Capture Stroke helps NHS stroke care teams to meet latest SSNAP changes
Upcoming SSNAP changes will prioritise patient focus for stroke care rehab and treatment delivery. Capture Stroke’s Chief Technology Officer Stephen Middleton explains how early collaboration on system development with customers means clinical and data teams can be confident about meeting the requirements of the new dataset.
When the latest set of changes to the SSNAP dataset come into effect on 1st October, we can expect a big shift in the recording of therapy data. For the clinical and data teams delivering stroke care on the pathway, this shift will drive a new focus on patient-centric care – recording therapy by patient rehab goals and treatment type, rather than by discipline.
These changes will also see a move from 45 minutes of each therapy discipline per patient per day, to three hours of motor therapy per patient per day – a move which will encourage group working among therapists and lead to a more intensive approach to rehabilitation for stroke patients, as outlined by new NICE guidelines.
At Capture Stroke, in advance of the new dataset requirements, we’ve been working closely with our existing customers to understand the challenges they are facing and ask what they would like to see in the next release of Capture Stroke and Capture Therapy.
Emphasis on therapy
Overwhelmingly, their feedback has emphasised the need to continue to use Capture Therapy to report on the disciplines engaging with stroke patients – something that could be difficult to do without systems like Capture Stroke, once the changes are in place and the reports come back from SSNAP showing the patient-centric view of therapy received.
We always aim to provide customers with system changes a couple of months before they go live. However, this April all our customers got access to the next release almost three months ahead of the original July deadline – a little longer for User Acceptance Testing, reflecting the significant changes that are involved, particularly around therapy delivery.
This means that with the additional questions in Capture Stroke and new activities driven by patient rehab goals in Capture Therapy, clinical teams will be able to trial these changes on their test systems before the switchover.
One of the most significant effects of the new dataset requirements will be to encourage more group working among multidisciplinary therapy teams (MDTs) to achieve the three-hour/five-day goal for the delivery of direct therapy. Patients are also discussed in MDT meetings. These meetings would be classed as indirect therapy: the consultant/therapist is not face-to-face with the patient, but the clinical team are still spending time discussing their care.
While SSNAP are not collecting indirect therapy data, we provide the ability to record it in Capture Therapy. This enables more accurate resource management – giving therapy leads data on exactly how much time was spent with a patient or across the cohort of stroke patients. This data could be used to build a case for additional staff or beds within the team.
This is just one example of the way we’ve completely rewritten Capture Therapy to accommodate SSNAP changes, but also how we see them as an opportunity to go a step further than SSNAP by consulting our existing client base to build the system they want to use. We’ve achieved this by taking a fail-fast approach; the development team push out a release internally almost every week, which gets tested in house and then by some of our customers. After all, what we as developers think looks like a great idea might not be so useful in a clinical setting.
The latest round of SSNAP changes were indeed particularly challenging on the therapy side as the entire front end of Capture Therapy has to be updated: the user interface has shifted focus, from 45 minutes for each individual discipline to a total minute counts across all activities.
The value of feedback
There have been many meetings since the dataset changes were announced at the end of December 2023. Each one has been an opportunity for the development team to understand the needs and concerns of our customers, build dashboards and reports that are going to be needed and well-used, and ultimately create a better product for the stroke teams and their patients.
Unsurprisingly, feedback has focused largely on the therapy changes, and the desire to retain detail on time spent per therapy discipline. The benefits of recording exceptions such as reasons for therapy sessions not going ahead at all, or ending earlier than intended, are particularly relevant with the new intensive therapy approach from NICE guidelines.
Configurability has also been important. No two NHS trusts are the same, and therapy activities will vary between teams. Being able to customise activity lists and have Capture Stroke automatically handle the mapping of activity to treatment type will be a significant time saver for therapists entering the data.
Big picture thinking is what’s required to improve stroke care in the NHS today. SSNAP have already made big steps in this direction by splitting out the core and community datasets – and the new shift to patient-focused therapy delivery is another important milestone. Capture Stroke continues to support this evolution by providing a clear, accurate and contiguous record of the patient’s journey along the entire care pathway.
Author Stephen Middleton
Title Chief Technology Officer