Stroke in the UK: what to expect

Latest annual Sentinel Stroke National Audit Programme (SSNAP) report reveals further improvement in stroke care is needed.

The second annual SSNAP report reveals today that despite steady progress in stroke care, further work needs to be done to ensure that patients have access to key interventions and assessments when they are admitted to hospital.

SSNAP is commissioned by the Healthcare Quality Improvement Partnership (HQIP),* as part of the National Clinical Audit (NCA) Programme. The audit is led by the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit on behalf of the Intercollegiate Stroke Working Party.

SSNAP measures processes of care provided to stroke patients, as well as the structure of stroke services, such as staffing levels. Written in conjunction with patient representatives, this annual report provides answers about what happens to stroke patients, covering important interventions like clot busting treatment (thrombolysis), and the range of specialist assessments that patients should have before leaving hospital.

Headline results from this report on care of stroke patients between April 2014 and March 2015 include:

  • The percentage of patients being admitted to a stroke unit within four hours has reduced (56.8% compared to 58% in the previous year). This is concerning as admission to a specialist stroke unit has shown to be crucial in improving survival and reducing dependency after a stroke.
  • Improvements (compared to last year) in the percentage of stroke patients receiving a brain scan within 12 hours (88.2% compared to 84.6%) and in the time between having a stroke and receiving clot-busting treatment (thrombolysis)(56 minutes compared to 58 minutes) is encouraging as it suggests that stroke teams in hospitals are better organised compared to last year.
  • 68% of patients who needed a swallow screen had one within 4 hours of arriving at hospital – an increase of 4% compared to last year. This still means that many patients who might be struggling to swallow and are at risk of inhaling food and drink into their lungs are not being assessed promptly upon arrival.
  • Tracking data over time indicates that age discrimination in stroke units has been vastly reduced, if not eliminated. Data in 2004 showed that older patients were less likely to be admitted to a stroke unit than younger patients and this is no longer the case.
  • 3 out of 20 patients who needed a continence plan did not have one three weeks after their stroke. This is an improvement on last year (5 out of 20), but is still unacceptably high.

Professor Philippa Tyrrell Professor of Stroke Medicine and Consultant Stroke Physician, Salford Royal NHS Foundation Trust said:

This report has been designed by people with stroke, to help stroke survivors and their families understand more about what happens following a stroke, what treatments are provided and why, and how services vary in and out of hours.

Notes to editors

  • For further information or to arrange an interview, please contact Joanna Morgan, communications manager, RCP Care Quality Improvement Department, on 020 3075 1354.
  • SSNAP is leading the way in supporting the data transparency agenda and future improvements in stroke care in England, Wales and Northern Ireland. Transparency and open data is a government initiative that aims to publish information about clinical services and outcomes, and therefore enable patients, staff, academics and others to make informed decisions about healthcare services.
  • The SSNAP annual audit report is available on the RCP website from 2 December 2015 at www.strokeaudit.org/results.

*About HQIP, the National Clinical Audit Programme and how it is funded The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NCAPOP is funded by NHS England, Welsh Government and with some individual audits also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands.