Driving quality improvement in Stroke Centres

Mechanical Thrombectomy (MT) is a highly effective treatment for acute ischaemic stroke which has compelling evidence from randomised clinical trials that it significantly reduces disability for people with stroke. Whilst around 10% of stroke patients may be eligible for MT and rates have steadily improved over the last 4 years, currently only 2% nationally receive MT.

This Thrombectomy Quality Review is a first-of-its-kind collaboration between the Getting It Right First Time Programme (GIRFT), the National Stroke Programme at NHSE, the Sentinel Stroke National Audit Programme (SSNAP), Specialised Commissioning, the Promising Effective and Rapid Stroke care research programme (PEARS) and AI decision-support software providers (BRAINOMIX, RapidAI). The review brought together data from a number of sources, with the objective of tackling variations in the way MT services are delivered across the NHS, and by sharing best practice between Stroke Centres.

The approach aimed to provide a constructive, data-driven tool to examine four areas relating to the provision of thrombectomies: 1) the profile of demand and capacity, 2) challenges to delivering consistent access, 3) understanding the variation in the management of thrombectomies and 4) the effectiveness of thrombectomy services and discharge practices.

As part of the programme, we provided detailed data packs for every Comprehensive Stroke Centre and Acute Stroke Centre in England. Their purpose was to help services identify areas where there are opportunities to strengthen patient care and improve the provision of mechanical thrombectomies.

Additionally, workshops were held which brought together over 100 Stroke Centres in total, improving referral patterns and pathways within “communities of practice”. The collaborative sessions referenced data from a range of sources and facilitated shared learning. Specifically, the analysis examined data accuracy, processes of care, workforce requirements, funding needs and areas for specific targeted improvement, and supported a continued quality improvement journey for MT delivery.