TY - JOUR

T1 - Exploring variation in the six-month review for stroke survivors

T2 - a national survey of current practice in England

AU - Holmes, Rich

AU - Ackerley, Suzanne

AU - Fisher, Rebecca J

AU - Connell, Louise A

PY - 2025/1/28

Y1 - 2025/1/28

N2 - BACKGROUND: The Six-Month Review (6MR) was introduced in the United Kingdom to provide a holistic, systematic review of the ongoing needs faced by stroke survivors. However, a theoretical underpinning regarding how it should work is lacking, potentially leading to wide variation in service provision. This study aimed to understand the current degree of variation in 6MR delivery across England and explore the potential driving factors.METHODS: A cross-sectional study was conducted via an online survey distributed to 6MR services within England. Data were collected over 12 weeks in 2023. Descriptive statistics were used to demonstrate the degree of variation in service delivery, and associations were explored between features of the 6MR service and contextual factors.RESULTS: Ninety-two responses were received, representing approximately 53% of 6MR services in England. Wide variation was observed in relation to service structure, content and processes, and in how outcomes, experience and effectiveness are measured. A number of significant associations were observed between features of the 6MR and contextual factors, most commonly, in relation to the provider organisation.CONCLUSIONS: This study highlights the degree of variation in 6MR delivery across England. The provider organisation may be a driving factor for this variation that warrants further investigation. Future research should focus on understanding how, and under what circumstances, the 6MR works so that its effectiveness can be evaluated and best practice established.

AB - BACKGROUND: The Six-Month Review (6MR) was introduced in the United Kingdom to provide a holistic, systematic review of the ongoing needs faced by stroke survivors. However, a theoretical underpinning regarding how it should work is lacking, potentially leading to wide variation in service provision. This study aimed to understand the current degree of variation in 6MR delivery across England and explore the potential driving factors.METHODS: A cross-sectional study was conducted via an online survey distributed to 6MR services within England. Data were collected over 12 weeks in 2023. Descriptive statistics were used to demonstrate the degree of variation in service delivery, and associations were explored between features of the 6MR service and contextual factors.RESULTS: Ninety-two responses were received, representing approximately 53% of 6MR services in England. Wide variation was observed in relation to service structure, content and processes, and in how outcomes, experience and effectiveness are measured. A number of significant associations were observed between features of the 6MR and contextual factors, most commonly, in relation to the provider organisation.CONCLUSIONS: This study highlights the degree of variation in 6MR delivery across England. The provider organisation may be a driving factor for this variation that warrants further investigation. Future research should focus on understanding how, and under what circumstances, the 6MR works so that its effectiveness can be evaluated and best practice established.

KW - Humans

KW - England

KW - Cross-Sectional Studies

KW - Stroke/therapy

KW - Survivors/statistics & numerical data

KW - Stroke Rehabilitation/statistics & numerical data

KW - Surveys and Questionnaires

KW - Female

KW - Male

U2 - 10.1186/s12913-025-12323-6

DO - 10.1186/s12913-025-12323-6

M3 - Journal article

C2 - 39871235

VL - 25

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

M1 - 159

ER -