Hampshire Hospitals NHS Foundation Trust wanted to increase rates of thrombolysis for their stroke patients. One hundred thousand people have strokes each year in the UK. Thrombolysis is a disability-saving treatment, but the decision to thrombolyse needs to be made quickly. For every 30-minute delay, outcomes decline by around 10%.

Case study

Blackpool Teaching Hospitals had failed to make any change to its 8.4% thrombolysis rate, despite efforts to improve it between 2020 and 2024. So, when neighbouring Lancashire Teaching Hospitals joined the first cohort of TASC (the Thrombolysis in Acute Stroke Collaborative network) and succeeded in improving its own thrombolysis rates, Blackpool was keen to follow suit.

Case Study

Torbay and South Devon NHS Foundation Trust wanted to increase rates of thrombolysis for their stroke patients. One hundred thousand people have strokes each year in the UK. Thrombolysis is a disability saving treatment, but the decision to thrombolyse needs to be made quickly. For every 30-minute delay, outcomes decline by around 10%.

Case study

Prior to joining TASC, UHD had already introduced several innovations to improve stroke care, including pre-hospital video triage and CT Perfusion imaging. These developments had strengthened the pathway and increased access to reperfusion therapies. The Trust joined TASC to build on this foundation, reduce variation in thrombolysis rates and identify further opportunities for improvement.

Case Study

Introducing a ‘Code Stroke’ approach increased thrombolysis rates from 8% to 12%, while reducing treatment delays and improving coordination across emergency and stroke teams.

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Increasing thrombolysis rates from 9% to 13% by tackling pathway delays, strengthening collaboration with emergency department teams, and using regular case reviews to reduce variation in treatment decisions.

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Faced with scanner pressures and out-of-hours delays, the team improved thrombolysis rates and reduced scan-to-needle times from 65 to 24 minutes through pathway redesign and stronger collaboration.

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Shifting the focus from “shall we thrombolyse?” to “why not thrombolyse?” helped increase thrombolysis rates from 8% to 18%, supported by regular case reviews, training, and stronger clinical decision-making.

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Using structured quality improvement, simultaneous stroke alerts and redesigned imaging processes to increase thrombolysis rates from 12% to 18.5% while strengthening multidisciplinary decision-making and reducing unwarranted pathway variation.

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Redesigning thrombolysis governance meetings increased clinician confidence in treatment decisions by 50%, helping build a more open, consistent decision-making culture and supporting rising thrombolysis rates.

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Using data-driven improvement methods to challenge assumptions, identify bottlenecks and strengthen teamwork, they reduced variation across the stroke pathway and sped up access to time-critical treatment.

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By uncovering hidden delays across a complex stroke pathway and strengthening whole-system collaboration, the team increased thrombolysis rates, improved clinical decision-making, and expanded access to advanced imaging.

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Using quality improvement methods and stronger system-wide collaboration, the team increased thrombolysis rates from 11.2% to 14.5%, tripled thrombectomy referrals, and reduced arrival-to-scan times by an average of 19 minutes.

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Increasing thrombolysis rates from 5-10% to 22%, while reducing door-to-needle times to 44 minutes through targeted pathway improvements, stronger multidisciplinary working, and a culture of continuous quality improvement.

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Reducing door-to-needle times by 10 minutes through faster CT access, 24/7 Code Stroke and team-based improvement, while strengthening multidisciplinary working and pathway reliability.

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Reducing both door to needle and door to scan times by 10 minutes through faster CT access, improved team coordination and a 24/7 Code Stroke system.

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Doubling thrombolysis rates from 9.8% to 20% while improving decision-making consistency through regular case reviews, staff education, and stronger collaboration across ambulance, emergency, radiology, and stroke teams.

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Faced with out-of-hours delays and inconsistent decision-making, the team increased thrombolysis rates from 9% to 20-22% through pathway redesign, targeted education, and a stronger focus on early stroke identification and escalation.

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