Stroke Association is a national charity that helps people rebuild their lives after a stroke, through specialist support, funding research and campaigning for change.
As part of its ongoing work to ensure people affected by stroke get the very best care, the charity piloted a new Life After Stroke service in Norfolk and Waveney. Delivered jointly with (and funded by) the NHS, the service aims to provide a pathway from the point of NHS discharge to meet ongoing informational and emotional needs.
We worked with the Stroke Association team to evaluate the programme, helping them understand and evidence its impact.
Our research is being used to shape the future of the service.
Our role
- Independent evaluation
- Data analysis
- Quantitative and qualitative research
- Stakeholder and client surveys
- Evaluation and learning report writing
Why PS Research?
Stroke Association needed to learn how well its new approach of combining two standalone services—a free Connect phone support service and funded keyworker Stroke Recovery Service—met the needs of stroke survivors in Norfolk and Waveney (more on the reasons why soon).
They chose us on the strength of our proposal:
“Your proposal stood out among the submissions, demonstrating a strong understanding of our project requirements, and a clear alignment with our objectives.”
It’s always nice to get this kind of feedback because it’s what we go into each project to show.
We only submit proposals for research we’re passionate about and know our skills can make a difference.
Experience with similar projects—including our award-winning evaluation of a participant-led employability programme in Cumbria—gave us a clear understanding of the charity’s requirements.
We also bring a combination of quantitative and qualitative expertise to projects to deliver a mixed methods evaluation that helps the client see the full picture.
The clear alignment with objectives? That part comes from picking up the phone.
Chatting about the project helped us learn more about the charity and their work. At the same time, they got to know us.
It’s something we do with every project. A conversation is always the best way to find out if we’re the right fit for each other.
In this case, creating a connection meant we could deliver a proposal that ticked all the right boxes.
Start with existing data and build on it
Stroke Association needed evaluation to do three things:
- Meet funder requirements (a common objective for pilot programmes)
- Establish the value and impact of the service to secure ongoing funding
- Uncover insights for improvement
For us, that meant mixing quantitative and qualitative methodologies to answer some important questions like:
- What is the impact of the service on stroke survivors?
- Is the impact as expected (and are there any unexpected impacts or benefits)?
- What’s working well (and how)?
- What’s not working so well?
- How can challenges be improved?
- What can everyone learn from the new approach?
We always start our research by working with what the client already has. It means we can hit the ground running and build on existing data by collecting new complementary data.
In some projects, data is there in a spreadsheet ready to analyse. In others, you need to do a bit more digging. We like to be flexible. If you need extra help finding what’s in your system, we’re handy with a spade.
Stroke Association had collected plenty of data during the project, but not all of it was relevant to the evaluation.
We worked with them to pull the most useful information they were allowed to share. This sounds like a straightforward task, but you have to make sure the right agreements are in place and personal data is anonymised or pseudonymised before you can begin to decide what’s worth using. We're always happy to help with this.
Together, we were able to find data on the overall number of clients reached, their demographics (e.g. age and gender), referral sources and needs met. This gave us a clearer picture of the project’s scope.
To learn more about its impact we created two surveys:
1. A stakeholder survey for partners and professionals
Collecting responses from partners (e.g., NHS clinicians, volunteers and local authority staff) helped us understand what those on the caregiving side thought of the Life After Stroke service and its impact on them.
We also asked for their feedback on the service and what improvements they’d like to see.
2. A ‘client’ survey for stroke survivors
This gave stroke survivors the opportunity to tell us about the support they received, how useful they found it, what they liked and what could have been better.
For speed and efficiency, we usually run these kinds of surveys online. But while that was the better approach for the stakeholder survey, we agreed together with the Stroke Association’s team that a paper-based survey might get better engagement from stroke survivors. It did, meaning we had more valuable data to work with.
This is a good example of why we work with and not for clients. We want to be able to share ideas and plan approaches together, rather than blindly ploughing on with whatever’s worked in the past.
We ended the survey by asking survivors if they’d like to speak to us to give more feedback to support our qualitative research.
If you want to understand someone, talk to them
Quantitative research tells you a lot about how much or to what extent a programme has worked. But to fully understand impact and bring a project to life, you need people’s thoughts and experiences.
The qualitative side of the project was the biggest chunk of our evaluation. We had a lot of people we wanted to chat with to get different perspectives on the Life After Stroke service. Thankfully, with the help of the Stroke Association’s team, dozens of them were up for it.
We collected feedback in several ways:
- Interviews with stroke survivors and their carers to understand the lived experience of those who accessed the service
- Interviews and focus groups with Stroke Association project members to understand the journey of the project, key successes and challenges and learning for the future
- Interviews with wider partners and stakeholders to understand their experiences of the project
- Focus groups with clinical teams within relevant NHS services to understand the need for the service, its impact on their roles, their experiences, successes and challenges and suggested improvements
The more we spoke to people, the more invested we became in telling the story of the project.
To do it justice, we knew we had to expand the qualitative approach to include more focus groups with internal staff members and NHS clinicians. Except this wasn’t in our proposal or the budget.
We made a decision: absorb the cost, interview more people and ensure our evaluation gives the most rounded view of the project.
Again, we like to be flexible. If it makes sense and benefits the project, we’re happy to adapt our approach while sticking to the budget.
Speaking of which…
One project, several reports
A big factor in this project from the start was a tight deadline. Stroke Association needed findings sooner rather than later for business planning.
We decided to shift resources earlier into the evaluation than originally planned so we could deliver a more detailed interim report.
By doing this, the team were able to use findings to make a strong business case for funding. It also meant we weren’t sitting on lots of valuable data until it was too late.
We followed up the interim report with:
- A full evaluation report identifying key strengths of the service and areas for improvement, including ways of working within the healthcare and wider system
- A shorter evaluation report summarising key findings, strengths and suggested improvements for external partners
We also produced a separate ‘learnings’ report that went into detail on the internal learnings we found during evaluation.
This is something we do for every evaluation client.
Why?
Because it’s our job as independent evaluators to report on everything honestly. This means uncovering all of the good stuff, as well as some areas that might hold a project back.
The ‘learnings’ report includes useful things you can improve on or consider differently for next time, without detracting from the key findings of the full evaluation. It’s always practical advice and insights that challenge you in a positive way. We’re not here to lecture you.
Turning evaluation into action
Our research is helping the Stroke Association and NHS Norfolk and Waveney meet its objectives for planning and learning.
The interim evaluation report was used to evidence the benefits of the Life After Stroke service to help secure additional short-term funding. The full report is helping demonstrate the service’s impact to secure future funding and hopefully introduce it to more areas.
Internal learnings have proven useful too. The team has used the report to improve its referral process and discuss wider strategies around how they collect data, promote their services and work with other organisations.
We often find the evaluation process uncovers new ideas, insights or ways of working that benefit clients in various ways. Sharing them gives us the opportunity to have a bigger impact than just the “work.”
For the Stroke Association, this means more people getting support when they need it most. We’re happy to have played a part.