With the 7th biannual report the NSSA aimed to demonstrate that national audit can help improve the quality of stroke care in community hospitals 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).
- Patients with acute stroke should be admitted directly to specialist stroke beds and have access to continuous physiological monitoring. General assessment units are not an adequate substitute.
- Standards of care offered in all specialist stroke beds should meet those defined in the National Clinical Guidelines for Stroke 2008.
- Stroke services should be organised to deliver thrombolysis to all appropriate patients regardless of where they live or the time of day or week they present.
- Patients requiring end of life care should be able to receive such care to a high standard on a stroke unit.
- Vocational rehabilitation should be made available to all stroke patients wishing to return to work.
- Care of stroke patients transferred to community hospitals should meet the standards defined for specialist stroke unit care set out in the National Clinical Guidelines for Stroke 2008.
- All services should be able to deliver high quality specialist early supported discharge to appropriate patients.
- High quality longer term rehabilitation should be provided to all patients who require on-going treatment without undue delay.
- Facilities to investigate high risk patients after TIA should be available at all times including weekends.
- Information provision should be improved to provide universal access to all inpatients and outpatients.
This audit was funded by the Healthcare Quality Improvement Partnership (HQIP) and run by the Clinical Effectiveness and Evaluation unit (CEEu) of the Royal College of Physicians of London. It was co-ordinated by the CEEu and data were collected within trusts using a standardised method. This audit was overseen at a trust level by a lead clinician for stroke who was responsible for the quality of data supplied. The audit was guided by a multidisciplinary steering group responsible for the Stroke Programme – the Intercollegiate Stroke Working Party (ICSWP)