The Stroke Improvement National Audit Programme (SINAP), commissioned by the Healthcare Quality Improvement Partnership (HQIP) and run by the Royal College of Physicians’ Stroke Programme, shows that 8% of patients received clot-busting treatment (thrombolysis) following a stroke, up from only 1% in the 2008 audit.
The audit collects data on the care of stroke patients in the three days following a stroke. Individual hospital results are available on the Royal College of Physicians (RCP) website and are updated quarterly. The audit shows that stroke care for patients is still improving overall. Over half of patients are now admitted to a stroke unit within four hours of their arrival at hospital. Just over one-third of patients are still being admitted to non-specialist units when they should be admitted to stroke units. The evidence shows that patients treated on stroke units have better outcomes, and the audit advises that Trusts who are not admitting patients routinely to stroke units should reconsider their pathways of care. Another area of concern is continence. All incontinent patients should have a clear continence management plan within 72 hours of admission, but this is only happening in 57% of cases. Commenting on the figures, Joe Korner, director of communications at The Stroke Association said: “The first few hours following a stroke are absolutely crucial to the level of recovery that someone can expect to make. The guidelines and expectations are set out for stroke care in the Stroke Strategy for England but unfortunately some hospitals are falling short. Someone with stroke symptoms should be admitted to a specialist stroke unit as soon as possible so they can receive the correct treatment. “We have seen that some parts of the UK are achieving excellent results whereas others have some way to go, particularly when it comes to administering clot-busting treatment that is currently only being given to around half of patients who are eligible to receive it. “We are also very concerned about the number of hospitals that have provided data for this audit, which is designed to gather a national perspective and help to drive standards of care up so that more people can survive their stroke and make the best possible recovery. The fact that only 95 out of 171 eligible hospitals took part is clearly holding back the process and preventing people from finding out what standard of treatment they are receiving.” Professor Tony Rudd, chair of the Intercollegiate Stroke Working Party and director of the RCP stroke programme said, “Acute stroke services are improving in England, albeit from a low base. Not all hospitals contributed to this national audit and one has to be concerned that the quality of care in the nonparticipating hospitals may be lagging behind those who have been willing to share their data. We will be working hard to increase participation as I believe that publicly available data comparing each hospital against their peers is a very powerful tool to improve the quality of care.”
