The development of the Stroke-Specific Education Framework


In response to the National Stroke Strategy (2007) the UK Stroke Forum developed a training arm with the task of establishing nationally recognised, quality-assured and transferable education programmes in stroke. With funding from the Department of Health, a Steering Group and four Task Groups developed the Stroke-Specific Education Framework (SSEF), a freely available resource for anyone interested in stroke care.

The SSEF consists of 16 Elements of Care, and the recently developed 4 Elements of Professional Practice, based on the quality markers in the National Stroke Strategy and related to the stroke strategies in all four UK countries.  Within each Element there are key competences that reflect the ‘knowledge and understanding’ and ‘skills and abilities’ an individual should possess if they work in that area of stroke care delivery.

Since the publication of the SSEF in 2009, further work has been undertaken to develop Standardised Role Profiles, a Course Library, and a Staff Calculator, to support stroke workforce planning and development. In 2014, a collaboration between the UK Stroke Forum and the University of Central Lancashire saw the development of the SSEF Online Toolkit, bringing all of these resources together to simplify and improve the user experience. The Guardian University Awards recognised this innovative approach through the presentation of the award for Digital Innovation 2017.

Levels of knowledge and skills

The levels of knowledge and skills described under Courses and Role Profiles are taken from the definitions used by Skills for Health:

  1. Basic – a generalised understanding that something exists but an individual would not need to know any details
  2. Factual – a knowledge that is detailed on a factual level, but does not involve any more than a superficial understanding of any principles or theories
  3. Working – the application of factual knowledge in a manner that takes account of widely understood technical principles and implications within the field of practice
  4. In-depth – a broad and detailed understanding of the theoretical underpinning of an area of practice, including conflicting theories and constructs
  5. Critical – the ability to evaluate and devise approaches to situations that depend on the critical application of theories and conceptual constructs within the area of practice

The NHS Long Term Plan: Collaboration with Health Education England

The NHS Long Term Plan 2019 identified stroke as a priority for improvement, particularly in relation to modernisation of the stroke workforce. The National Stroke Workforce Steering Group were convened to operationalise this aim. The SSEF and its Online Toolkit were recognised as the mechanism to underpin workforce transformation across the newly established Integrated Stroke Delivery Networks (ISDNs).

The SSEF Project Team undertook a programme of work to explore methods of increasing engagement with the SSEF, and embedding its use in workforce development processes across the stroke care workforce. This programme of work included: A nationwide stakeholder engagement survey; an in-depth review of the SSEF; and the development of 4 Elements of Professional Practice. Work is ongoing to support the developments and raise awareness across the stroke workforce.

Nationwide Stakeholder Engagement Survey

The views of those working in stroke were sought via a survey, disseminated in 2020, which explored their engagement and experiences of using the SSEF and its Online Toolkit. The survey also sought to identify: areas for improvement; examples of effective implementation; and the facilitators and barriers to wider adoption and embedding of the SSEF in stroke workforce development processes.

We received 250 responses to the survey, representing 15 healthcare professions, with the majority (89%) considering the SSEF a valuable resource to inform stroke care. The findings have, and continue to, inform future developments and implementation. Further information about the findings can be found here.

SSEF engagement

The Elements of Professional Practice

The SSEF was developed to detail the stroke-specific knowledge and skills required in the delivery of safe and effective care. In response to feedback from healthcare professionals using the SSEF, four additional Elements of Professional Practice were developed. The additional elements detail the knowledge and skills required in the broader aspects of practice, and support individuals to undertake a holistic self-reflection to inform their personal development planning. Designed to be relevant to the multidisciplinary team, and informed by multiple professional frameworks, the Elements of Professional Practice can be viewed here.