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National Sentinel Stroke Audit (NSSA)

What we are doing

The National Sentinel Stroke Audit (NSSA) monitored the rate of progress in stroke care and services in England, Wales and Northern Ireland on a two year cycle from 1998 until 2010. It consisted of a clinical component which measured the quality of stroke care and an organisational component which measured the quality of stroke service organisation.

The NSSA aimed to demonstrate that national audit can help improve the quality of care by involving trusts across the country in large-scale audit that enables them to compare their results to the national data (Irwin et al 2005).

The aims of the audit are:

  • To enable Trusts to benchmark the quality of their stroke services compared to national standards
  • To identify changes in stroke service organisation and quality of care for stroke patients since the 2004 national sentinel audit
  • To evaluate the extent to which the National Clinical Guidelines for Stroke have been implemented.
  • To monitor the progress of stroke care delivery post National Service Framework Older People (Chapter 5 stroke).

The Royal College of Physicians conducted the first round of National Sentinel Stroke Audit in 1998 and have since conducted further rounds in 1999, 2002, 2004, 2006, 2008 and 2010. The first and second rounds were funded by the Department of Health and the third round by a consortium of funders including the Stroke Association. The fourth and fifth rounds were funded by the Healthcare Commission. The objective of the sentinel audit is to assess the quality of care for people who have had a stroke and to help trusts use audit as a means of quality improvement. The audit is based on evidence-based standards for the organisation of services and process of care agreed by the representatives of the Colleges and professional organisations of the disciplines involved in the management of stroke.

The NSSA has been replaced by the Sentinel Stroke National Audit Programme (SSNAP).

Who's involved


  • The NSSA was conducted by The Royal College of Physicians on behalf of the Intercollegiate Stroke Working Party and was centrally funded by the Healthcare Quality Improvement Partnership (HQIP).
  • For further information, including how to access the audit web tool, please email stroke@rcplondon.ac.uk or call +44 (0)20 3075 1318.

What we have produced

With the 7th biannual report the NSSA aimed to demonstrate that national audit can help improve the quality of stroke care in community hospitals.
In 2008 the NSSA carried out an audit of 224 hospitals in Britain to find out whether hospitals had followed the Guideline.
The 5th round of the NSSA on the organisation of care was conducted in April 2006 having taken place on a two-year cycle since 1998.