How have acute stroke care staffing levels changed between 2019 and 2021? Data from the Sentinel Stroke National Audit Programme (SSNAP)

ABSTRACT

Introduction: The Sentinel Stroke National Audit Programme (SSNAP) includes a biennial 'snap-shot' of the organisation of stroke services in acute hospitals in England, Wales, and Northern Ireland. The timing of the 2019 and 2021 audits, before and during the COVID-19 pandemic, provides an opportunity to assess its impact on acute stroke care services. Method(s) A web-based proforma was sent to eligible acute hospitals requesting details of the organisation of acute stroke care services on 3rd June,2019 and 1st October,2021. In 2019, 183 acute services representing 4,847 acute beds were included. In 2021, 182 acute services were included representing 4,707 acute beds. This represents 100% participation of eligible providers. Result(s) 82% of sites (128/157) made changes in response to COVID-19 and as of October 1st, 2021, 90% reported that these changes remained in place. The number of sites reaching minimum staffing levels in several criteria fell. The availability of band 6 or 7 specialist nurses per ten beds at weekends reduced (58%-46%, p=0.03), and sites with at least one stroke consultant vacancy rose to 52%. Hospitals with a qualified psychologist on the acute unit remained low (7%-9%). A decrease was seen in sites meeting the minimum number of nurses on duty at the weekend (30%-23%,p=0.13). Conclusion(s) A large majority of sites made changes in service provision due to COVID-19 and many of these remained in place in October 2021. Reductions in the number and availability of senior clinical staff over the pandemic are reflected in these changes over time, which may have implications for the recovery of services.