NSW Stroke Reperfusion Project (SRPP)


  • To improve early access to thrombolysis for ischaemic stroke patients.
  • To improve pre-hospital assessment by paramedics for identification of stroke through a validated standardised assessment tool.  
  • To improve in-hospital reception, assessment and management of stroke patients to achieve early access to safe reperfusion.  
  • To improve mechanisms across the whole patient journey to deliver effective rehabilitation.


There are multiple benefits involved in this project:

  • To train paramedics in the application of the ‘FAST’ (Face, Arm, Speech and Time) stroke assessment tool, which is both internationally recognised and validated
  • To define, locate and govern permanently operating stroke-unit hospitals that offer thrombolytic therapy
  • To provide road-based transport for stroke patients to arrive at stroke-unit hospitals within 4.5 hours of symptom onset
  • To maintain strong networks between facilities, so patients are returned appropriately for ongoing acute and rehabilitative care, close to their point of origin, rather than remaining in designated 24/7 Acute Thrombolytic Centres (ATC)
  • To model demand for road-based transport of patients to hospitals with stroke units that do not offer 24/7 thrombolysis, if the patient has missed the 4.5 hour target


The NSW  SRPP will train paramedics to recognise a stroke that is possibly amenable to thrombolytic therapy.

Thrombolysis should only be delivered in emergency departments, stroke care units or high acuity units with adequate expertise and infrastructure for monitoring, rapid assessment and investigation for acute stroke patients.*

Early detection by paramedics will allow for these patients to be transported to a hospital that offers a 24/7 stroke thrombolysis service.

Following early access to a Computed Tomography (CT) scan and a neurology review, the decision on appropriateness of thrombolytic therapy will be made, and other clinical management commenced.

This program includes governance and guidelines for the transfer of stroke patients to the appropriate clinical service beyond the acute phase of their care.

*  Clinical Guidelines for Stroke Management 2012: National Stroke Foundation


The Stroke Reperfusion Project has been trialled in 20 Acute Thrombolytic Centres across 11 Local Health Districts, as well as at the Sydney Adventist Hospital. 


Key Dates

May 2010Stroke Reperfusion Project Committee formed
September 2010Partnerships commenced with NSW Local Health Districts (LHD), Ambulance Service NSW (ASNSW)
September 2012Correspondence to Chief Executives of Local Health Districts (LHD) inviting the LHD to participate in the project
November 2012The ACI Stroke Network, CPDI and ASNSW collaborated through site visits to support strategies at the sites. This initial support was enhanced by the development of a Community of Interest monthly teleconference to bring sites together to discuss and provide guidance in relation to problem solving.
21 January 2013Go Live date for the program
April 2013Commence evaluation of the program in terms of economic and patient outcomes
December 2014

As nominated within the program logic of the evaluation, individual sites who participated in Phase 1 on the evaluation have received their qualitative and quantitative data.

Feedback on the program has been received and will be included in development of the program logic of Phase 2 of the evaluation

June 2015

Phase 2 of the evaluation will be undertaken June 2015 - June 2016.

Pilot Sites

Implementation Sites

ACI Authenticated Acute Thrombolytic Centres.

Central Coast Local Health DistrictGosford Hospital
Hunter New England Local Health DistrictTamworth Rural Referral Hospital
John Hunter Hospital
Illawarra Shoalhaven Local Health DistrictWollongong Hospital
Mid North Coast Local Health DistrictPort Macquarie Base Hospital
Murrumbidgee Local Health DistrictWagga Wagga Base Hospital
Nepean Blue Mountains Local Health DistrictNepean Hospital
Northern NSW Local Health DistrictLismore Base Hospital
Northern Sydney Local Health DistrictRoyal North Shore Hospital
Hornsby Ku-ring-gai Hospital
South Eastern Sydney Local Health DistrictPrince of Wales Hospital
St George Hospital
South Western Sydney Local Health DistrictCampbelltown Hospital
Bankstown Lidcombe Hospital
Liverpool Hospital
St Vincent's Health NetworkSt Vincent's Health Network
Sydney Local Health DistrictConcord Repatriation General Hospital
Royal Prince Alfred Hospital
Western NSW Local Health DistrictOrange Health Service
Bathurst Base Hospital
Western Sydney Local Health DistrictWestmead Hospital
Blacktown Mount Druitt Hospital (Blacktown Campus)


Phase 2 of the evaluation will be undertaken June 2015 - June 2016 and reflect patient and economic outcomes.

Related Initiatives

Further Details

For further information: http://www.aci.health.nsw.gov.au/networks/stroke/priorities/stroke-reperfusion

National Stroke Foundation: http://strokefoundation.com.au/

Stroke Recovery Association NSW: http://www.strokensw.org.au


Mark Longworth
Network Manager - Stroke
02 9464 4614

Director, Acute Care
02 9464 4602

Page Top | Added: 8 November 2013 | Last modified: 25 June 2015

Mark Longworth
Network Manager - Stroke
02 9464 4614