Each year in the UK over 110,000 people suffer a new or recurrent stroke resulting in 60,000 deaths annually. Stroke costs the NHS 2.8 billion pounds a year, 1 billion pounds more than the cost of coronary heart disease. To improve outcomes for stroke patients in the UK a unique on line training course (accredited by the UK Stroke Forum, Education and Training) has been launched to support clinicians in recognising patients who present with the more subtle signs of a stroke or transient ischaemic attack (TIA). A stroke is the brain's equivalent of a heart attack and in nine out of ten cases it is caused by a blocked blood vessel in the brain. Recognising this quickly and getting a person to a specialist hospital for treatment is the priority and has proven to save lives and reduce the devastating effects of a stroke. Many healthcare professionals working in the community will benefit from undertaking this course. Developed with a team of UK stroke specialists the course enables clinicians to apply the Miami Emergency Neurologic Deficit Test or MEND examination. The MEND assessment takes just three minutes to complete and does not require any specialist equipment, just the knowledge of the clinician that they will learn from the course. It involves assessing mental status, cranial nerves and limb movement. The MEND assessment can then be continued from the pre-hospital stage into hospital. Originally devised in the USA where it has proven to save lives and reduce the effects of stroke the four-hour on-line course also increases knowledge and skills in other areas of stroke recognition. As an on-line course clinicians can complete it wherever and whenever they have access to the internet. As they complete the course learners will undertake assessments to ensure they have understood and can apply the new skills. At the end of the course the learners watch a number of clips where they have to make their patient assessment and if successful automatically receive a certificate endorsed by professional bodies. Adrian South, Deputy Clinical Director of South Western Ambulance Service NHS Foundation Trust, said: 'In the case of patients experiencing a stroke, the National Ambulance Clinical Quality Indicators demonstrate that pre-hospital clinicians are good at managing patients who present with FAST positive signs. The challenge now is for clinicians to develop their skills to spot and correctly manage the far more challenging group of patients who are not FAST positive; those who present with issues that are rapidly identified by the MEND exam. The introduction of ASLS will be at the forefront of South Western Ambulance Service NHS Foundation Trust's drive to further improve the care that we deliver to patients experiencing a neurovascular event'