mechanical thrombectomy is a powerful treatment for blood clots in large arteries in the brain, but it is only available at specialist regional hospitals; secondary transfer from local hospitals to these typically delays thrombectomy by at least 90 minutes and reduces its benefit. We are testing a new pathway to see if ambulance crews and hospital clinicians can identify suitable patients to go directly to the specialist centres, rather than their nearest stroke hospital. The study has grown from its beginnings in WMAS to now include 7 hospitals across 5 English ambulance services.

WMAS are experienced in delivering high-quality research. We have: taken part in all three PARAMEDIC cardiac arrest studies; developed and tested the candidate national major trauma triage tool in the MATTS study; compared ketamine and morphine as one of the two Trusts delivering PACKMAN; and tested pre-hospital blood products against routine fluid treatment in RePHILL. Our patient records are electronic, so research data is easily and securely available without the delays of paper-based systems. We have just 15 ambulance stations, making study delivery and monitoring straightforward, and almost every ambulance is crewed with a paramedic, making research requiring paramedic skills more readily achievable.