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Advanced Neurology The South London Stroke Register

SLSR data informed the 2005 National Audit Office outcomes for those disadvantaged. While routinely
report ‘Reducing Brain Damage: faster Access to Better collected health data will continue to answer some of these
Stroke Care’, which detailed the poor state of stroke care in questions, labour-intensive population-based research has
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the UK, leading to the National Strategy for Stroke 2007, a unique role to play due to its low recruitment bias and
devised by the Department of Health. The subsequent detailed, consistent and disease-specific data. Population-
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2010 National Audit Office report ‘Progress in Improving based registers can serve as a suitable sampling frame for
Care’ again used SLSR data to demonstrate improvements trailing digital and other interventions. Future directions
in care and cost-effectiveness, specifically the provision of of research might include artificial intelligence methods
stroke unit care and ESD. 28 research, for example, in relation to brain imaging, and
further linkages between different types of datasets, to
SLSR data underpinned the successful 2010
reconfiguration of stroke services in London, which extract the most impactful insights for improvements in
stroke prevention, care and outcomes.
involved a centralisation from 30 hospitals into eight Hyper
Acute Stroke Units covering the first 72 h of stroke care. Acknowledgements
SLSR data were used to estimate the expected number of
stroke patients and to model the most cost-effective way to The authors thank the stroke survivors, their families and
deliver stroke services, that is, the number and allocation carers, the staff in the stroke services facilitating the study
of Acute and Hyper Acute Stroke Unit beds. A subsequent and the fieldworkers who have collected data over the
evaluation of the reconfiguration estimated an additional course of the study.
96 lives saved per year. 29 Funding
SLSR data contributed to the 2020 evidence review This project is funded by the UK’s National Institute for
‘Stroke pathway – Evidence Based Commissioning’, Health and Care Research (NIHR) under its Programme
commissioned by NHS England, summarising current Grants for Applied Research (NIHR202339) and is supported
understanding and knowledge gaps across the stroke by the NIHR Applied Research Collaboration (ARC) South
pathway, and informing service providers and national London at King’s College Hospital NHS Foundation Trust,
policymakers of what needs to be achieved to provide UK. The views expressed are those of the authors and not
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high-quality services. Finally, evidence based on SLSR necessarily those of the NIHR or the Department of Health
data regularly informed the development of the National and Social Care (UK). The study has previously received
Clinical Guidelines for Stroke. 31 funding from many sources including The Dunhill Medical
To further bridge the divide between research findings Trust, the NIHR funding streams (Programme Grants for
and policymaking, the current programme is running Applied Research and Research for Patient Benefit), the
a series of ‘Policy Labs’, an innovative model that brings European Union, the Health Foundation, the Department
together key decision-makers, professionals, stroke of Health (UK), the Stanley Thomas Johnson Foundation,
survivors and carers to address how research findings can the Stroke Association and Guy’s and St Thomas’ Charity.
be put into policy and practice.
Conflict of interest
7. Conclusion The authors declare no conflicts of interest.

Since the beginning of the SLSR in 1995, stroke care and
services have been profoundly transformed in London Author contributions
and elsewhere. Data and evidence provided by the SLSR Conceptualization: Charles D.A. Wolfe, Eva S. Emmett,
were central for stakeholders to drive this change forward, Fara Hamidi
improving the lives of stroke survivors and their families. Writing – original draft: Eva S. Emmett, Fara Hamidi
Among the many unanswered questions for future Writing – review & editing: Iain J. Marshall, Charles D.A.
research are the implications of the new WHO ICD-11 Wolfe, Hatem A. Wafa, Jack Coumbe, Matthew D.L.
definition of stroke; the trend of stroke incidence in the face O’Connell, Abdel Douiri, Ajay Bhalla
of demographic, environmental and economic challenges; Ethics approval and consent to participate
the management of stroke as a long-term chronic condition
as well as multimorbidity in an ageing population, with Not applicable.
a focus on vascular health more broadly; the drivers of
inequalities in stroke risk and outcomes between socio- Consent for publication
demographic groups and the approaches used to improve Not applicable.

Volume 4 Issue 1 (2025) 77 doi: 10.36922/an.4771