## Ssnap Clinical Executive Summaries - Wales An Overview Of Hospital Stroke Care Quality Up To November 2016

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This regional pack contains an overview of the hospitals' overall SSNAP score performance in a series of graphs charting the change in score over time for each hospital. The overall SSNAP score is a composite score combining the achievement on 44 care process measures derived from National Clinical Guidelines for Stroke and adjusted for case ascertainment and audit compliance. The 44 key indicators are grouped into 10 domains of care. The change over time in this overall score has been summarised in two ways:   

- 
Performance over the whole two and a half year period has been characterised as Improving, Not Improving or Worsening depending on the slope of a trend line plotted through all the hospital's scores at every time point. 
- 
Recent performance has been characterised as Good, Adequate or Poor depending on where the trend line meets the latest time period.  
This regional pack also contains the individual executive summaries of the stroke care provided by the hospitals in this region between April 2014 and November 2016. These executive summaries highlight areas of good, adequate and poor performance in order to identify key areas to draw up action plans for improvement. Further information on resource use for stroke is given including activity, length of stay, cost of stroke and admissions to care homes after stroke. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve. 

Nationally, it is encouraging to see that most teams are "Improving", though there are a number of teams who are consistently not achieving "Adequate" scores, and it is concerning that performance within a few services appears to be deteriorating.  

## Wales: Ssnap Clinical Executive Summaries

Overall SSNAP score performance from April 2014 to November 2016

## Routinely Admitting Teams: Good And Improving Adequate And Improving Adequate And Worsening Poor And Improving Glan Clwyd District General Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains     | Mainly GOOD domains            |
|--------------------------------|-----------------------------|--------------------------------|
| (D or E average):              | (C average):                | (A or B average):              |
| Scanning                       | Specialist Assessments      |                                |
| Stroke Unit                    | Speech and Language Therapy |                                |
| Thrombolysis                   |                             |                                |
| Occupational Therapy           |                             |                                |
| Physiotherapy                  | Discharge Processes         | Multidisciplinary Team Working |
| **areas where further          |                             |                                |
| improvements are still needed. |                             |                                |
| **areas to focus quality       |                             |                                |
| improvement on, as require     |                             |                                |
| substantial improvement        |                             |                                |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Good Improving

Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

## Glan Clwyd District General Hospital - Ssnap Executive Summary Activity And Length Of Stay In August-November 2016 This Hospital Treated 120 Patients, Of Which:

0 patients were transferred in from another hospital
120 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=120                                |
| 26.7% (32)                       |                                      |
| 20.8% (25)                       |                                      |
| 28.3% (34)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 5.8% (7)                         |                                      |
| 18.3% (22)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
7%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
13%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 2.0% (2/102) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=105 24.8% (26) 22.9% (24) 27.6% (29) 5.7% (6) 19.0% (20) 17.3 days
£11,000

## Royal Gwent Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains    | Mainly GOOD domains    |
|--------------------------------|----------------------------|------------------------|
| (D or E average):              | (C average):               | (A or B average):      |
| (None)                         | Stroke Unit                | Scanning               |
| Thrombolysis                   | Specialist Assessments     |                        |
| Discharge Processes            | Occupational Therapy       |                        |
| **areas where further          |                            |                        |
| improvements are still needed. |                            |                        |
| **areas to focus quality       |                            |                        |
| improvement on, as require     |                            |                        |
| substantial improvement        |                            |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Good Improving

Physiotherapy Speech and Language Therapy Multidisciplinary Team Working Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

1 patient was transferred in from another hospital
229 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=230                                |
| 50.9% (117)                      |                                      |
| 28.3% (65)                       |                                      |
| 19.6% (45)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 0.4% (1)                         |                                      |
| 0.9% (2)                         |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
9%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
20%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 2.5% (5/198) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=204 52.0% (106) 29.9% (61) 17.6% (36) 0.0% (0) 0.5% (1) 5.0 days
£11,000

## Ysbyty Gwynedd - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains    | Mainly GOOD domains    |
|--------------------------------|----------------------------|------------------------|
| (D or E average):              | (C average):               | (A or B average):      |
| Stroke Unit                    |                            |                        |
| Thrombolysis                   |                            |                        |
| Discharge Processes            |                            |                        |
| Scanning                       | Specialist Assessments     |                        |
| Occupational Therapy           |                            |                        |
| Physiotherapy                  |                            |                        |
| **areas where further          |                            |                        |
| improvements are still needed. |                            |                        |
| **areas to focus quality       |                            |                        |
| improvement on, as require     |                            |                        |
| substantial improvement        |                            |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Good Improving

Speech and Language Therapy Multidisciplinary Team Working Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

## Ysbyty Gwynedd - Ssnap Executive Summary Activity And Length Of Stay In August-November 2016 This Hospital Treated 100 Patients, Of Which:

0 patients were transferred in from another hospital
100 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=100                                |
| 57.0% (57)                       |                                      |
| 22.0% (22)                       |                                      |
| 19.0% (19)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 1.0% (1)                         |                                      |
| 1.0% (1)                         |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
8%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 4.3% (3/70) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=85 58.8% (50) 21.2% (18) 17.6% (15) 1.2% (1) 1.2% (1) 5.1 days
£11,000

## Prince Charles Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains    | Mainly GOOD domains    |
|--------------------------------|----------------------------|------------------------|
| (D or E average):              | (C average):               | (A or B average):      |
| Speech and Language Therapy    | Scanning                   | Stroke Unit            |
| Thrombolysis                   |                            |                        |
| Specialist Assessments         |                            |                        |
| Multidisciplinary Team Working | Occupational Therapy       |                        |
| Physiotherapy                  |                            |                        |
| **areas where further          |                            |                        |
| improvements are still needed. |                            |                        |
| **areas to focus quality       |                            |                        |
| improvement on, as require     |                            |                        |
| substantial improvement        |                            |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

Standards by Discharge Discharge Processes **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

3 patients were transferred in from another hospital
184 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=187                                |
| 20.3% (38)                       |                                      |
| 21.4% (40)                       |                                      |
| 43.3% (81)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 7.5% (14)                        |                                      |
| 7.5% (14)                        |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
11%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
52%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 4.8% (7/145) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=162 21.6% (35) 22.2% (36) 41.4% (67) 8.0% (13) 6.8% (11) 12.4 days
£11,000

## University Hospital Of Wales - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains    | Mainly GOOD domains    |
|--------------------------------|----------------------------|------------------------|
| (D or E average):              | (C average):               | (A or B average):      |
| Thrombolysis                   | Scanning                   | Stroke Unit            |
| Specialist Assessments         |                            |                        |
| Speech and Language Therapy    |                            |                        |
| Occupational Therapy           | Physiotherapy              |                        |
| Standards by Discharge         |                            |                        |
| Multidisciplinary Team Working | Discharge Processes        |                        |
| **areas where further          |                            |                        |
| improvements are still needed. |                            |                        |
| **areas to focus quality       |                            |                        |
| improvement on, as require     |                            |                        |
| substantial improvement        |                            |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

**areas to celebrate success, maintain performance and identify whether further improvements are feasible.

3 patients were transferred in from another hospital
171 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=174                                |
| 40.2% (70)                       |                                      |
| 28.7% (50)                       |                                      |
| 27.0% (47)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 3.4% (6)                         |                                      |
| 0.6% (1)                         |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
17%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
45%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 2.3% (3/132) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=154 41.6% (64) 29.2% (45) 26.6% (41) 2.6% (4) 0.0% (0) 6.4 days
£11,000

## Morriston Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains     | Mainly GOOD domains            |
|--------------------------------|-----------------------------|--------------------------------|
| (D or E average):              | (C average):                | (A or B average):              |
| Scanning                       | Occupational Therapy        |                                |
| Specialist Assessments         | Physiotherapy               |                                |
| Stroke Unit                    |                             |                                |
| Thrombolysis                   |                             |                                |
| Discharge Processes            | Speech and Language Therapy | Multidisciplinary Team Working |
| **areas where further          |                             |                                |
| improvements are still needed. |                             |                                |
| **areas to focus quality       |                             |                                |
| improvement on, as require     |                             |                                |
| substantial improvement        |                             |                                |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

0 patients were transferred in from another hospital
226 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=226                                |
| 33.2% (75)                       |                                      |
| 26.1% (59)                       |                                      |
| 30.1% (68)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 8.8% (20)                        |                                      |
| 1.8% (4)                         |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
24%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 6.3% (11/175) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=200 32.5% (65) 27.5% (55) 29.0% (58) 9.5% (19) 1.5% (3) 9.2 days
£11,000

## Prince Philip Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains        | Mainly GOOD domains    |
|--------------------------------|--------------------------------|------------------------|
| (D or E average):              | (C average):                   | (A or B average):      |
| Stroke Unit                    |                                |                        |
| Occupational Therapy           |                                |                        |
| Physiotherapy                  |                                |                        |
| Discharge Processes            | Scanning                       |                        |
| Thrombolysis                   |                                |                        |
| Specialist Assessments         |                                |                        |
| Speech and Language Therapy    | Multidisciplinary Team Working |                        |
| **areas where further          |                                |                        |
| improvements are still needed. |                                |                        |
| **areas to focus quality       |                                |                        |
| improvement on, as require     |                                |                        |
| substantial improvement        |                                |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

8 patients were transferred in from another hospital
60 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=68                                 |
| 17.6% (12)                       |                                      |
| 20.6% (14)                       |                                      |
| 29.4% (20)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 4.4% (3)                         |                                      |
| 27.9% (19)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
13%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 11.5% (6/52) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=52 15.4% (8) 21.2% (11) 26.9% (14) 3.8% (2) 32.7% (17) 30.2 days
£11,000

## Maelor Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains        | Mainly GOOD domains    |
|--------------------------------|--------------------------------|------------------------|
| (D or E average):              | (C average):                   | (A or B average):      |
| Scanning                       | Specialist Assessments         |                        |
| Thrombolysis                   | Multidisciplinary Team Working |                        |
| Stroke Unit                    |                                |                        |
| Occupational Therapy           |                                |                        |
| Speech and Language Therapy    | Physiotherapy                  | Standards by Discharge |
| Discharge Processes            |                                |                        |
| **areas where further          |                                |                        |
| improvements are still needed. |                                |                        |
| **areas to focus quality       |                                |                        |
| improvement on, as require     |                                |                        |
| substantial improvement        |                                |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

**areas to celebrate success, maintain performance and identify whether further improvements are feasible.

0 patients were transferred in from another hospital
122 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=122                                |
| 27.9% (34)                       |                                      |
| 23.8% (29)                       |                                      |
| 28.7% (35)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 6.6% (8)                         |                                      |
| 13.1% (16)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
8%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
12%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 3.2% (3/95) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=106 25.5% (27) 25.5% (27) 29.2% (31) 6.6% (7) 13.2% (14) 15.3 days
£11,000

## Withybush General Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains        | Mainly GOOD domains    |
|--------------------------------|--------------------------------|------------------------|
| (D or E average):              | (C average):                   | (A or B average):      |
| Speech and Language Therapy    | Stroke Unit                    | Scanning               |
| Thrombolysis                   | Specialist Assessments         |                        |
| Occupational Therapy           | Physiotherapy                  |                        |
| Discharge Processes            | Multidisciplinary Team Working |                        |
| **areas where further          |                                |                        |
| improvements are still needed. |                                |                        |
| **areas to focus quality       |                                |                        |
| improvement on, as require     |                                |                        |
| substantial improvement        |                                |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

3 patients were transferred in from another hospital
63 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=66                                 |
| 24.2% (16)                       |                                      |
| 21.2% (14)                       |                                      |
| 19.7% (13)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 7.6% (5)                         |                                      |
| 27.3% (18)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
9%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 3.8% (2/52) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=57 26.3% (15) 19.3% (11) 19.3% (11) 7.0% (4) 28.1% (16) 23.7 days
£11,000

## Bronglais Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains    | Mainly GOOD domains    |
|--------------------------------|----------------------------|------------------------|
| (D or E average):              | (C average):               | (A or B average):      |
| Specialist Assessments         | Scanning                   |                        |
| Multidisciplinary Team Working | Stroke Unit                |                        |
| Occupational Therapy           |                            |                        |
| Physiotherapy                  |                            |                        |
| Speech and Language Therapy    | Discharge Processes        | Thrombolysis           |
| **areas where further          |                            |                        |
| improvements are still needed. |                            |                        |
| **areas to focus quality       |                            |                        |
| improvement on, as require     |                            |                        |
| substantial improvement        |                            |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Adequate Worsening

Standards by Discharge **areas to celebrate success, maintain performance and identify whether further improvements are feasible.

0 patients were transferred in from another hospital
47 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=47                                 |
| 31.9% (15)                       |                                      |
| 27.7% (13)                       |                                      |
| 17.0% (8)                        |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 4.3% (2)                         |                                      |
| 19.1% (9)                        |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
22%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 12.5% (5/40) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=46 32.6% (15) 26.1% (12) 17.4% (8) 4.3% (2) 19.6% (9) 18.8 days
£11,000

## Princess Of Wales Hospital - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains        | Mainly GOOD domains    |
|--------------------------------|--------------------------------|------------------------|
| (D or E average):              | (C average):                   | (A or B average):      |
| Scanning                       | Speech and Language Therapy    |                        |
| Specialist Assessments         | Multidisciplinary Team Working |                        |
| Stroke Unit                    |                                |                        |
| Thrombolysis                   |                                |                        |
| Physiotherapy                  | Occupational Therapy           | Standards by Discharge |
| Discharge Processes            |                                |                        |
| **areas where further          |                                |                        |
| improvements are still needed. |                                |                        |
| **areas to focus quality       |                                |                        |
| improvement on, as require     |                                |                        |
| substantial improvement        |                                |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Poor Improving

**areas to celebrate success, maintain performance and identify whether further improvements are feasible.

1 patient was transferred in from another hospital
91 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=92                                 |
| 30.4% (28)                       |                                      |
| 25.0% (23)                       |                                      |
| 20.7% (19)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 7.6% (7)                         |                                      |
| 16.3% (15)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
9%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
0%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 1.3% (1/80) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=86 31.4% (27) 24.4% (21) 18.6% (16) 8.1% (7) 17.4% (15) 16.6 days
£11,000

## West Wales General - Ssnap Executive Summary

The Sentinel Stroke National Audit Programme (SSNAP) is the National Clinical Audit for Stroke and the main source of stroke data in the NHS. Data is collected on every stroke patient admitted to hospital in England, Wales and Northern Ireland. This is a summary of the stroke care provided by this hospital over the last two and a half years highlighting areas of good, adequate and poor performance. It should be shared with everyone involved in developing and providing stroke care in this hospital, including the non-executive team and managers, in order to draw up action plans for improvement. The SSNAP website has a range of additional tools to help drill down deeper into the data and identify ways to improve.

| Mainly LOW scoring domains     | Mainly ADEQUATE domains        | Mainly GOOD domains    |
|--------------------------------|--------------------------------|------------------------|
| (D or E average):              | (C average):                   | (A or B average):      |
| Occupational Therapy           | Scanning                       |                        |
| Physiotherapy                  | Standards by Discharge         |                        |
| Stroke Unit                    |                                |                        |
| Thrombolysis                   |                                |                        |
| Specialist Assessments         | Multidisciplinary Team Working |                        |
| Speech and Language Therapy    | Discharge Processes            |                        |
| **areas where further          |                                |                        |
| improvements are still needed. |                                |                        |
| **areas to focus quality       |                                |                        |
| improvement on, as require     |                                |                        |
| substantial improvement        |                                |                        |

https://www.strokeaudit.org/results/Clinical-audit/National-Results.aspx

## Poor Improving

**areas to celebrate success, maintain performance and identify whether further improvements are feasible.

2 patients were transferred in from another hospital
92 patients were first admitted to this hospital

| Length of stay:                  | For all routinely admitting teams    |
|----------------------------------|--------------------------------------|
| nationally                       |                                      |
| For all patients treated at this |                                      |
| team                             |                                      |
| N=27,507                         | N=94                                 |
| 18.1% (17)                       |                                      |
| 20.2% (19)                       |                                      |
| 26.6% (25)                       |                                      |
| 40.3% (11,087 patients)          |                                      |
| 20.3% (5,580 patients)           |                                      |
| 21.4% (5,886 patients)           |                                      |
| 5.3% (1,446 patients)            |                                      |
| 12.8% (3,508 patients)           |                                      |
| 8.5% (8)                         |                                      |
| 26.6% (25)                       |                                      |
| 0-3 days                         |                                      |
| 4-7 days                         |                                      |
| 8-21 days                        |                                      |
| 22-30 days                       |                                      |
| 31+ days                         |                                      |
| Mean                             | 14.0 days                            |

These costs have been derived from the SSNAP health economic model. This estimates the average cost of stroke according to patients' age, sex, stroke type and stroke severity. NHS costs include acute treatment costs, bed stays, inpatient and postdischarge rehabilitation, drug prescribing and follow up GP and hospital visits. Social care costs include the costs of nursing home admission and packages of care. They are not the costs for a specific hospital, but the average cost across all providers. The model explored the cost effectiveness of two evidence-based interventions for acute stroke patients; thrombolysis and discharge with Early Supported Discharge. Both of these interventions are appropriate for a subset of acute stroke patients.

Your current thrombolysis rate
11%
Thrombolysis rate at top 20 performing units
20%
Thrombolysis Cost Savings over 5 years:
Average NHS cost saving by thrombolysing 1 more eligible patient
£4,100 £6,900
Average social care cost saving by thrombolysing 1 more eligible patient Overall average cost saving by thrombolysing 1 more eligible patient Average quality-adjusted life-years gained by thrombolysing 1 more eligible patient
0.26 QALYs
Your current rate of discharge with ESD
1%
Rate of discharge with ESD at top 20 performing units
60%
Average NHS cost saving by discharging 1 more eligible patient with ESD
£1,600
Early Supported Discharge (ESD) Cost Savings over 5 years:
Average social care cost saving by discharging 1 more eligible patient with ESD
£8,700
Overall average cost saving by discharging 1 more eligible patient with ESD
£10,300
Average quality-adjusted life-years gained by discharging 1 more eligible patient with ESD
0.14 QALYs

Nationally, 7.0% of patients discharged alive from inpatient care between August-November 2016 were newly institutionalised into a care home for the first time upon leaving hospital. This compares to 7.7% (6/78) for patients treated by this hospital and discharged from inpatient care either by this hospital or another hospital.

www.strokeaudit.org/results Information is available for different types of users:

o o o
Data on stroke **care quality** for all **services** in England, Wales and Northern Ireland Regional slideshows and **Easy Access** Versions Reporting outputs for Clinical Commissioning Groups (**CCGs**) in England and 
Local Health Boards (**LHBs**) in Wales 
Information about **patient outcomes** (30 day all cause **mortality** and AF outcomes) Data about **patient characteristics** (e.g. AF, age profiles) 
o o o o o
Nationally benchmarked data on how effectively stroke services are organised (e.g. **staffing levels**, acute care **protocols** and provision of specialist services) Interactive root-cause analysis tools for to help to speed up thrombolysis and **intra-arterial intervention** times (*requires log-in* ) Detailed data on the **costs of stroke**, and the **costs and benefits** of improving 
thrombolysis and Early Supported Discharge
Interactive **maps, infographics** and dashboards.
o

For patients discharged/transferred alive from this team N=80 17.5% (14) 23.8% (19) 22.5% (18) 7.5% (6) 28.8% (23) 25.0 days
£11,000