From: How unmet are unmet needs post-stroke? A policy analysis of the six-month review
Case study 1 | Case study 2 | Case study 3 | |
---|---|---|---|
Setting and model of review | |||
Who carried out the 6MR? | SNSs based in NHS Trusts that provided community stroke rehabilitation. | SNS employed by a social enterprise that provided community stroke rehabilitation. The SNS’s post was split between 6MRs and Early Supported Discharge. | SA co-ordinator. |
Model of review | Medical model focused on medication, investigations and referrals to other statutory services. | Medical model supplemented by two sessions of a ‘life after stroke’ group which focused on self-management and a ‘personal stroke plan’ booklet provided in the acute setting. | Social model focused on sign-posting to community services such as exercise classes. |
Timing of the 6MR | Generated by administrative system, mostly at 6 months. | Generated by administrative system, mostly at 6 months. | SA co-ordinator liaised with the community stroke team so reviews coincided with therapy withdrawing. |
Were 6 week reviews provided? | Yes, by SNS and/or the stroke consultanta. | Yes, by the SNS in the acute setting and/or the stroke consultanta. | Some initial visits when requested by therapists and/or consultant reviewsa. |
Were annual reviews funded? | Yes | No | No |
Respondents: patients | |||
Number of patients (and carers) interviewed after 6MRb | 26 (14) | 15 (11) | 5 (5) |
Patients’ age range, years. | 28-88 | 31-91 | 67-80 |
Number of patients of working age at time of stroke | 11 | 6 | 1 |
Number of patients with other long-term conditions | 13 | 6 | 3 |
Number of patients who were married or co-habiting | 17 | 10 | 4 |
Respondents: reviewers & others | |||
Stroke nurse specialists | 3 | 3 | - |
SA co-ordinator | - | - | 1 |
SA support workers | 1 | 1 | - |
Physio/ occupational therapist, service manager, GP or commissioner | 6 | 5 | 2 |
Across site interviews including SA managers | 6 | ||
Observations of reviews | |||
6MR | 10 | 9 | 4 |
1 year review | 6 | - | - |