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Implementation and evaluation of local-level priority setting for stroke

Lookup NU author(s): Dr David Chappel, Dr Jarrod Bailey, Dr Rosie Stacy, Emerita Professor Helen Rodgers, Emeritus Professor Richard Thomson


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We aimed to develop and evaluate a prioritisation process to combine the evidence base with stakeholder involvement within a stroke programme for a Health Improvement Programme (HImP). Implementation involved: formation of a district stroke group (DSG); review of the evidence; survey of DSG members; survey of other key professionals; consensus within the DSG; consultation with local users of the service. Evaluation was through semi-structured interviews and documentary analysis. The process was accepted as appropriate and valuable by the majority of participants, and a district HImP implementation group allocated £100 000 for stroke development as a result of this process. However, some felt that stroke itself had been an imposed, rather than an agreed, local priority. The priority setting process was not clear to all participants and change of personnel, particularly in the NHS trusts, led to some perceived lack of ownership. Professionals from secondary care participated, but later criticised the process when they felt that the priorities in the HImP could limit their ability to access money for other service developments. The user consultation days occurred too late to influence the 1999/2002 HImP. We have shown that it is possible to develop an approach that is broadly accepted by stakeholders and balance the evidence base with local ownership. The participation of stakeholders, clarity of procedures, local ownership and awareness of local politics are important in effective priority setting. The model developed will be of value in other settings.

Publication metadata

Author(s): Chappel D, Bailey J, Stacy R, Rodgers H, Thomson R

Publication type: Article

Publication status: Published

Journal: Public Health

Year: 2001

Volume: 115

Issue: 1

Pages: 21-29

Print publication date: 01/01/2001

ISSN (print): 0033-3506

ISSN (electronic): 1476-5616

Publisher: W.B. Saunders Co. Ltd.


DOI: 10.1038/

PubMed id: 11402348


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