First reported 19 Oct 2020•Latest report 10 Sep 2025
Definition
What this concern includes
Includes failures of explicitly regional or centralised arrangements for time-critical specialist care, including inadequate specialist-centre capacity, absent or unreliable mutual aid, transfer support and cross-service arrangements needed to deliver urgent interventions.
Not included
Excludes failures confined to a single named clinical treatment pathway where no regional or centralised specialist-care arrangement is deficient.
Excludes generic hospital, ambulance or workforce capacity problems unless they directly impair regional provision or mutual aid for time-critical specialist care.
Excludes ordinary referral, communication or transfer delays where regional specialist capacity or mutual aid is not the shared unsafe condition.
Excludes non-urgent, elective or routine specialist-care access concerns.
Reports
5
Distinct published reports
Individual concerns
5
A report can raise multiple concerns
Date range
2020–2025
First to latest report issue date
Stated actions
18
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
NHS England3
Blackpool Teaching Hospitals NHS Foundation Trust1
Department of Health and Social Care1
East of England Ambulance Service NHS Trust1
Lancashire Teaching Hospitals NHS Foundation Trust1
Northern Care Alliance NHS Foundation Trust1
the Newcastle Upon Tyne Hospitals NHS Foundation Trust1
NHS trust4
Executive non-departmental public body3
Ministerial department1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Newcastle and North Tyneside
Concerns raised1
Unavailability of mechanical thrombectomy services outside 9.00am to 5.00pm
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Established a multidisciplinary Mechanical Thrombectomy Steering Group to develop and oversee a plan for achieving 24/7 service provision.
Stated by the Newcastle Upon Tyne Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 19 September 2025.
Action
Implemented a joint interventional neuroradiologist rota with James Cook University Hospital, providing sufficient neuroradiologist capacity for 24/7 service delivery.
Stated by the Newcastle Upon Tyne Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 19 September 2025.
Action
Reviewed the clinical model and service costs, then submitted a revised 24/7 Mechanical Thrombectomy model and costing to NHS England.
Stated by the Newcastle Upon Tyne Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 19 September 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
The Trust cannot expand mechanical thrombectomy to 24/7 without adequate funding to recruit additional clinical staff.
Stated by the Newcastle Upon Tyne Hospitals NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Approval and funding for expanded mechanical thrombectomy services must be provided by NHS England and commissioners.
Stated by the Newcastle Upon Tyne Hospitals NHS Foundation TrustRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Lancashire and Blackburn with Darwen
Concerns raised1
Lack of regional mutual aid for thrombectomy
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.8
Action
Establish regional mutual-aid arrangements by engaging neighbouring thrombectomy centres and progressing a coordinated support agreement.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 10 June 2025.
Action
Conducted initial regional-aid discussions and assessed the impact of potential support on Salford Royal services.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 10 June 2025.
Action
Convene a regional stakeholder meeting with Salford Royal Hospital and The Walton Centre to scope coordinated mutual aid.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 10 June 2025.
Action
Monitor progress against the 24/7 service and regional-aid plans through monthly executive review.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 10 June 2025.
Action
Work with regional stakeholders and clinicians to explore and progress plans for overnight thrombectomy access across Lancashire and South Cumbria.
Stated by Northern Care Alliance NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 10 June 2025.
Action
Support an options appraisal of regional nighttime thrombectomy models to improve equal access across the North West.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 10 June 2025.
Action
Visit comprehensive stroke centres and issue measurable recommendations to improve thrombectomy access, workforce capacity and inter-centre coordination.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 10 June 2025.
Action
Establish regional thrombectomy aid arrangements by contacting neighbouring providers, assessing options and convening a stakeholder meeting.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 10 June 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Regional mutual aid is not currently agreed because neighbouring services face fragility and logistical challenges across the North West.
Stated by Lancashire Teaching Hospitals NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Concerns about thrombectomy provision and clinician understanding in Lancashire fall outside the Trust’s commissioned Greater Manchester functions.
Stated by Northern Care Alliance NHS Foundation TrustOutside remitThe respondent said that this matter was outside its role or authority.
Suffolk
Concerns raised1
Inadequate means for delivering centralised exigent care through regional centres
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Provide £200 million of additional ambulance funding to expand capacity and improve response times.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 19 January 2024.
Action
Deliver new ambulances and specialist mental health vehicles.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 19 January 2024.
Action
Increase the NHS ambulance and support workforce.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 19 January 2024.
Action
Boost the number of paramedics by up to 15,600 through the NHS Long Term Workforce Plan.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 19 January 2024.
Action
Review the National Framework for Inter-Facility Transfers with NHS England in light of the death.
Stated by The TrustStated plannedThe respondent said that this action was planned when they made their response on 19 January 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Centralised PPCI care is clinically justified because specialist centres provide superior outcomes and continuous expert cover.
Stated by NHS EnglandDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Centralising care in regional centres falls outside the ambulance service’s scope.
Stated by The TrustOutside remitThe respondent said that this matter was outside its role or authority.
Lancashire and Blackburn with Darwen
Concerns raised1
Failure of regional coordination of thrombectomy services
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Formalise the interim mutual-aid arrangement for Lancashire patients with three North West thrombectomy units.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 22 November 2023.
Blackpool and the Fylde
Concerns raised1
Failure to formalise urgent ophthalmic patient transfer arrangements
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Develop and implement an ophthalmology emergency protocol covering handover, internal patient pathways and specialty attendance in the Emergency Department.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 3 December 2020.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
A formal urgent-transfer agreement may not prevent similar incidents, so the concern is addressed through responsive protocols within existing services.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
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Includes failures of explicitly regional or centralised arrangements for time-critical specialist care, including inadequate specialist-centre capacity, absent or unreliable mutual aid, transfer support and cross-service arrangements needed to deliver urgent interventions.
