National Stroke Audit

NICE Stroke Care quality indicators 2015 consultation document

Stroke Improvement National Audits: Sentinel audit, SINAP, SSNAP (no login or password required)

SSNAP Data entry and local reports  (login and password required)

CQC reports: West Midlands Quality review Service assessment of Acute care and stroke 2010 Report published in 2011 


Stroke management

The report of the Expert Working Group of the Commission on Human Medicines on alteplase July 2015

NICE IPG 472 Closure of PFO /ASD  (Dec 2013)

NICE IPG458 Mechanical clot retrieval for the treatment of acute ischaemic stroke (July 2013)

NICE CG 162 Stroke Rehabilitation- long-term rehabilitation after stroke (June 2013)

RCP Stoke Guideline 2012. Please search for “RCP stroke guideline 2012” in your app store / android market and you should see options for “clinical” and “patient and carer” versions. 

NICE STA Rivaroxaban to prevent stroke and systemic embolism in AF (March 12)

NICE TA 249 Dagibatran for stroke prevention in patients with AF

UK DH Stroke Improvement programme Consensus Statement on Intra-arterial thrombolysis and mechanical thrombectomy February 2011

Best practice statement: The management of pain following acute stroke. NHS Scotland 2011  

NICE  TA 210 Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events. Review of NICE TA 90.

NICE quality standards for stroke published June 2010

British Association of Stroke Physicians Stroke Service Standards latest update  May 2010.

The European Stroke Organization has amended the Guidelines on thrombolytic therapy (Jan 2010)- read here

NICE Guidance on preventing venous thrombolembolism January 2010

RCP National Clinical Guideline for Stroke (3rd edition, Intercollegiate Working Party, July 2008, 187 pages)

Stroke - National clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA) developed by the National Collaborating Centre for Chronic Conditions published 21 July 2008 (137 pages).

NICE Stroke and TIA guidance July 2008 

National Clinical Guidelines for stroke. The Royal College of Physicians guideline for stroke management (The UK view, July 2008).

Sign Guidelines for stroke management (the Scottish view, December 2008).

The European Stroke Initiative Virtual Stroke University, Stroke treatment guidelines, slide shows for acute management, prevention, rehabilitation (the European view). Full guidance 2008   Slide Presentation Short update 2009 

NICE guidance on Thrombolysis for stroke July 2007. 

The Brain Attack Coalition. Stroke management guidelines, stroke care pathways, assessment scales, standard medical orders, patient information material by the American Heart Association (The US view).

Management of stroke in children American Heart Association guidance July 2008.

Cochrane database of systematic reviews contains systematic reviews of the evidence supporting stroke treatments. Click here for free abstracts.


Stroke Prevention

Cardiovascular risk calculators

QRISK Risk Score (NICE recommended)

GRASP tool for determining if patients with AF should be given warfarin

Risk benefit of carotid endarterctomy (recommended by 2012 RCP Guideliens)


NICE Cardiovascular Guidance Updates/ Consultations

NICE Guidance on Lipid modification: Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. Full Guideline Quick Guide Patient information / Understanding the guidance (May 2008, next review 2011)

NICE Guidance on Familial hypercholesterolaemia: Identification and management of familial hypercholesterolaemia. Full Guideline Quick Guide Patient information / Understanding the guidance (May 2008, next review 2011)

NICE guidance on smoking cessation and useful resources which will help in meeting the requirements of the NICE guidance on smoking cessation.

NICE PH25 Prevention of Cardiovascular Disease: public health guidance 

NICE IPG348 Extracranial to intracranial bypass for intracranial atherosclerosis 

IPG349 Percutaneous occlustion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism: guidance  

Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology 2010.

Alcohol advice, NICE guidance, resources and screening tools


Stroke unit standards

BASP Stroke Service Standards 2014 2010

BASP calculator for medical workforce requirements in relation to number of stroke admissions and catchment population 2012

BASP definition of a Stroke Specialist 2011

BASP statement on services for intra-arterial intervention for stroke 2012

UK Forum for Stroke Training staffing calculator, which can provide an estimate of staffing levels for a stroke service.  The calculation of staff numbers is based around the throughput of patients, staff working hours and the different tasks that staff perform. 

Stroke Service Specification (useful documents produced by London Healthcare to guide commissioning of Hyperacute Stroke Unit (HASU), Stroke Unit (SU),  and TIA services (includes staffing numbers).


Professional organizations

The British Association of Stroke Physicians promotes the advance of Stroke Medicine in Britain. It runs educational events and regular thrombolysis training courses. Have a look at the online CT training course.

The National Stroke Nursing Forum requires registration and a fee to join.


Stroke organizations and charities

The Stroke Association website should be the first port of call for people affected by stroke. It provides information on strokes, prevention, research, fundraising, local branches, contacts, campaigns, services, products and much more.

Different Strokes A Charity Set up by Younger Stroke Survivors for Younger Stroke Survivors. It helps stroke survivors to optimise their recovery, take control of their own lives and regain as much independence as possible by offering 'rehabilitative services', information and advice. Look here for survivor stories and information how to get back to work and leisure activities.

Strokes R Us A charity set up for younger individuals with stroke in Stoke on Trent and North Staffordshire. Please check website for contacts, activities, and events.


Sites for people with stroke related speech problems

Dysphasia Support This site provides information and contacts for people who have speech problems after stroke. In addition to general information it also contained detail of local branches and groups.

CONNECT The communication disability network. A resource for people with communication disorders, their families and friends and for professionals with an interest in communication problems. Click here for the newsletter.

Information leaflet on communication problems form the Scottish Chest Heart and Stroke foundation.

How to find a speech and language therapist  If you think you or relative needs to see a speech and language therapist ask your GP, district nurse, health visitor  for a referral. You can also refer yourself to your local speech and language therapy service. You do not have to wait for someone else to refer you.

My Voice: An app has been developed in the US called MyVoice. It is a communication aid, inspired by someone who had a stroke. It is free to download, though there is a charge for additional features.


Information materials for patients ad carers

Information leaflets produced by the Scottish Chest Heart and Stroke Foundation can be downloaded here. Topics covered are: salt, cholesterol, warfarin, communication, Holiday information, sympathetic insurance companies, driving, air travel, mouth care, swallowing, incontinence, eye problems, HRT, risk factors, Just move (exercise), and many more.... .

Personal experiences of stroke Personal stories of individuals who have had a stroke and answers to a number of frequently asked questions.

Stroke News is a free magazine produced by The Stroke Association for people affected by stroke and professionals working with stroke patients.

Patient Plus is a UK source of general health information for patients

Medline Plus is a US source of general health information for patients (National Institute of Health)

EQIP is an information-rich website about strokes and a list of support groups and services related to strokes. Each topic has a section of ‘Useful links’ - these websites have been accredited by staff at NHS West Midlands and are aimed at the public.

Each topic also has a list of ‘Support groups and services’ - websites in this list have not been accredited but they may give additional information on specific topics

Self management

Bridges Stroke Self Management  is a  training programme designed specifically for individuals after stroke to support the development of self-management skills. The programme includes one-to-one training sessions with a therapist or nurse, and the sessions are supported with an interactive workbook.

Research and clinical networks

The Stroke Research Network (National site/Newcastle). Click here to get all relevant information about the stroke research network, and to keep up with the latest information.

The West Midlands Stroke Research network gives up to date information on network research relevant to the West Midlands.

The National Physiotherapy Research Network  provides contacts, access to knowledge and support for physiotherapists interested in research.

The Royal College of Nursing Research and Development Centre provides access to knowledge, support, training resources and career advice for nurses interested in research.

NHS Networks is a means of promoting and connecting the many networks which exist throughout the NHS.


Public involvement in research

INVOLVE This is a Department of Health website providing information on and support for public involvement in NHS, public health and social care research.

PEOPLE IN RESEARCH helps members of the public make contact with organisations that want to actively involve people in clinical research. It has been developed by the UK Clinical Research Collaboration, INVOLVE and others.

The UKCRN strategy for public and user involvement in research is outlined and updated on the UKCRN site. #



Stroke: Practical Management. Eds: Warlow et al. Blackwell Publishing, Oxford 2007 (995 pages). ISBN 978-1-4051-2766-0 [free access for Keele Students and staff- requires Athens Log in and password]


Stroke Morbidity and Mortality

SEPHO (Solutions for Public Health) Cardiovascular disease indicators 2011. Data for each PCT /network on stroke and CVD incidence, mortality, and risk factors. 

Stroke Statistics (British Heart Foundation 2009) Click here for pdf.


Older Stroke Strategy and Service improvement documents

30-day mortality after admission with stroke is one of the 44 Commissioning Outcomes Framework (COF) data proposed by NICE in 2012  (see link for detail)

The stroke improvement team has produced a set of 8 documents with ‘practical principles’ for improving stroke care ( improving psychological care; developing an early supported discharge service; improving access to CT scanning; TIA; joint care planning; reviews for stroke survivors      ; being the best in acute stroke ;  developing a community stroke service).

DH Authorisation Framework for Clinical Commissioning Groups Sept 2011

Unbundling the stroke tariff, as outlined in the Payment by Results Guidance 2011/12. 

NHS  listening exercise 07 04 2011

Care Quality Commission Report on Supporting Life after Stroke: Supporting life after stroke A Review of Services for people who have had a stroke and their carers (January 2011)

Stroke Improvement Programme Website for the latest news of the SIP

Atrial fibrillation (AF) included in NICE high level summary of recommendations for 2012/13 QOF indicators published August 2011

Stroke Improvement National Audit Programme (SINAP). This audit collects all the key data for the first 72 h after stroke and allows free fields for individual trust data. Data collection form  Sinap presentation P Tyrrell.

Key measures of the Stroke acceleration programme 2010/2011. Click here for detailed instruction on how to collect the data circulated 19.04.2010, .A slide set on the Accelerated Stroke Improvement programme has been developed to explain further, supported by briefing notes. If you have any questions on the measures you would like answered in these, please send to Sarah Gillham.  

National Stroke Sentinel Audit results, forms deadlines, information. Next set of data collection will start 1.4.2010.

DH Vital Signs for stroke and TIA to be achieved by the end of 2010/0011 click here for more detail form an explanatory doc June 2008) and here for FAQs published September 2009 to clarify the definitions. Please click here for results.

West Midlands Quality Review Service (WMQRS) Standards for Stroke and TIA April 2010

West Midlands Stroke Service Specifications (Acute stroke)

Data collection form for West Midlands Stroke Service Standards, AIP and Vital signs.

Accelerating Stroke Improvement national Plan July 2010 Update.

Stroke Improvement Bulletin (NHS) all the latest news and initiatives related to the NHS Stroke improvement programme.

NHS Stroke Improvement Programme Key site to keep abreast with National stroke Strategy and the Stroke Improvement programme.

Stroke Specific Education Framework

Stroke Core Competencies: a new online training resource for health and social care staff which is based on the Stroke Core Competencies, developed jointly by NHS Education Scotland, Chest Heart & Stroke Scotland, the University of Edinburgh and expert stroke clinicians from across Scotland.

Getting better: Improving stroke services across the UK. This new report from The Stroke Association brings together twelve case studies of stroke services from across the UK covering the whole of the stroke care pathway.

Commissioning for prevention: Arial Fibriallation (17.Jun.2009)

DH Implementing the Stroke Strategy An imaging Guide

Putting Prevention First. NHS Health Check. Risk assessment and management. Best Practice Guidance. DH April 2009.

Commissioning guide: diagnosis and initial management of acute stroke. (published December 2008). 

Commissioning guide: TIA service (published December 2008)

National Stroke Strategy released 05.12.2007. Essential read for everyone interested in stroke or involved in developing stroke services.