Monitoring progress in implementing the Stroke Strategy

At present it is difficult to see to what extent the Stroke Strategy is being implemented although the Department of Health plans to monitor a) the number of patients who spend at least 90% of their time on a stroke unit and b) the percentage of higher risk TIA cases that are treated within 24 hours.

There has been some difficulty in collecting this data. The best source of information on the provision of stroke services is contained in the National Sentinel Audit for Stroke 2008, published in April 2009.

This audit, funded by the Healthcare Quality Improvement Partnership (HQIP), was carried out on behalf of the Intercollegiate Stroke Group by the Royal College of Physicians' Clinical Effectiveness and Evaluation Unit. 

Its major finding was that a quarter of patients were not offered the best treatment for stroke - a stay in a dedicated stroke unit. 

Others findings included:

  • 29% of patients were admitted to a stroke unit on the same day as their stroke and 57% were admitted either the same day or the following day. This is a major improvement since 2006.
  • 74% of patients now spend some of their time and 68% spend more than half their time in a stroke unit which is a very considerable improvement from 2006.
  • Only 17% of patients are admitted to an acute stroke unit within four hours of admission.
  • Use of the FAST Test (Face, Arm, Speech Test) by ambulance staff was recorded in only about a quarter of patients' notes.
  • Only 21% of patients had a brain scan within 3 hours where appropriate, an improvement over the last audit (16% in 2006) but nowhere near high enough if patients are to receive the best outcomes.
  • Over a quarter of patients were not screened for swallowing difficulties within 24 hours, 20% have no record of visual field testing and 15% no record of sensory testing.
  • Marked improvements have been achieved in the last two years in speed of assessment by therapists after admission. While far from perfect it is clear that a major effort has been made to improve the quality of care being provided nationally.


You can access the full report, including details of individual hospital trusts.

Find out more about other developments for the Stroke Strategy.