SSNAP’s clinical audit collects a minimum dataset for stroke patients in every acute hospital in England, Wales and Northern Ireland, and follows the pathway through recovery, rehabilitation, and outcomes at the point of their 6 month assessment. SSNAP is the only national stroke register in the world to collect longitudinal data on the processes and outcomes of stroke care up to 6 months after stroke.

The aims of the SSNAP clinical audit are:

• To benchmark stroke services regionally and nationally
• To monitor progress against a background of organisational change to stroke services and more generally in the NHS
• To support clinicians in identifying where improvements are needed, planning for and lobbying for change and celebrating success
• To empower patients to ask searching questions.

Every year data from over 90’000 patients are submitted to the audit for analysis, representing over 90% of all stroke hospital admissions in the NHS. This means that the data presented in SSNAP reports are complete and robust.
 
A core minimum dataset was developed by the ICSWP in collaboration with key stakeholders. The data items collected by SSNAP include acute care processes and interventions, assessments and rehabilitation, and longer term care provision. The core dataset is available to download here. Detailed help notes are provided to ensure standard interpretation of the dataset questions across all participants.

Extensive support in the form of FAQs, user guides and videos are available online and a helpdesk is available to answer queries here.

Eligibility criteria

Patients: All patients with a primary diagnosis of stroke coded as I61, I63 and I64 should be submitted to SSNAP. The minimum age for patient submission is 16.

Stroke services: Any stroke service in England, Wales or Northern Ireland which treats at least 10 patients per year are eligible to participate in SSNAP. All acute hospitals in these countries that provide stroke care are actively submitting data to SSNAP with increasing numbers of post-acute care providers registering and participating in SSNAP.

Ambulance quality indicators

Since April 2019, ambulance trusts in England have entered key pre-hospital timings for patients who have a confirmed stroke diagnosis after hospital admission, i.e. those patients already entered on SSNAP by inpatient teams. This data is entered, retrospectively, on a monthly basis.

This data is published as part of the Ambulance Quality Indicators (AQI) by NHS England (https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/). The purpose of the AQI are for:

(As taken from: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/04/AQI-Quality-Statement-2015-v1.2.pdf)

• Ambulance Services to manage the service they provide;
• NHS England to monitor the service, and respond to enquiries from the media and the public;
• Department of Health to brief ministers on performance and account to Parliament;
• Parliament, the media and the public to hold the public service organisations to account; and
• Clinical Commissioning Groups to commission services

Overall, the AQI help in improving care for stroke patients conveyed to hospital by ambulance.