GP receptionists need more training to help them recognise stroke survivors in need of urgent care, says research from West Midlands

Posted on 29 June 2015 (Permalink)

More can be done to improve the way GP practices deal with patients with stroke symptoms, research from the West Midlands has shown.

An article published today in the British Journal of General Practice highlights the important role of GP receptionists in directing stroke patients towards timely, emergency care. The RECEPTS study used ‘mystery shopper’ telephone calls from researchers posing as patients with stroke symptoms: around one third of calls were not recognised as emergencies.

The RECEPTS study, conducted by researchers at the Universities of Birmingham and Oxford, suggests more specialist training - as well as clearly defined policies on how to deal with potential emergencies - could help stroke patients get to hospital quicker. This in turn could save lives and minimise the impact of stroke.

A stroke happens when blood supply to part of the brain is cut off and brain cells are damaged or die. It is important because patients who suffer from a stroke can experience significant and lasting disability if they are not treated by a specialist in hospital immediately. Early diagnosis and treatment in a specialist hospital unit can improve a patient’s chances of survival and their quality of life post-stroke. National awareness campaigns such as the NHS’s Act FAST initiative are designed to help the public recognise symptoms and call an ambulance, but studies show more than 20% call their GP first.

Designed to understand how GP reception staff recognise and respond to patients with stroke symptoms, RECEPTS involved 52 family practices across the West Midlands, using questionnaires, focus groups and ‘mystery shopper’ telephone calls.

Each practice received ten calls from actors mimicking between one and three symptoms of stroke. The receptionist was not aware the situation was simulated until the end of the call. If taking a call from a suspected stroke patient, receptionists should ask the caller to dial 999 immediately or immediately transfer the call to a GP.

The study found that:

  • In 69% of simulated calls were judged to be correctly referred for immediate care - receptionists told the caller to contact 999 or transferred the caller directly to the GP.
  • Difficult to recognise calls (where symptoms were not obvious) were 85% less likely to be immediately referred than easy to recognise calls.
  • Calls with fewer or no symptoms used in the Act FAST campaign - Has their face fallen? Can they raise both arms? Is their speech slurred? - were less likely to be immediately referred than calls with all three FAST symptoms.
  • Almost all receptionists (96%) were able to name at least one stroke symptom but 40% reported one or more incorrect symptoms.

Publication of the findings comes as researchers are about to launch a free training programme for GP receptionists to help address the problem.

The programme, ‘Getting to Hospital at a Single Stroke’, will launch across the wider West Midlands this autumn. It offers two complementary and flexible ways to access training: an e-learning module accessed online and a half-day face-to-face training event delivered at venues around the region. It is based at the University of Birmingham, and supported by the WMAHSN in partnership with the NIHR CLAHRC West Midlands.

For more information on Getting to Hospital at a Single Stroke visit or email