You don’t have to be over 65 to have a stroke; it’s the third largest killer in the UK and can affect people at any age. Moreover, stroke care has a significant impact on public expenditure: the NHS estimated its national cost at £2.8 billion per year. In line with National Stroke Strategy requirements the Greater Manchester & Cheshire Cardiac and Stroke Network (the ‘Network’) set out to improve care for the three million citizens of Greater Manchester and its immediate surrounding area. At the end of 2007, stroke patients received variable levels of care depending on where they lived. The Network believes that “every citizen of Greater Manchester shall have equal access to a fully integrated, evidence based hyper-acute and acute specialist stroke care pathway”.