{
  "abstract": "Objective To explore multiprofessional views about system-wide factors influencing (impeding or facilitating) the delivery of stroke mechanical thrombectomy (MT) services and/or improvements to this pathway in England.Design A pragmatic exploratory qualitative study using online focus groups and semi-structured interviews with National Health Service (NHS) professionals and those working in a stroke strategic/policy lead role. We thematically analysed the data using the Framework Approach to understand participants’ views on the challenges to improving current and future MT implementation.Setting NHS trusts and other key stroke strategic/policy organisations covering 10 geographical regions in England and a national perspective.Participants A total of 29 professionals, working in an NHS clinical and managerial position and/or a stroke strategic national/regional clinical/policy lead role, participated in five focus groups and six individual semi-structured interviews between April and June 2024.Results We identified five themes relating to MT implementation progress and challenges (1) workforce, (2) clinical care pathways, (3) service/system, (4) cross-cutting theme: communications and (5) cross-cutting theme: culture. Our analysis emphasised the increasing complexity and inter-related factors shaping the emergency stroke pathway for MT provision and a need to acknowledge key people-related, organisational and sociocultural factors during service planning.Conclusions Despite the challenges and complexity, professionals were optimistic that further progress would be made with MT delivery in England. However, ongoing improvement strategies are required, which also acknowledge wider cultural factors and system-wide relationships and are not just focused on care pathways and resources.",
  "authors": [
    {
      "affiliations": [
        "Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK"
      ],
      "name": "Rosemary L Simmonds"
    },
    {
      "affiliations": [
        "NIHR Applied Research Collaboration South West Peninsula, Health and Community Sciences, University of Exeter, Exeter, UK"
      ],
      "name": "Jo Day"
    },
    {
      "affiliations": [
        "Royal Devon University Healthcare NHS Foundation Trust, Exeter, England, UK"
      ],
      "name": "Martin James"
    },
    {
      "affiliations": [
        "Stroke Research Group, Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Phil White"
    },
    {
      "affiliations": [
        "Stroke Research Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Christopher I Price"
    },
    {
      "affiliations": [
        "Stroke Research Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Lisa Shaw"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust and Radcliffe Department of Medicine, University of Oxford, Oxford, UK"
      ],
      "name": "Gary Ford"
    },
    {
      "affiliations": [
        "Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"
      ],
      "name": "Catherine J Pope"
    }
  ],
  "title": "10 years on from the landmark stroke thrombectomy trials, where are we now? A qualitative study examining professional views on the implementation of endovascular treatment for ischaemic stroke in England",
  "uid": "331bcc63-64e2-5a39-9131-5e3a75b475f2"
}