ABSTRACT
Based on the principles of the NHS Plan (DoH 2000), the NSFOP set standards for tackling age discrimination and promoting person-centred care, and was the first ever comprehensive strategy to ensure fair, high-quality, integrated services for older people. More recently a report by the National Director for Older People looked at progress made as a result of the NSFOP, as well as work still to be completed using three major themes: Dignity in Care; Joined-up Care; and Healthy Ageing (DoH 2006a). This report draws attention to the significant progress made in a number of key areas, not least in the development of stroke services. There have been numerous consultation and policy documents released, further shaping services with a strong emphasis on integration between independent, voluntary, health and social care sectors (DoH 2004, 2005a, 2005b, 2006b). The NSFOP of 2001 has eight standards outlining what is expected so that health and social care agencies work toward developing effective services to support independence and promote health in older people. Standard five of the NSFOP focuses on reducing the incidence of stroke and the development of integrated stroke care services. Building on this standard, in 2007 a National Stroke Strategy (NSS) was published with a framework of 20 quality markers (QMs) for raising the quality of stroke prevention, treatment, care and support over the next decade (DoH 2007a). The National Collaborating Centre for Chronic Conditions (NCCCC) (2008) published national clinical guidelines with the major focus on acute stroke and transient ischaemic attack care. The Intercollegiate Stroke Working Party (ISWP 2008b)
in their recently updated UK National Guidelines for Stroke cover all aspects of stroke care including long-term management following recovery as well as the recommendations of the NCCCC national guidelines.
