Determining local service levels for a service for the diagnosis and initial management of acute stroke
Benchmarks for a standard population
Available data suggest that the standard benchmark rate for admission to an acute stroke unit is 100% of people who are admitted to secondary care following a stroke, or 120 per 100,000 population based on the national average, per year.
Available data suggest that the standard benchmark rate for treatment of acute ischaemic stroke with alteplase is 9% of people admitted to secondary care following a stroke, or 11 per 100,000 population based on the national average, per year.
For an average primary care trust population of 300,000, the average number of people requiring admission to an acute stroke unit would be 360 per year (0.12% of the population).
Of these, approximately 30 (9% of 360) may be expected to need treatment with alteplase for acute ischaemic stroke.
For an average general practice list size of 10,000, the average number of people requiring admission to an acute stroke unit would be 12 per year (0.12% of the population).
Of these, approximately 1 (9% of 12) may be expected to require treatment of acute ischaemic stroke with alteplase.
Examine the assumptions used in estimating these figures.
An acute stroke service is likely to fall under the programme budgeting category 210B (cerebrovascular disease).
Use the acute stroke service commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
Further information
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- Annex A of the Commissioning framework for health and well-being outlines the process and data needed to undertake a joint strategic needs assessment.
- Department of Health Delivering quality and value - focus on benchmarking.
- NICE Health equity audit - learning from practice briefing.
- The Disease management information toolkit (DMIT) is a good-practice tool for decision-makers, commissioners and deliverers of care for people with long-term conditions. It includes data on conditions that contribute to high numbers of emergency bed days. It also models the effects of interventions that may be commissioned at a local level and helps users to consider the likely impact of different commissioning options.
- Disease prevalence models produced by the Association of Public Health Observatories (APHO) provide PCT-level prevalence estimates for hypertension and coronary heart disease.
- PARR (Patients at risk of re-hospitalisation) is a risk prediction system for use by PCTs to identify patients at high risk of hospital re-admission.
- PRIMIS+ provides support to general practices on information management, including how to record for and analyse data quality, and a comparative analysis service focused on key clinical topics.
- Payment by Results (PbR) for stroke and transient ischaemic attack (TIA) services.
This page was last updated: 26 March 2010
- Diagnosis and initial management of acute stroke
- Commissioning a service for the diagnosis and initial management of acute stroke
- Specifying a service for the diagnosis and initial management of acute stroke
- Determining local service levels for a service for the diagnosis and initial management of acute stroke
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance
