Practical principles - how to manage reviews for stroke survivors One of a set of eight practical principles publications. The full set are: 1 - Improving psychological care after stroke 2 - Developing an early supported discharge service 3 - Improving access to CT scanning 4 - Transient Ischaemic Attack (TIA) 5 - How to establish joint care planning 6 - How to manage reviews for stroke survivors 7 - Being the best in acute stroke 8 - Developing a community stroke service (Published November 2011)

1. NHS
NHS Improvement
PRACTICAL PRINCIPLES
to manage reviews for stroke survivors
1. Use a standardised form
2. Establish stroke specialist competencies and training
3. Consider how to share information
4. Monitor to see what the effects are QUALITY ACCELERATING
MARKER 14 STROKE
IMPROVEMENT
8
Use a standardised form
• This ensures every review in your
area covers the same information,
regardless of who undertakes the
review, giving equity of service
• Current models of stroke reviews use
a standardised tool which cover, at a
minimum, five key areas:
• medical and secondary prevention:
medical aspects, including
medicine management, prevention
• ability: how an individual presents
in all areas of movement, hand
function, etc
• daily living: functional aspects of
an individual's life, what day to
day tasks they are able to carry out CASE STUDY CASE STUDY
and how
• social life and support: around the Clinicians from the South South Tees NHS Foundation
individual – including carers, Central Cardiovascular Network Trust use a nurse based in the
support groups and how to have developed the Community NHS working with a local
manage long term Stroke Review tool for six week authority occupational therapist
• psychological support: issues that and six month reviews. to undertake reviews, and have
the individual, or family, may have noted that both have learnt
around coping with the emotional from each others professional
and psychological impact. skills.
Establish stroke specialist
competencies and training
CASE STUDY
• There is variation in who undertakes CASE STUDY
Collaboration for Leadership in reviews, often due to local
Applied Health Research and South Central Cardiovascular
circumstances or staff available, and
Care (CLAHRC) for Greater Network has developed
they may be done by a mixture of
Manchester worked with local competencies for staff
staff (nurses, occupational therapists,
teams to develop the ‘GM-SAT undertaking stroke reviews.
speech and language therapists,
tool’ for six month reviews. stroke coordinators, family and
support workers, volunteers)
• The key is the right training and • Staff undertaking six month reviews
competencies. Competency based may not need the same skills as for a
training means all reviewers have a six week review, but are still stroke
broad range of stroke specific skilled
knowledge, regardless of their • There may be benefits from a joint
professional background or grade approach with social care.

2. NHS
NHS Improvement
Consider how to share information Monitor to see what the effects are
The six month review is a
• Give individuals, and where • Include measures that can be used to good point at which to collect
appropriate their carers, a copy of identify change over time for the data on timely access to
the review and provide contact individual psychological support.
details of who to contact for more • Use the data to review your overall
information service. The Care Quality
• For continuity, link the information Commission (CQC) found a For more information and case
from the joint care plan and the six correlation between areas providing studies, please visit the NHS
week, six month and annual reviews reviews and other aspects of the Improvement website:
so each reviewer can build on assessment www.improvement.nhs.uk/stroke
previous discussions • Suggested areas to measure the
• Consider difficulties in sharing percentage:
information across health services • of people getting reviews at six
and with social care. weeks, six months, annually
• which find unmet needs (and what
they are)
CASE STUDY • which lead to referrals (and what
they are)
South Central Cardiovascular • which resolve potential problems
Network is developing an IT • showing progress towards goals.
solution to ensure links
between six week and six
month reviews, using their
CASE STUDY
standard tool.
The CLAHRC for Greater
Manchester and South Central
Cardiovascular Network
CASE STUDY reviewed the impact on
referrals, and found that this
Cornwall Stroke Services have a was not as high as they had
template letter that is sent to expected. Patients and carers
GPs, identifying Quality and also consistently reported high
Outcomes Framework (QOF) levels of satisfaction with the
indicators that have been met in review process.
the review.
CASE STUDY
NHS Scotland has developed an
online form for GPs to use.1
1 www.strokeresource.scot.nhs.uk
ACCELERATING
STROKE IMPROVEMENT