An audit by the Sentinel Stroke National Audit Programme (SSNAP) from January to March, 2022, has shown stroke services at the South West Acute Hospital (SWAH) are outperforming many of those at Altnagelvin.

SSNAP, run by King’s College London, was released recently and measures stroke care by collecting information from hospitals about the care provided to stroke patients from the time they arrive at the hospital up until six months after their stroke.

The audit aims to improve care for stroke patients.

The report gives information on 10 aspects of stroke care – brain scanning, stroke unit, thrombolysis, special assessment, occupational therapy, physiotherapy, speech and language therapy, multidisciplinary teamwork, and standards by discharge and discharge processes.

Grade

Each hospital in England, Wales and Northern Ireland in the SSNAP audit are given a grade on how well they have performed, with ‘A’ being the best, and ‘E’ the worst.

The SWAH and Altnagelvin submitted 70-79 per cent of their stroke patients to the audit, with the results showing the SWAH performing better than Altnagelvin in all but one of the 10 aspects.

The term ‘clock start’ is used throughout SSNAP reporting to refer to the date and time of arrival at first hospital for newly-arrived patients, or to the date and time of symptom onset if the patient is already in hospital at the time of their stroke.

As such, some 97.1 per cent of patients are scanned within 12 hours of clock start at the SWAH, compared to 77.8 per cent at Altnagelvin.

The median time between clock start and a scan at the SWAH is one hour and one minute, compared to one hour and 29 minutes at Altnagelvin.

In the dedicated stroke units at each hospital, the SWAH performs significantly better, with 81.8 per cent of patients directly admitted to the unit within four hours of clock start, compared to only 16.3 per cent at Atlnagelvin.

Patients only had a median wait time of two hours and 51 minutes at the SWAH between clock start and arrival at the stroke unit, while in Altnagelvin this is 21 hours and 15 minutes.

While neither hospital performed well in administering thrombolysis (a clot-busting drug), it was in the SWAH where all patients eligible for thrombolysis were given it between January and March of this year.

All stroke patients at the SWAH were assessed by a stroke specialist consultant physician with 24 hours of clock start, compared to 88.9 per cent at Altnagelvin.

The median time between clock start and assessment at the SWAH was 23 minutes, compared to 11 hours and 44 minutes at Altnagelvin.

Higher proportion

There was also a higher proportion of SWAH patients who were seen by a stroke nurse (97.1 per cent) within 24 hours, compared to Altnagelvin’s 64.4 per cent. It is also the same concerning swallow screenings.

In terms of physiotherapy, speech and language therapy and multidisciplinary team working, the SWAH scored higher than Altnagelvin.

Both hospitals received a similar score concerning standards by discharge and discharge processes.

However, a higher proportion of patients at the SWAH had a continence plan within three weeks of clock start, and had a mood and cognition screening by discharge.

And also more patients were treated by a stroke skilled early supported discharge team at theSWAH than Altnagelvin.

Looking at patients assessed at six months after admission, 53 out of 75 eligible patients at Altnagelvin were assessed, while at SWAH it was 40 out of 60 eligible patients.