The value of our services

Research emphasises the importance of coordination and continuity of care for patients with complex needs and long term conditions. This evidence suggests people with multiple long term conditions can benefit from greater predictability of support (1), better experience of and satisfaction with services (2), leading to ultimately improved quality of life.

‘The continuity of the Stroke Association's services and the ongoing relationship with the coordinator is valued, enabling a continuous source of support whilst other services may be more time-limited. The companionship and rapport stroke survivors and carers had with their coordinator were important in alleviating a sense of being alone when managing recovery after stroke.’ (3)

Research suggests that a holistic needs assessment can facilitate a person-centred approach with significant benefits. By being more involved in decisions about their care, people are more likely to receive support appropriate to their needs (4). This can both improve people’s health outcomes and reduce how often people use services, reducing the overall cost of care (5).

‘The ability of the service to support people across a wide range of needs (either directly, or indirectly through signposting and advocacy) is a valued aspect of the services. So too is the way the services provide joint or one-to-one support to stroke survivors and their carers.’ (6)

Self-management (7) is a term which covers a range of interventions and approaches. Recovery planning and goal setting, shared decision-making and motivational interviewing are all associated with positive outcomes for patients with chronic conditions (8):

• Goal setting and action planning can increase patient adherence to therapy programmes and increase confidence to engage in meaningful activities (9).
• Evidence-based decision-aids and question prompts can improve service user knowledge and experience (10).
• Motivational interviewing can enhance individuals’ readiness to make changes in health behaviour and therefore improve stroke survivors’ mood and reduce mortality 12 months post-stroke (11).

‘The Stroke Association's approach of developing a recovery plan based on identifying individual needs and desired outcomes, and tracking progress at regular review points, is seen as a useful aid to recovery.’ (12)

Home visits and carers’ support can have positive outcomes:

• Home-based support and advice may result in improved knowledge, satisfaction and mood of service users.
• Providing information, education and opportunities to connect with caregiving peers can have a positive impact on carers (13).

‘Carers reported that caring for someone initially left them feeling anxious and lacking in confidence. In this regard, they found the informational, practical and emotional support received from coordinators particularly helpful.’ (14)

Support to adopt and sustain healthy behaviours and support to re-engage with life outside the home, including with peers, are associated with positive outcomes for people affected by stroke.

• Breaking activities into small steps and providing ongoing positive, personalised feedback can help people sustain behaviour change (15).
• Supporting people affected by stroke to engage with meaningful social activities can help them reintegrate into the community (16).
• Leisure programmes that encourage positivity and acceptance of limitations may help reduce psychological distress (17).
• Peer support has been associated with improvements in reduced distress (18), as well as improved quality of life, confidence and self-care (19).

‘Support groups were a common source of support for stroke survivors, often hosted by or connected to the Stroke Association, and the Stroke Support Coordinator was instrumental in encouraging stroke survivors to attend.’ (20)