TIA and Minor Stroke

Communication with health professionals

Many of the people we interviewed felt comfortable and satisfied with the way in which the health professionals they came into contact with had treated them. There were a number of routes that people took in seeking care (see ‘Seeking help – routes to care’ and ‘Delay in seeking help’) including dialling 999, calling NHS direct, visiting the GP, attending A&E. On-going care came through referral to specialist services such as a TIA clinic or a neurology department. Some people had been enrolled in a research study so had also come into contact with a clinical research team (see ‘Taking part in TIA research’).
Whilst it could be difficult to know when or whether to seek help (see ‘Delay in seeking help) those people who called 999 for an ambulance said that they felt they were in good hands. Because of the seemingly ‘trivial’ nature of some of the presenting symptoms it could be easy to worry about wasting paramedics’ time, but as Rosemary points out (below), they would rather come out and see someone who is concerned about worrying symptoms because rapid treatment is the most effective way to prevent anything more serious happening. Yvonne admitted that it could be difficult to bring yourself to complain about symptoms when you were not sure how serious they were but she realised from her experience as a policewoman that it was important not to disregard apparently minor complaints.
some people first sought help from the GP and in most cases the GP recognised or suspected a TIA or minor stroke and made an urgent referral to a TIA clinic or neurology department. Some people made a routine appointment with the GP because they didn’t realise that they ought to be seen urgently, and there were several people who said they found it difficult to get an urgent appointment with the GP. Roger felt let down by the fact that the GP’s receptionist would not give him an appointment on the day he called up for one, and ended up phoning NHS Direct, who told him to go straight to an emergency department to be seen. Later his GP agreed that receptionists should be trained to recognise potentially serious symptoms.
People sometimes found it hard to get health professionals to take them seriously. When Mike experienced his TIA he saw a locum GP who was part of the ‘on call service’ but instead of treating him urgently the locum doctor just told him to go and see his GP the next day. Michelle visited the GP several times before she had a major stroke, with symptoms that in retrospect were diagnosed as TIAs, but the GP diagnosed anxiety and neuralgia and she felt she wasn’t being listened to. Sometimes negative experiences like this could make people feel reluctant to consult their GP.
The way that people experienced care in hospital and through outpatient clinics varied widely. Many people were very happy with the way they were treated by A&E staff, ward nurses, doctors and consultants (see also Keith above).
One man who had to have surgery after his TIA was very impressed with the way in which the anaesthetist explained everything and felt reassured by the fact that he was in control and could make choices based on the information he was given. On the other hand some people were less inclined to want to be overloaded with lots of information and were happy to have been given a basic explanation of what had happened and what they needed to do.
A few people felt less well supported than they felt they needed, and some felt quite let down by their experience overall. Some felt that the fact that medical staff were often so busy could sometimes mean that they appeared not to have enough time to give adequate support and information to patients, although this did not necessarily affect the standard of medical care.
Some people had more difficult experiences in hospital and afterwards. Sometimes this was due to poor communication which could make people feel frustrated and upset. Vernon believed he had been given permission to leave the hospital but discovered the doctor had not mentioned this to the nursing staff. Michelle (below) had a TIA followed by a stroke, but felt let down by the fact that she was treated by staff who were more accustomed to dealing with people who were much older than her. Gilly found it difficult when she questioned the hospital about the length of time it was taking for her to be seen by a specialist.
Some people felt unable or unwilling to ask too many questions, either because they felt they didn’t want to be a nuisance, waste the time of busy staff, or sometimes because it could be difficult when there were so many things to think about especially when they were experiencing symptoms such as disorientation, confusion and speech problems. Clare found it helpful to record the consultation she had with the specialist on a small dictaphone because she felt she wouldn’t remember what she had been told otherwise.
Whilst many people felt that they had been given their diagnosis in an acceptable and straightforward way, a few people said they felt that the consultant needed to be more sensitive and aware of the impact of what was being said.
Some of the people we interviewed had taken part in a research study about TIA and minor stroke (see ‘Taking part in TIA research’). Most of these people were impressed with the way in which the research nurses and doctors had the time and expertise to talk to them in depth about their experience.
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Some people had quite difficult experiences in getting a diagnosis or afterwards. Some felt they didn’t want to make a fuss and complain. A few people did make formal complaints about their treatment but this could be fraught with difficulty, as well as adding to the pressure of an already stressful situation.

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Last reviewed June 2017.


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