SSNAP Regional Reports AGENDA Stroke System Report Aug – Nov 2016 UPDATES *TEAM CENTRED RESULTS* March 2017

CHANGES OVER TIME July – Sept 15 Oct – Dec Jan – Mar 16 Apr – July Aug – Nov 2016 Blackpool E D before Adjustment D YEHA Blackburn Lancaster C before Adjustment Furness C ↑ D ↓ C before adjustment Preston C Chorley B Pendle

CASE ASCERTAINMENT Jan – March 15 Apr – June Jul – Sept Oct – Dec 15 16 Apr – July Aug – Nov 2016 Blackpool B A ↑ A Blackburn B ↑ Lancaster Furness C ↓↓ A ↑↑ Preston

AUDIT COMPLIANCE Jan – Mar 15 Apr – June Jul – Sept Oct – Dec 16 Apr – July Aug – Nov 2016 Blackpool C ↑ B ↑ B A ↑ A Blackburn D B↑ A ↑ Lancaster Furness B ↓ D ↓↓ ↑C Preston

SCANNING - CHANGES OVER TIME Jul – Sept 15 Oct – Dec 15 Jan – Mar 16 *Patient Centred Apr – July 16 Aug- Nov 2016 Areas to improve to achieve next level Blackpool – Overall 1hr scan 12hr scan Median Time (hr:min) E 12.2% 85.2% 2.49hrs 12.7% 87.3% 2.20hrs D ↑ 20% 91.9% 2.17hrs D 28% ↑ 92.7% ↑ 2.06hrs ↑ C 30.5% ↑ 92.5% ↑ 1.40hrs ↑ B 43% 90% <75mins Blackburn – Overall 30.4% ↑ 79.5% ↓ 2.18hrs ↓ 35.3% 82.6% 1.45hrs C ↑ 40.3% 1.41hrs 35.8 ↓ 89.4% ↑ 1:32hrs ↑ D ↓ 28.6 ↓ 85.2 ↓ 2:01 ↓ 30% 85% <90mins Southport & Ormskirk 48.1% 88.6hrs 1.05hrs C ↓ 45.4% 94.8rs 1.18hrs 43.9% 93.4% 1.21hrs B ↑ 46.1% 93% 1.07hrs↑ 54.9% 90.3% 0.51hrs↑ A 48% 95% <60mins Lancaster – Overall 1hr Scan A ↑ 55.3% 97.9% 0.54hrs 51.6% 95.7% 0.58hrs C ↓↓ 40.8% 94.7% 1.13hrs 42.6% ↑ 97.4% ↑ 1:17hrs ↓ T.Level 42.2% 97.4% 1:19hrs P.Level 59.3%↑ 97.2%↓ 0.47h↑ Furness – Overall 62.3% 98.1% 0.50hrs 50% 96.4% 0.48hrs B↓ 52% 94% 1:00hrs 53.4% ↑ 95.9% ↑ 0:57hrs ↑ 43.2% 93.8% 1:09hrs <60min Preston – Overall 32.8% 84.9% 1.48hrs 39.5% 95.2% 41.7% 1:17hrs 39.5% ↓ 91.5% ↓ 1:29hrs ↓ 36.3% ↓ 95.8% ↑ 1:47hrs ↓

STROKE UNIT MEASURE - CHANGES OVER TIME Jul – Sept 15 Oct – Dec Jan – Mar 16 *Patient Centred Apr – Jul Aug-Nov 16 Areas to improve to achieve next level Blackpool - Overall Stroke Unit within 4hrs Median Time to arrival SU 90% stay B ↑ 71.7% 2.22hrs 93.2% C ↓ 59.5% 3.23hrs 87.5% D↓ 45.9% 4.20hrs 87.2% D 54% ↑ 3:34hrs ↑ 78.1% ↓ 53% ↓ 3:16hrs ↑ 82.3% ↑ C 60% <4hrs 80% Blackburn - Overall E ↓ 46.9% 4.00hrs 72.7% D ↑ 53.4% 3.51hrs 64.7% 4hrs 78% 47.6% ↑ 4:01hrs ↓ 83.7% ↑ D (=) 51.7 ↑ 3:59 ↑ 82.4%↓ Southport & Ormskirk - E 37.7% 6.03hrs 74% 34.4% 6.09hrs 67% 26.7% 6.20hrs 75.3% 18.6%↓ 8.43hrs↑ 61.9%↑ 29.7 ↑ 7.25hrs↑ 69%↑ 55% <5hrs 75% Lancaster - Overall 65.2% 3.47hrs 91.5% D ↓ 35.6% 4.23hrs 87.4% E↓ 32.4% 6.17hrs 90% 36.8% ↑ 4:51 ↑ 82.1% ↓ 29%↓ 5.12h↓ 82.5%↑ Furness - Overall B ↑↑ 76.5% 3.17hrs 97.5% C ↓ 68% 93% 57% 3.56hr 95.9% 47.7% ↓ 4:05 ↓ 92.4% ↓ C↑ 60%↑ 3:43↑ 93.4%↑ B <3hrs Preston - Overall 3.44hrs 85.4% 61.8% 3.50hrs 83.8% 47% 4.08hrs 84% 46.1% ↓ 4:00hrs ↑ 79.2% ↓ 38.5%↓ 5.21h↓ 72.2%↓

THROMBOLYSIS – CHANGES OVER TIME Domain Targets Jul – Sept 15 Oct – Dec 15 Jan- Mar 16 *Patient Centred Apr – July Aug – Nov 2016 Actions to achieve next level Blackpool % Thrombolysed % Eligible Thrombolysed Thrombolysed within 1hr % Directly admit SU 4hrs + Thrombolysed or justifiable ‘no but’ Median Time to Thrombolysis D 7.0% 80.0% 37.5% 70.8% 1.08hrs E ↓ 3.7% 57.1 20% 59.5% 1.35hrs E 8.9% 100% 45.9% 1.38hrs D ↑ 9.1% ↑ 87.5% ↓ 20% ↑ 54% ↑ 1:20hrs ↑ 8.6% ↓ 92.9% ↑ 15.4% ↓ 52% ↓ 1:16hrs ↑ C 12% 80% 40% 50% Less than 60mins Blackburn D↑ D (=) Lancaster E ↓ Furness Preston C↑ D ↓

SPECIALIST ASSESSMENTS - CHANGES OVER TIME Jul – Sep 15 Oct – Dec 15 Jan – Mar 16 P.Centre Apr – July 16 Aug – Nov 16 Actions to achieve next level Blackpool % Assessed by Stroke Consultant 24hrs Median Time Stroke Consultant % Assessed Stroke Nurse 24hrs Median Time Stroke Nurse Swallow Screen 4hrs Formal swallow 72hrs (applicable) D 65.2% 19.15hrs 90.4% 1:45hrs 73.7% 59.3% 68.7% 17.56hrs 88.1% 2.54hrs 63.3% 57.1% E↓ 62.2% 20.51hrs 3.05hrs 52.6% 51.4% D ↑ 65.9% ↑ 17:21hrs ↑ 90.2% ↑ 1:28hrs ↑ 71.8% ↑ 77.6% ↑ 67.5% ↑ 16:46hrs ↑ 88.1% ↓ 1:02hrs ↑ 70.1% ↓ 50%↓ C 80% Less than 12hrs Less than 3hrs 75% Blackburn E (TC) E D↑ E ↓ Lancaster ↓ Furness A B ↓ B Preston E ↓

Occupational therapy – CHANGES OVER TIME Domain Targets Jul – Sep 15 Oct – Dec Jan – Mar 16 Apr – Jul 16 Aug – Nov 2016 National Blackpool %Patients requiring OT Median no. Minutes /day Median % days received Compliance E 71.4 % (↓) 25.0 (=) 26.6% (↓) 18.5% (↓) E (48.3) 61.9% (↓) 31.1 (↑) 29.3% (↑) 21.9% (↑) 71.5%(↑) 26.3 (↓) 26.9%(↓) 19.7% (↓) E (54.0) 85.1%(↑) 30.0(↑) 25.5%(↓) 25.3%(↑) 74.2%(↑) 19.7%(↓) 19.9%(↑) 83.8% 40.0 62.5% 81.5% Blackburn D D (61.2) C (67.5) D (61.8) D (63.4) Lancaster C C (69.3) B C (67.4) Furness C (70.9) B (79.7) A (82.9) Preston A (96.3) A D (61.6) Chorley A (91.8) Pendle B (75.8) B (76.1)

Physiotherapy– CHANGES OVER TIME Domain Targets Jul – Sep 15 Oct – Dec Jan – Mar 16 Apr – Jun 15 Aug – Nov 2016 National Blackpool %Patients requiring Physio Median no. Minutes /day Median % days received Compliance E 73.9% (↑) 20.0% (↑) 31.4%(↓) 17.0% (↑) E (49.1) 69.8% (↓) 25.0% (↑) 34.4% (↑) 22.0% (↑) 72.4%(↑) 19.6(↓) 34.5%() 18.0% (↓) E (46.4) 86.3%(↑) 20.0(↑) 30.2%(↓) 19.1%(↑) 76.6%(↓) 25.0(↑) 30.5%(↓) 21.4%(↑) 85.7% 35.0 71.3% 78.3% Blackburn D D (60.8) D (66.1) D (64.2) D (61.9) Lancaster C (70.5) C B (75.7) Furness D (64.8) C (72.4) Preston B A (91.6) A D (61.3) Chorley B (83.5) B (84.9) Pendle C (73.3) B (75.3)

S&LT – CHANGES OVER TIME Domain Targets Jul – Sep 15 Oct – Dec 15 Jan – Mar 15 Apr – Jul 16 Aug – Nov 2016 National Blackpool %Patients requiring S&LT Median no. Minutes /day Median % days received Compliance E 40.3% (↑) 37.2 (↑) 21.8% (↓) 20.3% (↓) E (45.3) 46.8% (↑) 34.3 (↓) 22.3% (↑) 22.3%(↑) 36.6%(↓) 30.0(↓) 24.9%(↑) 17.0% () E (42.8) 48.4% (↑) 30.0 (=) 22.4% (↓) 20.2%(↑) 39% (↓) 15.6% (↓) 11.3%(↓) 50.5% 32.5 46.0% 47.0% Blackburn E (36.3) E (38.1) D (53.5) C (59) Lancaster D E (48.8) E (48.1) Furness E (39.0) E (42.9) E (43.5) Preston C (62.9) D (53.1) C Chorley C (58.1) Pendle C (55.1) C (60.2)

STANDARDS BY DISCHARGE - CHANGES OVER TIME Jul – Sep 15 Oct – Dec Jan – Mar 16 Apr – Jul 16 Aug – Nov 16 National Blackpool % Applicable patients mood & cognition screened by discharge C = 78.8% C = (71.0) 76.0% (↓) D ↓ 67.1%() 58.5%() C 55.3% 90.7% Blackburn B = 87.3% B = (91.5) 83.8% (↓) C (77.1) 72.6%() B (92.7) 98.6%() A (100) 100%(↑) Southport & Ormskirk B = 100.0% B = (83.3) 100% (=) B 98.3%() 98.8%() 94.1%() Lancaster A = 98.8% A = (95.0) 95.8% (↓) 98.5%() 92.5%() 98.9%() Furness B ↓ 83.9% D ↓ (67.4) 81.4% (↓) D 84.4%() 89.9% () 92.6% Preston 100% A ↑ (100) A 98.8%() 98.2% Chorley A ↑ A = (100) 100%(=) 97.1%() Pendle B (82.8) 89.1% 100% (↑)

DISCHARGE PROCESS - CHANGES OVER TIME Jul – Sep 15 Oct – Dec Jan – Mar 16 Apr – Jul 16 Aug – Nov 16 National Blackpool Joint Health + Social Plan ESD AF + Anticoagulation (app. patients) Named Contact B ↑ 100.0%(↑) 33.3%(↑) 100% (=) 74.0%(↑) C↓ (82.1) 87.5%(↓) 28.7% (↓) 93.8% (↓) 75.2%(↑) C 57.1% () 47.4% (↑) 100%() 60.0% () B (89.6) 91.3% (↑) 31.2% () 100%(=) 89.1% (↑) 100% (↑) 28.5% () 96.9%%() 86.9% (↑) 90.5% 33.7% 97.4% 93.3% Blackburn B = A ↑) A (97.9) C (82.8) D (73.6) Lancaster B C↓ (82.8) B ↑ A (97.4) Furness C ↓ (82.4) C (78.4) Preston D ↑ D = (60.6) D C (77.4) Chorley C (77.2) Pendle.