About this release

The Scottish Stroke Improvement Programme 2021 annual national report 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 2020, measuring each hospital against Scottish stroke care standards (2016).

Main points

  • COVID-19 had an unprecedented effect on the world, NHSScotland and stroke services. This has made it difficult to know if year-on-year changes in audit figures reflect true changes in the quality of stroke care.
Image caption Percentage of confirmed strokes achieving inpatient stroke standards for stroke unit admission, swallow screen, brain imaging, aspirin administration and bundle
Percentage of confirmed strokes achieving inpatient stroke standards for stroke unit admission, swallow screen, brain imaging, aspirin administration and bundle.

We see fluctuations in performance of the inpatient stroke standards and the inpatient stroke bundle.
  • There has been some deterioration in performance against the stroke standards for stroke unit access (77% in 2020; 82% in 2019), swallow screen (79%; 81%) and aspirin administration (89%; 92%).
  • The drop in attainment shows the vulnerability of specialist stroke services to urgent external pressures. However, in view of the widespread disruption caused by the COVID-19 pandemic, it is perhaps striking that the decline was not more marked overall.
  • There are stroke standards where performance has improved. These include brain imaging within 12 hours of arrival (86% in 2020 compared to 84% in 2019), transient ischaemic attack (TIA) specialist review (87%; 83%), time to carotid intervention (61%; 59%) and mean thrombolysis door-to-needle (DTN) time (51 minutes in 2020 compared to 53 minutes in 2019).


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 scan 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

For more information on the Scottish Stroke Improvement Programme see the Scottish Stroke Care Audit Website.

The next release of this publication will be June 2022.

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Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 20 November 2023
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