Sentinel Stroke National Audit Programme (SSNAP)

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The Sentinel Stroke National Audit Programme (SSNAP) aims to improve the quality of stroke care by measuring both the structure and processes of stroke care against evidence based standards. These standards are informed by the National Clinical Guideline for Stroke, and national and local benchmarks.

Building on 15 years of experience delivering the National Sentinel Stroke Audit (NSSA) and the Stroke Improvement National Audit Programme (SINAP), SSNAP has pioneered a new model of healthcare quality improvement through near real-time data collection, analysis and reporting on the quality and outcomes of stroke care.

Key features of SSNAP

SSNAP is a prospective, longitudinal audit that measures the quality of care that stroke patients receive throughout the whole care pathway up to 6 months post admission in England, Wales and Northern Ireland. With near 100% case ascertainment for stroke, SSNAP offers clinicians, policymakers and the public a reliable and comprehensive source of data to inform quality improvement.

SSNAP provides regular, routine, reliable data to:

  • benchmark services nationally and regionally
  • monitor progress against a background of change
  • support clinicians in identifying where improvements are needed,  and help them lobby for change and celebrate success
  • empower patients to ask searching questions.

As the single source of data for stroke SSNAP:

  • provides the data for all other statutory data collections including the NICE Quality Standard and Accelerating Stroke Improvement (ASI) metrics
  • is the chosen method for collection for stroke measures in the NHS Outcomes Framework and the CCG Outcomes Indicator Set
  • metrics align with those in the Cardiovascular Disease Outcomes Strategy.

SSNAP is the most ambitious and sophisticated platform for collecting and reporting data on the quality of stroke care in any healthcare system in the world. It is providing hospitals, commissioners, patients and the public with an unprecedented level of insight into the performance of stroke services.

Professor Tony Rudd, chair of the Intercollegiate Stroke Working Party

Components of SSNAP

SSNAP clinical audit

The clinical component of SSNAP collects a dataset for every stroke patient, including acute care, rehabilitation, 6-month follow-up, and outcome measures in England, Wales and Northern Ireland.

National and regional results are available, each with easy access versions for stroke survivors, carers and the general public. Interactive maps of the results are available. New data are published every four months and annually. SSNAP also provides real-time analysis of patient level data for clinicians.

SSNAP acute organisational audit

The SSNAP acute organisational audit is a snapshot audit which runs on a biennial basis, and reports on the structure and organisation of acute stroke services in England, Wales and Northern Ireland. It has achieved 100% participation of acute sites since 2004 and produces information on staffing levels and skill mix, organisation of acute care processes, provision of stroke treatments such as thrombolysis and thrombectomy, access to early supported discharge (ESD) and patient and carer engagement. Results from the 2016 acute organisational audit were published in November 2016.

National and site-level results are available, including “easy access versions” for stroke survivors, carers and the general public.

Post-acute organisational audit

The SSNAP post-acute organisational audit focused on the structure and organisation of post-acute stroke care and reported in 2015. Results for the audit were published in two phases. Phase 1 obtained information from Clinical Commissioning Groups (England), Local Health Boards (Wales) and Local Commissioning Groups (Northern Ireland) on what post-acute stroke services they had commissioned (provided) for patients in their locality. Phase 2 collected data from all identified post-acute stroke services on the make-up of their service, including staffing levels, waiting times, time limits to service and 6 month reviews.

National, regional, and CCG/LHB/LCG level results are available, including “easy access versions” specifically for stroke patients and their carers and interactive maps showing the location of every post-acute stroke service identified.

Further information on SSNAP

The SSNAP core dataset and accompanying helpnotes are available to download below. Additionally there is a SSNAP information sheet and a flyer outlining the various reporting outputs available to participants, wider NHS stakeholders and the public.

Clinicians, managers and audit professionals employed by participating services can register via the website to submit data via a secure webtool and to access results for their team before they are made public. Additionally commissioners and their equivalents in Wales and Northern Ireland can also register for a SSNAP account to access the four-monthly and annual reports and receive notification of when new reports are made available. More information is available at the dedicated SSNAP website.

Who's involved

Organisations

SSNAP is run by the RCP Stroke programme on behalf of the Intercollegiate Stroke Working Party (ICSWP) and commissioned by the Healthcare Quality Improvement Partnership (HQIP). SSNAP is commissioned to run until at least March 2018.