In the last decade King’s research on stroke care has brought about significant improvements to service delivery and health planning, resulting in real benefits for stroke survivors, health providers and policy makers.

Stroke is a life-threatening medical condition and is the leading cause of disability in the UK. Occurring when blood supply to the brain is stopped, stroke can irreversibly alter a patient’s life, both physically and mentally, and it remains the fourth largest cause of death in the UK.

King’s researchers, led by Professor Charles Wolfe and Professor Christopher McKevitt, oversee The South London Stroke Register (SLSR) and The Sentinel Stroke National Audit Programme (SSNAP) – data repositories and quality improvement tools initiated to improve care and follow-up and benefitting the approximately 1.2 million stroke survivors in the UK, more than half of whom have a disability resulting from it.

Leading data collection

The SLSR, which was set up by King’s over 25 years ago, registers all first-ever strokes in patients of all ages living in Lambeth and Southwark and follows up with them annually. As the world’s longest-running stroke register, the SLSR provides King’s researchers with information on how many strokes are occurring as well as the immediate and long-term consequences of the disease, allowing them to test and evaluate new ways of providing care.

SSNAP is a major national healthcare improvement programme, setting goals for the NHS Long Term Plan and measuring progress towards these goals. Voted the most effective national clinical quality improvement programme in the UK for the last ten consecutive years, SSNAP (in collaboration with King’s) produces annual reports and academic analyses for all hospitals across England, Wales and Northern Ireland.

By facilitating analysis of the outcomes and impact of stroke in survivors and evaluating the requisite services the NHS provides, the data collected from SLSR and SSNAP have provided vital information for healthcare planning while also contributing to the Global Burden of Disease Study (GBD).

 

Improving services for the benefit of stroke survivors

Perhaps the most important measure of the impact of this work is how it has benefitted stroke survivors, which it has managed to do both locally and internationally.

SLSR data was used for the creation of the EU Burden of Stroke reports in 2017. These reports, presented to the EU parliament, highlighted the estimated future impact of stroke, identified inequalities in stroke risk, shortcomings in prevention and acute care, and the lack of longer-term care and outcome data. In doing so they advocated for better outcomes for stroke survivors by encouraging improved organised stroke care.

Two EU and country specific guidelines were developed as a direct result of this work: The Stroke Action Plan for Europe 2018-2030 and the Economic Impact of Stroke in Europe.

Locally, King’s researchers were able to estimate the future impact of stroke and identify gaps in the evidence that would allow for effective implementation of the NHS England’s Long Term Plan (LTP). They have subsequently developed a stroke care pathway framework to address these evidence gaps, outlining what types of research should take priority in the long term and offering senior NHS healthcare practitioners and commissioners an opportunity to access and exchange knowledge on transformation across health and social care.

This work translates to meaningful benefits for stroke patients through the ways in which it identifies gaps and inequalities in stroke care and provides evidence for structures and processes which can improve survival and long-term support.