A service evaluation of a new regional integrated stroke service in the NHS

Abstract

Background: Stroke is the UK's leading cause of disability and contributes to numerous deaths. In response, centralised stroke care is on the rise, both globally and in the UK. A local trust has formed a regional stroke centre to provide efficient and timely emergency treatment. Aims: This article evaluates hyperacute performance in a new service, identifying areas for improvement and monitoring standards. It also aims to address and minimise shortfalls in preparation for the upcoming opening of a designated stroke hub, which will admit patients directly to the stroke team, bypassing the emergency department. Methods: Data were extracted from the Sentential Stroke National Audit Programme (SSNAP) database from 26 September 2022 to 26 January 2023. Comparison was made to national quarterly SSNAP data from October 2022 to December 2022, due to the corresponding publication dates. Literature was sourced from the Cumulative Index to Nursing & Allied Health database. The main targets within SSNAP based on the first 4 hours of patient care were identified and analysed. Findings: From admission, 64% of patients underwent computer tomography scanning under 1 hour from admission, compared to a national average of 56.6%; 76% of patients underwent a swallow screening under 4 hours from admission, compared to a national average of 71.5%; and 37% of patients achieved admission to the hyperacute stroke unit under 4 hours from admission, compared to a national average of 39.5%. National average data were taken directly from SSNAP national averages from the report spanning October 2022 to December 2022. Conclusion: In comparison to national averages in many areas, the current service is performing well; however, there are many areas for improvement to address. Although the outlook for stroke care looks more promising as newer technologies emerge, stroke prevalence is increasing simultaneously. Stroke continues to cost the UK upwards of 26 billion pounds per year and causes significant detriment to survivors. Therefore, healthcare has a duty of care to continue to improve standards and innovate to improve outcomes.