From now on, the public can access very recent data on how their local hospital is diagnosing, treating and managing stroke.
The Sentinel Stroke National Audit Programme (SSNAP), led by the RCP, has made the information available on its website in easy-to-read graphs, pie-charts and percentage performance ratings. The results will be updated every three months, and cover all hospitals treating stroke patients in England and Wales, together with two hospitals in Northern Ireland. They allow each hospital to be compared to other local hospitals and to the national average against a range of 10 categories of care. These include:
- how quickly the patient has a scan
- whether they are admitted to a stroke unit and for how long
- whether they needed and received clot-busting drugs
- whether they needed therapy, if that therapy was provided, and for how long.
The at-a-glance maps also make it easier for doctors, nurses, therapists, patients, the public, health managers and commissioners to identify areas of good and poor practice, to drive change and improve services.
Standards of stroke care have improved in all hospitals over the past 15 years, so the standards for the audit have been set very high. The audit is trying to push hospitals to keep improving further, even the best performing hospitals. The results are presented in letters A to E representing performance. A requires a world class performance, and even standards D and E do not mean that the care is poor or unsafe.
Latest SSNAP audit report results
The Sentinel Stroke National Audit Programme (SSNAP) is the first national stroke register in the world to collect information about the entire stroke pathway, from being admitted to hospital to the six month follow-up appointment. The audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme. SSNAP is carried out by the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians.
While the results are largely similar to the previous two quarters, there is still unacceptable variation between hospitals and follow-up care outside hospital. Significant results included:
Acute care:
- 41.7 % of patients were scanned within one hour – the target is 50%
- 84.8% of patients were scanned within 12 hours
- 58.1% of patients were directly admitted to a stroke unit within four hours
- 83.5% of patients spent at least 90% of their stay on a stroke unit
- 74.7% of eligible patients were given clot-busting drugs.
Specialist assessments:
- 74.8% of patients were assessed by a stroke specialist consultant physicians within 24 hours
- 64.2% of patients had their ability to swallow checked within four hours
- 79.3% of patients had a formal swallow assessment within 72 hours.
Need and provision of therapies
- 81.2% of patients were reported as needing occupational therapy
- 86.2% of patients were reported as needing physiotherapy
- 47.8% of patients were reported as needing speech and language therapy.
Amount of time therapies were provided on the days they were provided:
- A median of 40 minutes of occupational therapy
- A median of 31.9 minutes of physiotherapy
- A median of 30 minutes of speech and language therapy.
Amount of days patients received therapies during their stay in hospital:
- A median of 45.3% of days of occupational therapy
- A median of 55.4% of physiotherapy
- A median of 27.9% of speech and language therapy.
Discharge planning
- 68.3% of patients received a joint health and social care plan
- 75.3% of patients received a continence plan within three weeks.
Professor Tony Rudd, chair of the Intercollegiate Stroke Working Party, said:
While it is encouraging that there we have seen improvements in stroke care for patients since we started collecting the data, it is clear that some hospitals and health communities are not matching the best. The value in continually collecting the data is that it shines a permanent spotlight on stroke care across the country, and by highlighting the best, shows what is possible, and allows for sharing of good practice.
For more information, please contact Linda Cuthbertson, head of PR, on 0203 075 1254 / 0774 877 7919, or email Linda.Cuthbertson@rcplondon.ac.uk
- The Sentinel Stroke National Audit Programme (SSNAP) is the most comprehensive and reliable source of information about the performance of stroke services in England, Wales and Northern Ireland. SSNAP aims to improve stroke care by measuring the quality of stroke services against evidence based standards and supporting staff to make improvements
- Transparency and open data is a government initiative that aims to publish information about clinical services and outcomes and so enable patients, staff, academics and others to make informed decisions about healthcare services. SSNAP is leading the way in supporting the data transparency agenda and supporting future improvements in stroke care in England, Wales and Northern Ireland.
- The SSNAP audit report is available here: http://www.rcplondon.ac.uk/projects/ssnap-clinical-audit
- And the interactive maps here: http://www.rcplondon.ac.uk/ssnap/maps
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 holds the contract to manage and develop the National Clinical Audit Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands. www.hqip.org.uk