Priority 11 Stroke Prevention, Diagnosis, Pre-hospital and Hospital Care

UNCERTAINTY: How do regional and other differences in access to stroke care affect outcomes for stroke survivors and their families? (JLA PSP Priority 11)
Overall ranking 11
JLA question ID 0106/11a
Explanatory note

Original submissions behind this question on access to stroke care identify a range of differences in provision of stroke care, such as whether or not there is a specialist stroke unit available locally, which professionals are members of multidisciplinary teams, where community and support services such as those provided by the Stroke Association are available, GP support, and access to eye care specialists and various therapists.

Public Health England's 2017 paper "Reducing health inequalities" recognises that the health care we receive is a factor in determining the health of individuals and that "everyone should have the same opportunity to lead a healthy life, no matter where they live or who they are". However for this to become a reality, evidence is required to understand the impact of these differences on stroke outcomes to inform effective interventions.

Evidence

Multiple Cochrane reviews which consider telerehab versus face-to-face rehab e.g. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000425.pub4/full
Health Research Classification System category Stroke
Extra information provided by this PSP
Original uncertainty examples Why is stroke aftercare such a postcode lottery basically non existent here in County Durham but 10 miles away over the border in Cleveland rehabilitation care is excellent at James Cook Hospital? ~ Why can't the same standard/level of care be provided for Stroke Survivors all over the UK, to ensure that all Stroke survivors get the same opportunities to aid their recovery? ~ Is there private stroke physios near Milton Keynes that can help me as my local NHS stroke rehab unit has finished?
Submitted by Stroke Survivor x 23, Health/social care professional x 25, Research Recommendations x 6, Not stated x 3
PSP information
PSP unique ID 0106
PSP name Stroke prevention, diagnosis, pre-hospital and hospital care
Total number of uncertainties identified by this PSP. 93 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 30th April 2021