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Stroke Pathway App

A mobile app which presents paramedics with a decision support tool for the stroke pathway to aid compliance. d2 Digital By Design Ltd have 25 years’ experience working with the public sector, national charities as well as not for profit organisations in web, app and platform development.

Working with the Greater Manchester Stroke Operational Delivery Network, Salford Royal F.T. and the North West Ambulance Service, we collectively designed and built the stroke pathway app. 

The partnership was borne during a Health Innovation Manchester hackathon; to date we have worked with 8 Acute Trusts in GM to ensure patients are getting the correct care.


Acute stroke patients benefit from rapid treatment and specialist care at Hyper Acute Stroke Units (HASUs). Within Greater Manchester there are three HASUs with up to 6000 strokes a year and a potential further 6000 non-stroke patients with symptoms mimicking a stroke. Patients with suspected stroke should be taken to a HASU following the stroke pathway, often bypassing their local A&E.

Research data previously identified 600+ breaches to one of the 3 HASUs in GM over an 18-month period. A scoping exercise also highlighted pre-hospital clinicians knowledge and confidence of the stroke pathway being low. 

The app presents the stroke pathway in digital format; taking approximately 10 secs to click through the pathway questions and using GPS location, the app provides paramedics with support around the most appropriate hospital for the patient.

A 2017 pilot promoted 43% of patients be diverted to their local hospital therefore fewer 'stroke mimics' were taken to a HASU. With reduced inappropriate attendances at HASUs and the ability of stroke clinicians to spend more time with true stroke patients, it allowed the team to improve the national stroke care targets within the Sentinel stroke national audit programme (SSNAP) during this period.

The app was launched on April 9th 2019 in all NWAS vehicles covering the GM region. To date there have been over 1500 visits to the app. With the University of Manchester, we are evaluating the clinical effects of the app using routinely collected HASU data to measure impact. Following this we aim to deploy the app, starting with the North West.

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