Research into Practice: How the ABC Bundle is Saving Lives
- The Natalie Kate Moss Trust
- May 15
- 3 min read
Updated: May 19
In a groundbreaking step forward for stroke care, researchers at The University of Manchester have developed a simple yet powerful, life saving, treatment; The ABC Bundle.
In 2012, The Natalie Kate Moss Trust established a partnership with The University of Manchester, aimed at placing more focus on brain haemorrhage research. Over the last decade the research has gone from strength to strength, with the most notable success being the ‘ABC Bundle’, led by Consultant Neurologist Adrian Parry-Jones. This treatment is an innovative approach to treating intracerebral haemorrhage (a type of stroke caused by bleeding in the brain) and is proving to reduce mortality by over 30% within the critical first month after a brain haemorrhage.
What is the ABC Bundle?
The ABC Bundle is a clinical protocol designed to deliver rapid and effective care to patients suffering from an intracerebral haemorrhage. Often referred to as the “golden hour,” the first 60 minutes after a brain haemorrhage are absolutely critical to determining whether a person survives and how well they recover.
The ABC Bundle was developed following years of research into how early intervention could dramatically improve patient outcomes. The “ABC” stands for:
A – Anticoagulant Reversal: For patients on blood thinners (used to prevent clots), this step reverses their effects immediately to stop further bleeding.
B – Blood Pressure Lowering: Administering medication to reduce blood pressure helps minimise, or prevent, any secondary bleeding in the brain.
C – Care Pathway: Ensuring the patient is quickly assessed for urgent neurosurgical intervention and managed appropriately on a specialist stroke unit.
These three steps, applied swiftly and systematically, have proven to significantly reduce death rates and improve long-term recovery.
From Breakthrough to Bedside
The ABC Bundle began as a pilot at Salford Royal Hospital in 2015, showing a dramatic 30% reduction in death within 30 days of a haemorrhage. Encouraged by these early results, the protocol was tested further in stroke units across Manchester in 2017.
By 2021, the ABC Bundle was rolled out across the North of England, with all data tracked and validated by the Sentinel Stroke National Audit Programme (SSNAP)—the national audit body that collects data on nearly every stroke patient in the UK (excluding Scotland). This extensive data analysis confirmed what the early trials suggested: the ABC Bundle was saving lives and helping people recover faster, with less time in hospital both initially and long term.
Now, in July 2025, the ABC Bundle is set to be rolled out across all NHS Trusts in England, marking a historic shift in how stroke patients are treated across the country.
A Global Standard in the Making
The long-term vision is ambitious but within reach: for the ABC Bundle to become standard care globally. By proving its impact through rigorous data and clinical implementation in England, the hope is that countries around the world will adopt this model, potentially saving thousands more lives every year.
What’s Next? A New Research Trial
Even as the ABC Bundle is being adopted nationally, Adrian Parry-Jones and his team are already looking ahead at how the protocol can be improved even further. As a charity we are therefore committing £125,882.04 over the next 2 years (2025 - 2027) to support a Clinical Research Fellowship to work specifically on this project.
This role will look will not only help support the national rollout of the treatment (it’s delivery and implementation as well as data collection) but will also look at how the treatment can be optimised eg. understanding the best blood pressure medication to use when treating brain haemorrhage specifically, potentially improving patient outcomes further.
Saving Lives is as Simple as A, B, C…
The ABC Bundle is a shining example of how targeted research, charitable support, and collaboration with healthcare providers can lead to real-world change. It’s more than a medical protocol, it’s hope for the future.
Thanks to the commitment of The Natalie Kate Moss Trust and the pioneering work of researchers at The University of Manchester, what started as a dream is now saving lives and could soon be the global standard of care.
Together, we can ensure this vital work continues. Because when it comes to stroke care, every minute matters. And every pound helps.
