Review

Projects

Below are details of a number of ongoing projects looking at developing a review service for people who have had a stroke. This page will be updated as the projects report their findings.

Bradford and Leeds, Academic Unit of Elderly Care and Rehabilitation
Longer-Term Stroke (LoTS) Care Stroke System of Care
The LoTS care stroke system of care provides clear treatment guidance for health professionals based around individual patient and carer assessments, and is designed to be used for assessment of stroke patients at any time, including reviews at six weeks, six months and annually post stroke. It was developed from a comprehensive review of the longer-term stroke care evidence base including systematic reviews of the qualitative and quantitative literature and interviews with patients and carers. As a result of this review, a manual has been produced containing reference guides and evidence-based treatment algorithms, each of which address an area of longer-term stroke care. The manual forms the basis of the system of care, which includes the use of an assessment linked to the reference guides and treatment algorithms in order to identify individual patient and carer needs.

The clinical and cost effectiveness of the LoTS care stroke system of care is currently being evaluated in a cluster randomised controlled trial in comparison to usual practice. This involves 800 stroke patients (living at home, with and without carers) in 32 stroke care co-ordinator led services across the UK. Following training of intervention services to deliver the system of care, recruitment began in July 2009 and is continuing until December 2010. Patients and carers will be assessed for psychological and functional outcomes at 6 and 12 months post recruitment using postal questionnaires. Results are expected summer 2012, after which the system of care will be available for implementation, once it has been shown to be effective.

Further information:
•Contact Dr Kirste Mellish
•LoTS care Stroke Research Programme website

King's College London
King's College London are developing a method of providing annual reviews after stroke. Having estimated one-year needs using South London Stroke Register data, and completed interviews with patients, families and healthcare professionals, the team will soon pilot a group approach to reviews, in a community setting.

Further information:
• King's College London website

Surrey Heart and Stroke Network
The Surrey Heart and Stroke Network appointed a project lead to facilitate and lead the development of a tool for patient and carer review at six months and annually thereafter. The objective is to provide a high quality, cost effective option for a service model, which will provide a route for delivery that can subsequently be rolled out across Surrey. The project is currently being piloted in south west Surrey, with a view to roll out any agreed proposals county-wide.

A draft tool has been designed by a project team that included representatives from acute and community stroke nursing, speech and language therapy, physiotherapy, occupational therapy, stroke coordinators and social care. The draft tool has been designed using evidence from the National Stroke Strategy and RCP guidelines, and local consensus, and is currently being piloted. Preliminary results will be reported on in October.

The project lead is also working on the development of service model options, and the most effective methods of delivery. All suggestions are underpinned by a commitment to design a safe, equitable and cost effective model of care which is centered on the patient and involves clinicians in the design and delivery.

Swindon PCT
Swindon PCT are running a project with a stroke coordinator reviewing patients at six months. A pilot questionnaire has been developed, covering physical, emotional, social, housing, financial and carer needs. The coordinator refers patients where relevant onto other services, either stroke specialist services or generic community or social care services. Advice and support is available to those who wish to return to work or volunteering. Signposting is also given to local voluntary organisations that support stroke survivors and their families.

Further information:
• Contact Sue Jones, Swindon PCT
• Tel: 07810 754195


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To let us know about your work or to get involved, please email Helen O'Kelly