“different people are responsible for different bits which is part of the problem. Part of the challenge. […] so we are relying on other people. […] it is a chain that involves so many different departments and so many individuals and you kind of need all bits of that chain to work for every patient.” (Interviewee 2)
Participants identified a potential solution in this area: to implement direct admission to their stroke units. This would resolve inconsistencies with achieving the SSCB.
“Direct admissions would solve it, yes, it would solve a lot of these problems, I think it would solve everything.” (Interviewee 3)
Knowledge
Noticeably, none of the participants could tell the interviewer exactly what the SSCB consisted of, with participants frequently forgetting or incorrectly providing timescales and target percentages. Commonly during interviews participants had to be prompted to discuss the ‘admission to a stroke unit’ element. Initially it seemed that they did not think of this as a core part of the SSCB. However, as the interviews and analysis progressed it emerged that they understood this but felt powerless to influence this component of the SSCB.
There was also a lack of knowledge in relation to the evidence base around the SSCB with some participants stating they knew there was some (none had read it) and others stating they knew there was evidence for some of the components, but they were unaware of any specifically related to the SSCB. Regardless of this all participants stated they were aware of the benefits of the SSCB in terms of improved outcomes for patients.