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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2006 October 1; 56(531): 775–780.
PMCID: PMC1920718

Feasibility study of a primary care-based model for stroke aftercare

Jenni Murray, MSc, Research Fellow, John Young, FRCP, Professor of Elderly Care, and Anne Forster, PhD, Reader
Academic Unit of Elderly Care and Rehabilitation Research, St Luke's Hospital, Bradford
Gill Herbert, BSc Hons, CQSW, MPhil, Development Consultant
Consultancy & Development Ltd. Huddersfield
Robert Ashworth, MRCGP, Honorary Research Fellow



A new primary care model for stroke aftercare has been developed to address the longer-term needs of patients who have had a stroke and their families.


To test the feasibility and acceptability of the new model on patients who have had a stroke and their carers.

Design of study

An observational feasibility study.


Patient and carer assessments and interviews conducted in patients' homes.


Patients who have had a stroke and their carers were assessed using a purposely developed primary care stroke model. Qualified health- and social-care professionals acted as stroke care coordinators and carried out the assessments. Four evaluations were undertaken as part of the study: analysis of care plans, a survey of unmet needs, focus group sessions for staff, and patient/carer interviews.


Forty-seven patients and 21 carers were recruited to the study. Analysis of care plans indicated that the assessment process was successful in identifying patient and carer problems (n = 219). Actions were instigated against 190 of these problems and, at 3 months after the assessment, 75% of the problems had been resolved. Patients/carers thought that the review process would be more valuable if conducted sooner after hospital discharge.


The model was acceptable to professionals, encouraging them to work in a manner more consistent with the expressed needs of patients and carers who were adjusting to the longer-term impact of stroke. Essential aspects informing the care process were also identified. Further work is now required to investigate the effects of the intervention on patient and carer outcomes.

Keywords: patient care management, primary healthcare, stroke

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners