Table 3 Themes from the focus groups

Concept of the checklist

Positive

“…and sometimes it’s something, you think “oh that, I may not have asked that if it wasn’t on a checklist”. So I do like checklists I have to say because it does remind you to ask things…” [Nurse]

“…it just gives a structure to that consultation which I think means things are less likely to get missed really.” [Nurse]

“… a checklist would be very useful because cut to the chase and gets to the way forward” [Stroke survivor]

Negative

“And I’m slightly worried with a list that, you know, you sort of put it out nationwide and there’s going to be certain, doctors are going to be “another checklist, another”, you know, I can see that the first gut feeling that you’re going to have about it is a negative one which isn’t a good start.” [GP]

Content of the checklist

Missing items

Work: “And to me that was very, very important to try and get some normality back and for me normality was getting back to work.” [Stroke survivor]

Carer needs: “Now I believe to solve the problem would be if when someone has a stroke there is a person who is nominated, possibly as a case worker probably, doesn’t matter, but someone who takes the relatives through what happens after someone has a stroke. Now when my wife was released from hospital after almost six months it was a case of “here’s a bag of tablets, bye” and it was great wheeling her out of the hospital. I got to the car, what do I do?” [Carer]

Intimate relationships: “Intimate relationships as well because I think it’s not spoken about…” [Physiotherapist]

Wording

“I suppose they could be, had been anxious and depressed for two years, doesn’t matter if they’re more anxious or depressed does it if they’re already, if that’s still not been managed that anxiety? Doesn’t matter if it’s more or less.” [Physiotherapist]

Barriers

Time constraints

“I liked the content but it’s long for, so if it was me seeing that patient in 10 min I would struggle to probably get through the first three questions in reality…” [GP]

Inhibiting patient-centred care

“You know, so I think it’s not personalised and that’s why doctors won’t use a checklist like this, it will just seem too artificial. So there’s the time constraint but it just doesn’t work in terms of getting a patient’s confidence in an interaction, you know.” [GP]

Resources

“I think that could cause certainly a resource issue for our team because we are absolutely tiny and our focus is, it tends to be the new strokes coming out of hospital, whereas we could end up seeing people a year down the line potentially because they do still have the problems and we know that.” [Occupational therapist]

Raised expectations

“…a lot [of patients] will have some lasting permanent damage which they’ve probably been told several times that it’s unlikely to change or improve but the patient is wanting that. And here you’re asking has their, is their mobility still a problem and they’re saying yes and then you’ve put review to the community stroke team, that will generate a lot more referrals if you like to a rehab team or to physiotherapy or to occupational therapy but actually that person may not have the potential to improve. So you’re almost raising their expectations that something will happen or something will be done.” [Physiotherapist]