UK Stroke Forum 2025 | Thrombolysis in Acute Stroke Collaborative (TASC): improving stroke thrombolysis rates in England

The Thrombolysis and Acute Stroke Collaborative, TASC, was an initiative that brought together several organisations. It was commissioned by NHS England as a result of us understanding that over the last 10 to 15 years we have been unable to improve the intravenous thrombolysis rate in England. A collaboration between them and NHS Elect, our national audit SSNAP, and the research group SAMueL. Together, those four organizations came together to provide one yearly quality improvement opportunities for six organizations in England. We picked the six lowest thrombolysing units in England, statistically significantly lower, and together worked with them with their own clinical data over the previous years, benchmarked against higher performing units in England, and allowed them to have a series of webinars and focused weekly interactions with the NHS Elect team to see if they could break down their stroke thrombolysis pathway to make small aggregational benefits. We’ve seen a transformation of the delivery of IV thrombolysis in those six early centres, 45% increase in their thrombolysis rate, a 20-minute reduction in their door-to-needle times. This equates to many more patients less disabled and a potential saving to the NHS running into the millions. The second year cohort has just completed, and this was 12 sites, different sites, again with lower thrombolysing numbers and percentages than the national average. And once again, we have seen their care transformed with an average increase relatively of 65%. The average rate of thrombolysis is over 17%. So together, this demonstrates that we’ve been able to work with the lower 20% of stroke units in England and bring them up to above the national average. Prior to TASC being developed, we had a national average of IV thrombolysis of just over 12%. It’s now 15%. So there is certainly a suggestion, a chronological association, with TASC and a national improvement in IV thrombolysis rates. We’re delighted that in the coming new year, 2026, we have partnered with Boehringer Ingelheim to have T-TASC 3, which will be looking at IV thrombolysis and mechanical thrombectomy referral rates, and again, working with 12 organisations to improve their use of lytics and access to mechanical thrombectomy. It’s a really exciting time.

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