Scottish stroke improvement programme
Annual report 2024

About this release

This publication by Public Health Scotland (PHS) presents information from the Scottish Stroke Improvement Programme 2024 annual national report and includes data from the Scottish Stroke Care Audit (SSCA). This describes the quality of stroke care in each acute hospital, grouped by NHS board, during 2023, measuring each hospital against Scottish stroke care standards (2016). The full report can be found on the PHS and SSCA websites.

Main points

• 10,803 Scottish residents had a final diagnosis of stroke in 2023. Of these, 85% (9,182) were ischaemic while 13% (1,451) were intracerebral haemorrhage. These proportions vary between NHS boards, and in a small number of patients - 2% (170) it is not known the type of stroke the patient had.
• Between 2022 and 2023 there has been little change in the stroke bundle performance across Scotland (49.9% v 51.3%) and it remains lower than 2019 when it was 64%.

The chart shows the increase in inpatient bundle until 2019 and then a decrease. It remains below 2019 levels in 2023.

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Percentage of confirmed strokes achieving the inpatient stroke care standards from 2010 to 2023

• Performance against the swallow screen standard (100% within 4 hours) remains challenging. There are fluctuations in performance across the country, but no NHS board does well. The Scottish average (67.7%) is almost identical to that reported in 2022, and down from 73% in 2021.
• Admission to a stroke unit within one day increased from 63% in 2022 to 66% in 2023 but remains below the 82% achieved in 2019.
• In 2023 across Scotland the overall geometric mean for door to needle time for thrombolysis was 55.6 minutes, similar to 55 minutes in 2022 and increased from 52.7 minutes in 2019. There is on average a 17-minute difference between in hours (Monday - Friday 9am - 5pm; 46 minutes), and out of hours (63 minutes).
• 153 patients received thrombectomy treatment across Scotland. Although an increase from 112 in 2022, this is still only 1.4% of the total number of people who had an ischaemic stroke.

Background

The SSCA monitors the quality of care provided by the hospitals in all NHS boards by collating data collected by the stroke managed clinical networks (MCNs). Appropriate care is measured using the stroke care bundle, which comprises four key components: admission to a stroke unit, swallow screen, brain imaging and aspirin. Not all patients are eligible for all four components. The stroke care bundle is important because achieving it is associated with a reduced risk of dying and an increased chance of getting back home. These data are used by the Scottish Government to monitor progress against the Scottish stroke care standards (2016) and the Scottish stroke improvement plan (2014). NHS boards are expected to identify aspects of their stroke services which do not meet the Scottish standards and to work with their stroke MCNs to improve their standards of care locally.

Further information

The next release of this publication will be 29 July 2025.