1. GM-SAT The Greater Manchester Stroke Assessment Tool April 2012

2. Background All stroke survivors should be offered regular reviews of their health and social care needs Ensures that people feel supported and provides a clear pathway back to specialist review, advice, information, support and rehabilitation where required. Many stroke survivors currently report a sense of ‘abandonment’ and have difficulty accessing the services they need.

3. Background

4. GM-SAT Evidence based assessment tool Developed in collaboration with patients, carers and professionals from across the stroke pathway. Covers 36 common post-stroke problems: Physical Emotional Social Secondary prevention

5. GM-SAT For each problem area there is a an algorithm These provide: 1. Questions to ask 2. Guidance on actions to take Act as a reference guide

6. Trigger Question Simple close ended question. Helps to quickly filter out the areas in which there are no problems/unmet needs and you to focus time on areas of concern. Actions The action to be taken depends on the answers received to the questions. GM-SAT: example

7. GM-SAT Each algorithm represents best practice. Teams are encouraged to ‘localise’ or ‘personalise’ GM-SAT to represent local service provision. GM-SAT also includes a proforma and a summary report template

8. Measurement of outcome 6m modified Rankin score: will feed into SSNAP Potential for rich data from detailed assessments

9. Secondary prevention: Blood pressure Pulse regular/irregular Medications

10. Easy Access GM-SAT Used to effectively identify and address the post-stroke needs of stroke survivors who have aphasia. Developed in collaboration with stroke survivors from Speakeasy. 2 components

11. Easy Access GM-SAT Trigger Question Resource (TQR)

12. Easy Access GM-SAT Conversation Support Resource (CSR)

13. Free to use and available to download from: http://clahrc-gm.nihr.ac.uk/resources/gm-sat/ GM-SAT

14. Delivering GM-SAT Models of service delivery need to be decided locally. Service users tell us that they ‘don’t mind who does the review, just as long as they know about stroke. GM-SAT now being used at multiple sites across the country by: Practice nurses Stroke specialist nurses Assistant practitioners Key workers (from across the MDT) Stroke Association IAS coordinators

15. Results of Stroke Association pilot 137 reviews completed during pilot phase Total of 464 unmet needs identified Average 3 per service user

16. Results of Stroke Association pilot Number (n) of unmet needs identified Percentage (%) of individuals presenting with unmet need Medication management43 Medication compliance1813 Secondary prevention (non lifestyle) 3022 Alcohol75 Diet97 Smoking107 Exercise1813 Vision86 Hearing86 Communication139 Swallowing75 Nutrition64 Weight management86 Pain129 Headaches/ Migraines97 Seizures00 Continence139 Activities of daily living139 Mobility97 Number (n) of unmet needs identified Percentage (%) of individuals presenting with unmet need Falls107 Depression2619 Anxiety2015 Emotionalism43 Personality changes1612 Sexual health43 Fatigue4734 Sleep pattern118 Memory,concentn and attention3526 Driving139 Transport and travel75 Activities and hobbies118 Employment97 Benefits and finances2518 House and home107 Carer/ Supporter needs118 Other32 TOTAL464

17. Importance of psychosocial needs GM-SAT pilot 34% fatigue 26% memory, concentration, attention difficulties 9% communication 9% continence CQC Little or no access to community rehab in some areas <40% PCTs provide psychologists or counsellors

18. Results of Stroke Association pilot

19. Number of referrals Audiology3 Communication support service3 Continence advisory service5 Counselling service2 Dietetics1 Falls clinic2 Falls prevention service1 Occupational therapy4 Physiotherapy3 Psychology2 Social services5 Speech and language therapy5 Visual impairment service1 TOTAL37

20. COF: 6 month post stroke assessment will be mandatory How do we ensure the assessment is relevant to stroke survivors? How do we feed back results and to whom?

21. GM SAT Developed with service users Takes a pragmatic approach to problems Designed to be aphasia friendly Provides COF and SSNAP requirements Yours to download!