Survey to investigate the role of the community stroke care coordinator

Abstract

The National Service Framework for older people recommends that patients recovering from a stroke should have access to a stroke care coordinator (SCC) to support their longer-term recovery. However, the knowledge base, skills and procedures for the role are poorly defined. We have therefore conducted a survey to examine the development and responsibilities of SCCs with a remit for longer-term support. We identified 39 SCCs, most of whom were nurses. Three role types were observed: enhanced community follow-up (n=22); hybrid (n=15); and hospital outpatient (n=2). However, there was overlap between the roles reflecting a wide variation in practice in respect of timing and frequency of patient contacts, and methods for assessing patients' needs. Workload and knowledge of the evidence-base were identified as the main challenges to delivering care. Meeting patients' needs was impeded by limited access to psychology and physical therapies. A more robust evidence-base to support longer-term stroke care, combined with routine clinical governance systems for monitoring care provision could enhance the development of the SCC role.