Stroke improvement plan 2023

3. Scottish Stroke Improvement Programme

The Scottish Government continues to support the Scottish Stroke Improvement Programme (SSIP), a key tool in driving improvement across stroke care. The SSIP annual national report collates information collected via the Scottish Stroke Care Audit (SSCA), which measures performance in NHS acute hospitals, grouped by NHS Board, against the Scottish Stroke Care Standards. This refreshed Stroke Improvement Plan does not make changes to the current Scottish Stroke Care Standards. However, we will work with Public Health Scotland regarding future changes, such as the inclusion of measures of rehabilitation outcome and measures to assess TIA services.

The SSIP annual national report also reports on the standards identified in the Stroke Improvement Plan (2014). Working with the Scottish Stroke Improvement Programme, we have made considerable changes to the criteria for assessing the provision of stroke care in NHS Boards, to reflect this refreshed Stroke Improvement Plan. Recommendations made in the Progressive Stroke Pathway have been incorporated into the SSIP review criteria.

Although the overall process of conducting reviews remains largely unchanged, the criteria against which NHS Boards are assessed have been altered to reflect recommendations made in the Progressive Stroke Pathway. The most significant change in the new criteria is a far greater emphasis on the delivery of post-acute care, including rehabilitation.

The reviews conducted in 2022 and 2023 represent the first round of reviews with NHS Boards using the new criteria for assessment, and this process has been treated as an opportunity to provide a baseline of current stroke care provision against the new, more challenging, criteria. We will continually review the information collected during SSIP reviews of stroke services and refine the criteria or the process for collecting data, if required.

Going forward, our expectation would be to see increasing performance against the criteria outlined in the review process. This will require NHS Boards to drive local improvements in their stroke services, in line with our ambitious vision for stroke care in Scotland.

It should be noted that the system of assessing compliance has been simplified to a RED, AMBER, GREEN (RAG) system. Within each aspect of care being assessed, multiple criteria are outlined. This allows us to monitor changes in service delivery within each of the RAG ratings. The revised RAG chart, against which the provision of stroke care provision in each NHS Board will be assessed, is included as an annex to the Stroke Improvement Plan (Annex A).