Improving Longer Term Stroke Care (LoTS-2-Care)



Stroke remains a major illness with at least 900,000 people living in England who have had a stroke. The early stages of the stroke care pathway are becoming more prescribed (treatment in acute and rehabilitation stroke units), but despite policy recommendations, strategies for longer-term care are not developed and stroke survivors and their families face a number of problems and challenges.

Aims & Objectives

We have received a 5 year NIHR Programme Grant which seeks to progress our current work (focused on the six months after stroke) to develop and evaluate key aspects of a replicable system of longer-term (nine months post-stroke) service delivery 'care strategy'. The emphasis will be on improving quality of life by addressing unmet needs and enhancing participation.


The programme of work involves five workstreams:-

Study 1: Interview stroke survivors and their carers to discuss with them factors influencing unmet needs and things that have helped or hindered their daily lives.  Alongside this we will update our literature review to identify any effective interventions, and recommended or innovative ideas to support the implementation of the care strategy.

Study 2: A national survey of stroke services to gain information on who might provide longer-term care and support.

Study 3: Use techniques of intervention mapping to develop a care strategy, supporting materials and training programmes (for stroke survivors, carers and staff) using the information we have obtained from studies 1 and 2.

Study 4:  Refine content and test implementation of the care strategy through case studies in three stroke services.

Study 5: A feasibility cluster randomised trial to refine procedures for a future large scale trial.

This research will address the gap in the stroke care pathway and provide a replicable, and evidenced and theory based system of longer-term stroke service delivery.

Partners & Collaborators

Grant applicants:

Anne Forster, John Young, Jenny Hewison, Allan House, Claire Hulme, Josephine Dickerson, Rebecca Hawkins, Gillian Richardson, Bipin Bhakta, Suzanne Hartley, Amanda Farrin, Mick Speed, Christopher McKevitt, Matthew Fay, Rosie McEachan, Robbie Foy

Further information

For further information contact Anne Forster

This summary presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Development and evaluation of strategies to provide longer-term health and social care for stroke survivors and their carers, RP-PG-0611-20010). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.