Transformation Unit

NHS Guildford and Waverley Clinical Commissioning Group

Future model of stroke care in West Surrey

The Client

NHS Guildford and Waverley Clinical Commissioning Group (CCG) is the NHS organisation responsible for the commissioning of hospital and community health services, medicines management and enhanced primary care services for the residents of Guildford and Waverley. It serves a population of more than 200,000 people.

The Challenge

We were commissioned to provide an independent report on the public consultation regarding proposed changes to stroke services and to determine the future model of stroke care in West Surrey. We were required to provide in-depth analysis of their public consultation and to identify main themes and relevant data from the public’s feedback.

For any potential change of service, NHS bodies have a legal obligation to involve and consult when developing proposals to change service provision as stated in the Health and Social Care Act 2012. Before commissioners could consider implementing a substantial change to the way services were delivered, they therefore had to listen to the views and opinions of the public and stakeholders by undertaking a formal public consultation.

As an independent, not-for-profit consultancy which specialises in large-scale clinical service transformation, we were appointed following a competitive pitch to analyse the public responses to the consultation, during the consultation period. This gave us just over a month to receive and analyse the data ahead of the West Surrey Committees in Common meeting for stroke services.

At the stage that we were appointed, the public consultation process has been designed and was already underway and so our focus was to produce a thematic report that set out the key messages from the consultation and could be used to support decision making at the next stage.

Our Approach

Plans had been developed by providers of stroke care in West Surrey to meet the South East Stroke Service Specification. Two substantial changes were proposed:

  • Consolidation of specialist stroke services at two hospital sites in West Surrey to enable seven-day hyperacute and acute stroke care, meaning stroke services would not be provided from a third site, the Royal Surrey County Hospital.
  • Consolidation of stroke specialist rehabilitation services for patients not quite well enough to be discharged home, in two bedded in-patient units in West Surrey.

Consultation responses were collated by NHS Guildford and Waverley CCG through responses from questionnaires, public meetings and written submissions. We used a mixture of qualitative and quantitative analysis in this report to enable the reader to build up a rich picture of the themes that arose out of the consultation and the issues that are important to the population affected. The main aim of the quantitative analysis was to determine how each area had responded in the consultation, looking across characteristics of the respondents, such as age, gender and caring responsibilities.

The qualitative analysis was about understanding the underlying reasons, opinions and motivations of responses. We analysed the insight received from stakeholders during the consultation process across West Surrey through their responses to the consultation to tease out the main and secondary themes.

To check the validity of the consultation results, we compared the results to a consultation on similar proposed plans in Greater Manchester in 2014.

We were subsequently asked to present the findings of the report to the West Surrey Stroke System Committees in Common at a meeting in public at which attendees were able to ask questions about the results of the consultation and the conclusions drawn from it.

The Outcome

Our report was part of the overall decision making process and reflected public feedback and opinion.  The major themes that emerged from the consultation related to travel, such as timely treatment and the importance of the ambulance service, as well as future services at the Royal Surrey County Hospital.

Additional themes came from special interest groups including post-discharge care; additional measures to support those with learning disabilities to adapt to changes; expected population growth in south Surrey; concerns from these residents around the proposed service changes; access to finance; and practical implementation in achieving the plans.

Our report informed the discussion and decisions taken by Guildford and Waverley CCG and North West Surrey CCG at the West Surrey Committees in Common meeting regarding the future model of stroke care in West Surrey.


“It is good to be able to commission an independent service such as we required from an NHS organisation. The Transformation Unit’s quote was competitive…but more importantly it was immediately apparent that we were on the same wavelength. In addition, all the people I dealt with and/or met were professional and respected what we were trying to achieve.”

  • Liz Patroe, Head of Partnership & Engagement, NHS Guildford and Waverley CCG

To view the full report we presented to the West Surrey Stroke System Committees in Common meeting click here.