Abstract
Introduction:Stroke survivors have complex health needs requiring long-term, integrated care. This study aimed to elicit generalists’ and specialists’ experience of stroke-related interprofessional communication, including perceived barriers and enablers.Design and Setting:Qualitative study involving generalist (primary care) and specialist services (acute and community) in England. Six focus groups (n = 48) were conducted.Method:Healthcare professionals were purposively selected and invited to participate. Audio-recordings were transcribed verbatim and analysed using Framework Analysis.Results:Four themes were identified: 1) Generalists and specialists have overlapping roles but are working in silos; 2) Referral decision-making process as influential to generalist-specialist communication; 3) Variable quality of communication; and 4) Improved dialogue between generalist and specialist services.Conclusions:Generalists and specialists recognise the need for better communication with each other. Current care is characterised by silo-based working that ignores the contribution of other sectors. Failure to bridge this communication gap will result in people with stroke continuing to experience unmet stroke needs and fragmented care.
Highlights
Stroke survivors have complex health needs requiring long-term, integrated care
Long-term care led by generalists in the community is recommended [2,3,4] and stroke survivors are encouraged to self-refer if any issues arise [2]
As part of a larger research programme to develop a new model of primary care for stroke survivors living in the community [22], we aimed to explore generalist-specialist communication concerning long-term stroke care following hospital discharge, : (1) What are the communication processes between generalists and specialists concerning stroke care after hospital discharge? (2) What are the barriers and enablers to communication between these groups?
Summary
Stroke survivors have complex health needs requiring long-term, integrated care. This study aimed to elicit generalists’ and specialists’ experience of stroke-related interprofessional communication, including perceived barriers and enablers. Current care is characterised by silo-based working that ignores the contribution of other sectors Failure to bridge this communication gap will result in people with stroke continuing to experience unmet stroke needs and fragmented care. Long-term care led by generalists in the community is recommended [2,3,4] and stroke survivors are encouraged to self-refer if any issues arise [2]. It is unclear whether primary care models of care are effective for addressing stroke survivors’ and carers’ unmet needs [4], and challenges to implementing integrated care remain [5, 6]. Cochrane reviews show that ESD for stroke does reduce hospital lengths of stay [8], but taken as a whole, early discharge services for adults (including stroke) have no effect on mortality [9]
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