The GM-SAT2 is made up of several components, which collectively provide tools to help deliver a comprehensive, person-centred post-stroke review. All components are fully described below, where they can be freely downloaded.
Why is it important?
Post-stroke reviews help ensure that stroke survivors and their families continue to feel supported after stroke. Stroke is a long term condition and survivors are likely to experience changes in their needs over time, so reviews provide the chance to access any advice, support, information and rehabilitation that may be needed.
The National Clinical Guideline for Stroke recommends that all stroke survivors should be offered a review at six months and 1 year after the stroke, and annually thereafter.
What did we do?
There have been several strands of work to develop the GM-SAT2 since 2009.
- Original GM-SAT: To promote the implementation of reviews, CLAHRC GM reviewed literature and worked with stroke survivors, carers and professionals to identify common, long-term problems people experience after a stroke. This informed what sort of questions should be asked at a review and led to the original Greater Manchester Stroke Assessment Tool (GM-SAT).
- Developing Easy-access (aphasia-friendly) tools: To support equality of access to reviews for those with communication difficulties, CLAHRC GM worked with Speakeasy, a communication support charity based in North West England.
- Local and National impact (see below): After its launch in 2010, the GM-SAT became the most widely used tool, nationally, to support delivery of post-stroke reviews.
- Feedback from healthcare professionals and research in care homes: We received feedback that the toolkit could be improved for use with stroke survivors living in care homes. So we collaborated to modify the GM-SAT and explored its acceptability, value and feasibility in care homes through a mixed methods research study. You can read more about that study on the project page here.
GM-SAT2 was launched in December 2018 after pooling our learning from all previous work. GM-SAT2 is suitable for conducting reviews with all stroke survivors, regardless of where they are living.
Watch our video below that describes more about GM-SAT2 and access all the components of the GM-SAT2 toolkit in the Downloadable Resources section at the bottom of the page.
The GM-SAT was launched in 2010 and is used by NHS and third sector organisations across the UK. It is the only post-stroke review tool to be referenced and recommended by the National Institute for Health and Care Excellence (NICE) Quality Standard for Stroke in Adults, as well as the British Association of Stroke Physicians.
The Stroke Association is commissioned to provide reviews for many services nationally and they use the GM-SAT for all clients.
“We find the GM-SAT brilliant to use for all patients as a stroke can devastate people’s day-to-day lives. While all the clinical tests and bloods may be fine, if they’re going home and can’t make a cup of tea then it is really hard for them. In Salford, we see around 30 patients every month for their six month review. For this we use the GM-SAT to recognise and plug the gaps that people have. It helps those who have gone back to work who no-one would really know that they’ve had a stroke and may just have confidence issues, all the way to patients who are severely cognitively impaired, doubly incontinent and need 24 hour care. It’s not just patients who appreciate the tool, the feedback from all our stroke coordinators is that GM-SAT is very easy to use. It’s simple – in a good way – and has put a structure and framework around what they were doing already. It gives them permission to ask questions that perhaps they might’ve found embarrassing in the past, such as around sexual health or financial questions and also means they don’t forget. It also gives stroke patients and their carers the opportunity to ask these questions too.” (Sue Fawcett, Community Stroke Coordinator for the Stroke Association in Salford, published Feb 2012)
Who did we work with?
- GM-SAT2 Components
There are several components of the GM-SAT2 that are all available for free but need to be individually downloaded.
Please click on the links for the tool you wish to download (we recommend you download them all). You will be re-directed to the ‘resources’ page of the CLAHRC GM website.
By downloading the components, you agree to the terms which can be found when downloading each resource below:
Guidance document – includes tips and information about the principles of a good review. It also includes information about using the other components of the toolkit, such as what questions to ask during a review and recommended actions to address any identified needs;
Documents that can be sent to stroke survivors in advance of a review.
The ‘advance patient information’ can help a stroke survivor understand what to expect from a review and includes space for them to reflect and prepare.
The ‘self-assessment questionnaire’ can encourage stroke survivors to think specifically about the support they might want to discuss. It may not be suitable for sending to all clients but has been reported to work well when reviews are being conducted as part of an outpatient clinic – it is something that could be completed in the waiting room to help guide the content of a review.
(Please note: we are working on producing easy-access (aphasia friendly) versions of these documents that may be more useful for clients with aphasia)
Review proforma – the actual document for professionals to use when conducting and recording the review in situ.
Summary report – a simple, brief document that summarises the outcomes of a review and documents what actions need to be carried out and by whom. Copies of this report are typically sent to the stroke survivor after review, as well as their General Practitioner (GP)
Easy access (aphasia-friendly) resources to support conducting a review with a stroke survivor who may have difficulties communicating. Please note: more work is required to full update these documents that are still the original resources developed with Speakeasy in 2010:
- Trigger Question Resource – to ask review questions and elicit responses from people with limited communication. Each question and response starts on a new page with large text and pictures in places, as chosen by people with aphasia.
Conversation Support Resource – is a broad-ranging resource. It includes information about aphasia and a wide array of materials that could be used to support communication and find out more about any unmet needs identified such as how long the stroke survivor has had the problem, where the problem is and how severe it is. It can additionally be used to discuss and describe any actions that may need to be taken to address or manage any unmet needs identified.
- Evaluation Reports
- News Stories
GM SAT presented at UK Stroke Forum (December 2012)
GM-SAT recognised in British Journal of Primary Care Nursing (October 2012)
Stroke work published in Clinical Rehabilitation (September 2012
Improving the quality of stroke assessment (July 2012)
Improving post-stroke management - Katy Rothwell
Defining And Delivering 6 Month Post Stroke Reviews - Katy Rothwell
Post Stroke Review Pilot Project - Katy Rothwell
GM-SAT Stroke Association Pilot Project Report Launch - Katy Rothwell
Post Stroke Six Month Assessment GM-SAT Tool - Katy Rothwell
The Greater Manchester Stroke Assessment Tool (GM-SAT) - Hester Benson