The Power of Peer Support in Post-Stroke Recovery
Introduction: Beyond Clinical Rehabilitation
The journey of recovery following a stroke extends far beyond the confines of acute medical treatment and formal clinical rehabilitation. While these interventions are critical for addressing the immediate physiological impact of a stroke or strokes, they usually conclude long before the survivor has even begun to understand, let alone accept the consequences.
I’ve been incredibly lucky, yet it’s only now two years on that acceptance is tangible.
My experience and the experience of others I have met, talked to, listened to and read of is that Stroke can precipitate multiple challenges, including chronic social isolation, heightened anxiety, depression, and the most fundamental disruption to one's sense of self and identity.
It is within this complex, long-term recovery landscape that peer-to-peer support emerges not as an ancillary social activity, but as an essential therapeutic resource.
It functions as a parallel (if lucky) or more likely sole track to clinical care and potential recovery. It can address the lived experience of stroke and provide the sustained support necessary for individuals and their families to rebuild their lives.
The Value of Shared Lived Experience
The efficacy of peer support is rooted in the unique power of shared lived experience. It can deliver distinct therapeutic benefits that are difficult to replicate in a formal clinical setting (even when available). It can operate in a multifaceted and deeply impactful way both stroke survivors and their carers.
Validation and Emotional Normalisation
One of the most immediate and powerful benefits of peer support is the sense of validation it offers.
A stroke is a brain injury, and for the stroke survivor it is that injured organ (the brain) which uniquely has not only to repair itself but deal with all the consequences of the injury for the rest of a survivor’s life.
Peer to peer support is when groups of survivors, families and their carers get together, formally or informally, virtually or in person.
Stroke groups can create what can be described as "safe and non-judgemental spaces” - that’s certainly my experience and why I am such a strong advocate for them.
They can be a place where survivors and their families can share their fears, frustrations, and triumphs. The simple act of meeting others who "know exactly how you're feeling" serves to normalise their experiences, dispelling feelings of “no-one understands how I am feeling” and/ or isolation. This shared understanding provides a powerful form of reassurance, validating the emotional and practical struggles which are part of post-stroke life.
Cultivating Hope and Confidence
Peer groups serve as a unique source of hope. Observing peers who are further along in their recovery journey, particularly those who have taken on roles as volunteers or group leaders, provides tangible evidence that a fulfilling life after stroke is possible. This experience can significantly boost morale, foster optimism, and help individuals feel more confident about their own potential for recovery. This process empowers survivors to move from a position of patienthood towards one of active participation in their own rehabilitation, helping them to "reclaim their lives".
It creates ownership and agency in one’s own recovery.
A 'Natural' Environment for Recovery
Clinical therapy can be excellent and the people who work in it are hugely dedicated professionals who passionately care about the survivors in their care. However, in a world in which health care resources are enormously outstripped by ever increasing demands, the support offered is finite and can be (by necessity) too structured and inflexible - in a sense a one size fits all service.
In stark contrast to that, peer to peer support can offer a survivor led, informal, social atmosphere, which in the right circumstances creates a low-pressure setting where individuals can practice and regain skills. For example, survivors with communication difficulties such as aphasia, these groups provide an invaluable opportunity to practice speech in a supportive context, free from the fear of formal assessment. This relaxed environment helps the rebuilding of social confidence, encourages interaction, and makes the hard work of recovery feel more like a shared, communal activity.
Practical Information and Mutual Aid
Beyond emotional support, these groups function as crucial hubs for the exchange of practical knowledge. Members share coping strategies, tips for navigating daily activities, and information about other local services, benefits, and resources.
This peer-to-peer information sharing is often highly practical and grounded in real-world experience, complementing the formal advice provided by healthcare professionals.
The structure of peer support in the United Kingdom reveals a system that functions as a low-cost, high-impact extension of formal healthcare. I believe it is in its infancy and the benefits of such are yet to be fully utilised.
With wider participation peer to peer support will constitute a third pillar of long-term care, filling critical gaps in statutory provision and absorbing demand that the state sector is not equipped to meet.
Peer to peer support, by its nature can be offered by the largest of organisations and all the way down to a determined individual wanting to contribute something to a community they unwittingly find themselves part of.
By example, The Stroke Association explicitly acknowledges that its (and others’) services provide a "lifeline" precisely because there are "gaps in statutory services" for long-term support.
This reality is embedded in the design of the NHS's own frameworks. The National Stroke Service Model, for instance, is built on a foundation of collaboration with the voluntary sector to deliver long-term community support and reviews.
Furthermore, public-facing NHS resources consistently signpost to charities and voluntary organisations as the primary providers of this type of ongoing support. This is something I want to see far more of.
This model is described by providers as both "sustainable" and "cost effective," a reality made possible by its heavy reliance on a dedicated volunteer workforce and local, self-funding mechanisms.
From a health economics and service planning perspective these groups are not a peripheral social amenity but a core, structural component of the UK's de facto stroke care infrastructure. For health and social care commissioners, supporting and sustaining this network should represent a strategic investment in preventative health—mitigating secondary complications like depression and social isolation—and enhancing overall system efficiency.
Further investment in this area must produce extraordinary productivity gains and future cost saving. Which care provider (public or private), is going to say no to that?
The United Kingdom's Stroke Support Infrastructure: A Hybrid Model
Stroke support across the United Kingdom is a complex hybrid, blending the efforts of large national charities, formal integration with the National Health Service (NHS), and a diverse network of independent local groups. This structure, while providing a broad range of services, varies significantly across the devolved nations.
The National Charity Backbone
Two major national charities form the backbone of the UK's peer support provision, each with a distinct focus and operational model.
The Stroke Association: Formed in 1992 from the Chest, Heart and Stroke Association (CHASA) to focus exclusively on stroke, the Stroke Association is the UK's largest charity in this field. It aims to operate a comprehensive suite of services designed to support survivors and their families at every stage of their journey. Central to its offering is the national Stroke Helpline, a primary point of contact for information and advice. The charity has also invested heavily in digital resources, most notably the 'My Stroke Guide' online platform, which provides information, videos, and moderated forums for peer connection. The Stroke Association coordinates the UK-wide "Stroke Group Network," a framework that includes both groups run directly by the charity and a larger number of affiliated independent clubs.5 The organisation's central office is located in London.
Different Strokes: This national charity occupies a vital and specific niche, focusing its efforts on supporting "working-age" and "younger stroke survivors" and their families.
Recognising that the needs of this demographic—which often include concerns about employment, childcare, and long-term financial planning—differ significantly from those of older survivors, Different Strokes champions a model of "active peer support". This is delivered through a multi-channel approach, including a national information line (0345 130 7172), online communities such as a dedicated Facebook Group, virtual meetings for both survivors and carers, and a network of local, in-person support groups across the country.
NHS and Statutory Service Integration
The relationship between the voluntary sector and the state is not merely one of informal signposting; it is increasingly codified within formal NHS policy and service models, although much more work needs to be done to fully exploit the opportunities available to survivors and care providers.
Based on information in the public domain, the following should be happening:
The National Stroke Service Model (NSSM): Developed jointly by NHS England and the Stroke Association, the NSSM aims to formalise a collaborative framework. It mandates that the Integrated Community Stroke Services (ICSS), which manage post-hospital rehabilitation, must work in partnership with the voluntary sector. This includes providing ongoing community support, facilitating 6-month post-stroke reviews, and ensuring long-term engagement. This policy elevates the role of charities from external resources to integrated partners in the official care pathway.
The Signposting Gateway: The NHS acts as the primary conduit connecting patients to the wider peer support ecosystem. This signposting should occur at multiple critical junctures: on the main NHS website, which directs users to charities and volunteer groups; through hospital-based teams, such as Early Supported Discharge (ESD) services, who, when best practice is observed,provide information upon a patient's return home; and via referrals from General Practitioners (GPs). The effectiveness of the entire support system is therefore highly dependent on the awareness, knowledge, and diligence of these frontline NHS professionals.
In my opinion, there is much work to be done in this area.
A Comparative Overview of Devolved Nations
The structure of stroke support is not uniform across the UK, with each devolved nation having developed its own distinct model of provision and partnership.
- Scotland: The Scottish landscape is characterised in the following manner. Both the Stroke Association in Scotland and the highly influential Chest Heart & Stroke Scotland (CHSS) operate independent networks of peer support groups. This provides a wide array of choices for survivors. NHS Scotland, through its public health information service NHS Inform, ought to actively signpost to both organisations, acknowledging their central role in long-term community care.
- Wales: In Wales, the Stroke Association is the principal charity partner, working in collaboration with the Welsh Government to provide services, including a commitment to bilingual resources and support through the Welsh language. An example of integrated care is the "Living Well After Stroke Service" (LWASS) within the Aneurin Bevan University Health Board, which promotes a model of longer-term, NHS-led support that works to signpost users to appropriate community resources.
- Northern Ireland: A dual system similar to Scotland's exists, with both the Stroke Association Northern Ireland and NI Chest Heart & Stroke (NICHS) playing key roles. A defining feature of the Northern Irish model is the formal partnership structure, where services are often delivered in conjunction with the local Health and Social Care (HSC) Trusts. This collaboration is guided by the government's overarching "Stroke Action Plan," which aims to set strategic direction for service reform and delivery.
Whilst the intent is good, in practice there’s an operational tension between the top down approach of Government and the NHS and the bottom up efforts of smaller local bodies/volunteer groups.
The system is shaped by the centralising forces of national charities and overarching NHS frameworks, which aim to standardise and scale support. These bodies create national strategies like the NSSM , aimed at developing consistent branding and quality standards, and build UK-wide digital platforms such as 'My Stroke Guide'.
Simultaneously, the final delivery of the service on the ground has, by necessity, to be carried out by local, autonomous, volunteer-run groups. These are grassroots, bottom-up entities. An example might be the Havering and District Stroke Club, a registered charity with its own governance and funding streams, or the Ealing Stroke Club, a small, friendly social group meeting in a church hall.
The clearest evidence of this operational and legal separation lies in the Stroke Association's own disclaimer regarding its network of independent groups, where it states, "we do not take any responsibility for their activities".
This creates a paradoxical system that is at once coordinated and fragmented. The perceived national scale and coherence of the support network relies on independent local actors. For service commissioners and healthcare planners, this means that engaging with the national organisation is not necessarily productive. I’d suggest that a multi-level engagement strategy that includes direct communication with and support for these grassroots groups is essential for ensuring both strategic alignment and effective local delivery.
Peer-to-Peer Support Services in Greater London
This is not a complete index of peer to peer support services, and I apologise to those I have missed out. It is based on publicly available information. I am happy to add to it and amend as necessary
An Overview of London's Support offerings
The provision of peer-to-peer support for stroke survivors in Greater London is complex and uneven. It is a patchwork quilt of services, with significant variation in type, availability, and visibility across the 32 boroughs.
The landscape ranges from highly integrated, professionally-led services embedded within the NHS, such as the on-ward Stroke Education Group for families at the Royal Free Hospital, to charity-commissioned services like the Islington Stroke Navigator, which provides one-to-one support. Alongside these are the more traditional, independent, volunteer-run social clubs, such as the South Islington Stroke Club, which has been operating for over 30 years.
A significant challenge for survivors, carers, and referring professionals is the variable quality and reliability of information. While major charities provide searchable databases, many smaller, independent groups can be difficult to find.
This creates a digital divide, rendering some services effectively invisible and hindering access for those who rely on online searches to find support. The result is a system where access to support can be determined as much by one's postcode and digital literacy as by one's need.
Directory of Local Stroke Support Groups in Greater London
The following directory provides an (incomplete) borough-by-borough overview of known in-person peer support groups for stroke survivors in the Greater London area. It aggregates information from multiple sources into a single, structured reference tool.
A note on data currency: The information presented below is based on the most recent available data from public sources. However, given the volunteer-led and often precarious nature of many independent groups, details such as meeting times, locations, and contact information can change. It is strongly recommended to make direct contact with a group before attending for the first time.
Barnet
Wesley Stroke Group
Independent
Wesley Methodist Church, High Barnet, Hertfordshire
Thursdays, 10:00 - 12:00
Social group with quizzes, games, outings, speakers, and exercises. Serves Barnet, Potters Bar, Radlett, Borehamwood, and Finchley. 39
Email: malcolm.sugar@virgin.net; Phone: Sylvia Sugar on 01923 852817
Barnet
(Unnamed Group)
Independent
Barnet Multicultural Community Centre, Algernon Road, Hendon
Group with a "welcoming cultural atmosphere," offering exercises, group activities, and an Asian vegetarian lunch.
Bexley
Friday Stroke Club
Independent
Sidcup Baptist Church Hall
Fridays, 10:00 - 14:30
Offers maintenance groups, activities, cards, chess, bingo, outings, and a freshly cooked lunch. 39
Email: Beryl.Howes@bexley.nhs.uk
Bromley
Bromley C.H.A.T. Group
Stroke Association
St. Andrews Church Hall, 136b Burnt Ash Lane, Bromley, BR1 5AF
First and third Thursday of each month, 14:00 - 16:00
Social support, guest speakers, presentations, singing, art/craft therapy, outings, walks, and selected Speech & Language Therapy input. 16
Janet Soile (Coordinator); Phone: 020 8778 7177; Mobile: 07961 007 954; Email: janet.soile@stroke.org.uk
Croydon
The Stroke Association Croydon Young Stroke Group
Stroke Association
The Angel Cafe, West Croydon
First Tuesday of the month
Social contact and information for stroke survivors of working age.
Phone: Paul on 020 8688 7570 or Sue on 020 8651 2906
Ealing
Ealing Stroke Club
Independent
St John's Church Hall, Mattock Lane, West Ealing, W13 9LA
Mondays, 10:30 - 12:30
Small, friendly social group with quizzes, word games, occasional outings, and lunches. A place for chat and fun.
Email: Johnhillman76@hotmail.com; Phone: John Hillman on 020-8868-5941
Greenwich
The Stroke Association Greenwich Stroke Club
Stroke Association
Leeds Courts, Orford Road, Bellingham, SE6
Second Wednesday of the month, 10:00 - 12:00
Social club for anyone who has had a stroke.
Email: helen.lolljee@googlemail.com; Phone: 07944 165602
Haringey
Haringey Stroke Clubs
Independent
Locations in Hornsey, Tottenham, and Wood Green
Term-time only (40 weeks/year), 12:00 - 14:00
Social interaction, programme of activities, outings, and light refreshments. Transport is provided.
Email: janis.needs@acharingey.org.uk
Harrow
Harrow Stroke Club
Stroke Association Affiliated
The Lodge, 64 Pinner Road, Harrow
Every other Wednesday, 12:30 - 15:30
Volunteer-supported social club. Activities include reminiscence sessions, bingo, exercises, quizzes, speakers, music, outings, and raffles. Low-cost lunch and tea provided.
Gordon: 07905 362885
Havering
Havering and District Stroke Club
Independent (Registered Charity No. 276659)
Royal Air Forces Association, 18 Carlton Road, Romford, RM2 5AA
Weekly (e.g., Wednesdays 14:00-16:00 at Trinity Church Hall previously mentioned, now at RAFA club)
Social group for survivors and helpers. Offers exercises with a qualified physio, activities like cards, dominoes, needlecraft, painting, and chat. Lunch is available.
Phone: 01708 722950 ; Brian: 07850 365736
Hounslow
Hounslow Stroke Club
Independent
St Paul's Church Centre, St Paul's Road, Brentford
Wednesdays, 10:30 - 12:30
Social club providing support and activities.
Not specified
Islington
South Islington Stroke Club
Independent (Stroke Association Network)
Mary's Community Centre, Upper Street, Islington, N1 2TX
Thursdays, 12:00 - 14:00
Friendly lunch club with conversation, word/picture games, gentle exercise, music, talks, and occasional outings. Wheelchair friendly. 13
Jane Pickering (Secretary); Phone: 07905 741705; Email: janepickering@hotmail.com
Islington
Manor Gardens Stroke Club
Manor Gardens Centre
Upper Holloway Baptist Church
Fridays, 10:00 - 15:00
Weekly club as part of a wider service providing one-to-one support and trained volunteers
Milena: 020 7561 5264; Hugh: 020 7561 5308; Email: milena@manorgardenscentre.org
Islington
Volunteer Group - Islington
Stroke Association
Islington Outlook Centre, 133 St John's Way, N19 3RQ
Thursdays, 10:30 - 12:30
Not specified
Contact via Stroke Association Helpline: 0303 3033 100
Redbridge
Redbridge Stroke Club
Independent
Loxford Youth Centre
Thursday afternoons, 14:00 - 16:00
Offers companionship, refreshments, raffles, gentle exercise, a speech group, and occasional outings.
Not specified
Southwark
Time and Talents Stroke Club
Time and Talents Association
Not specified
Weekly
A group of ~20 members meeting for talks, entertainment, outings, and information sharing.
Not specified
Waltham Forest
Chingdale Stroke Club
Independent
North Chingford (E4 area)
Alternative Monday evenings, 19:00 - 21:00
Small, friendly club offering refreshments, chat, bingo, quizzes, pub outings, and social entertainment.
Not specified
Waltham Forest
The Connaught Stroke Club
Independent
Connaught Day Hospital, Whipps Cross Hospital, Leytonstone
Every other Tuesday, 19:00 - 21:00
Social group that arranges annual holidays and day trips.
Email: Carol at Caroldavid65@talktalk.net
South West London
Moving On Stroke Club
Independent
Four venues: weekly in Roehampton; monthly in Hampton Hill, Richmond, and Teddington
Varies by location
Members can attend any session. Offers exercises, speakers, and days out to the seaside and places of interest. Welcomes survivors and carers.
Phone: Gill Ritchie on 020 8979 5877; Email: strokeinfo@aol.com
Digital and Pan-London Services
Transcending the geographical boundaries of London's boroughs, a growing number of digital and pan-London services provide crucial support to all residents of the capital.
The Rise of Virtual Support: The COVID-19 pandemic accelerated a shift towards online provision, and many of these services have become permanent fixtures. A key example is the London Peer Support Online Group, a dedicated, volunteer-led group run by the Stroke Association via Zoom. It is open to stroke survivors, carers, and supporters from across the London area, offering a space for connection and socialising, often featuring guest musicians and other speakers.10 This format provides a vital alternative for those who are unable to travel to in-person meetings due to mobility issues, fatigue, or caring responsibilities.
National Digital Resources: Londoners also benefit from the extensive digital infrastructure provided by national charities. The Stroke Association’s My Stroke Guide is a comprehensive online tool with information, advice, videos, and a moderated online community forum, accessible 24/7. Similarly, Different Strokes leverages digital platforms to connect its target demographic of younger survivors through virtual meetings and active social media groups, including a prominent Facebook group.4 These resources ensure that a baseline of support and information is available to anyone with an internet connection, regardless of their location within London.
Specialised Support Hubs in London
Beyond general social support, London is home to a number of services that offer specialised support tailored to specific post-stroke needs.
Communication and Aphasia Support: Aphasia, a disorder affecting speech and language, is a common and profoundly isolating consequence of stroke. Recognising this, several specialised services exist to provide targeted support. The Islington Aphasia Cafe, which meets fortnightly, and the Camden and Islington Communication Support Service, run by the Stroke Association, are prime examples. These services offer a safe environment for survivors to practice their communication skills, learn new strategies, and connect with others facing similar challenges, thereby rebuilding confidence and reducing social isolation.
Younger Stroke Survivors: While Different Strokes is the key national charity for this cohort, the need for local, tailored support is recognised within London.
The Stroke Association Croydon Young Stroke Group is a specific local initiative that provides social contact and information for working-age survivors. Such groups are critical as they can address age-specific concerns related to returning to work, managing family responsibilities, and the distinct psychological impact of experiencing a stroke at a younger age.
Carers and Families: The well-being of carers is integral to the recovery of the stroke survivor. Support for this critical group in London is delivered through various models. Many general stroke clubs, like the Havering and District Stroke Club, explicitly welcome carers to attend alongside survivors, providing a shared social outlet. At the other end of the spectrum are highly specialised and proactive services, such as the Stroke Education Group run by the psychology team on the acute stroke ward at the Royal Free Hospital. This group provides a dedicated space for families and carers to receive information, advice, and psychological support during the acute phase of their loved one's hospitalisation. Additionally, borough-level organisations like the Islington Carers Hub offer comprehensive advice, information, and support specifically for carers, linking them to relevant services and support groups.13
Navigating the System: Access, Referral, and Service Delivery Models
Pathways to Support
Accessing the diverse ecosystem of stroke support in London is achieved through several distinct pathways, each with its own characteristics and dependencies.
The most common model, particularly for the many independent community clubs is for survivors or their carers to find a group, often through an online search or word-of-mouth, and make contact themselves. A primary digital gateway for this is the Stroke Association's website, which features a postcode search tool to find local services and groups.
A second pathway is signposting and referral from statutory services. This is a cornerstone of the NHS's integrated care model. Hospital discharge teams, Early Supported Discharge (ESD) services, and GPs are ideally positioned to provide patients and families with information about relevant local support upon leaving hospital or during follow-up appointments.
A third, more structured model involves dedicated navigator services. The Islington Stroke Navigator Service, for example, is a professionalised role designed to proactively connect with stroke survivors, conduct home visits, and provide tailored advice and referrals to other local services. This model provides a more intensive and personalised level of support for navigating the complex local system.
The Volunteer-Led Community Model: Strengths and Fragilities
The bedrock of community-level peer support across London and the UK is the volunteer-led club. This model possesses significant strengths but also inherent vulnerabilities that impact its long-term sustainability.
Strengths: The primary strength of this model is its authenticity. The support is delivered by peers, for peers, creating a powerful dynamic of mutual understanding and shared experience.1 These groups are often deeply embedded in their local communities, fostering a sense of ownership and making them highly responsive to the specific needs and character of their membership. From a systemic perspective, they are extremely cost-effective, running on minimal budgets derived from small member donations and local fundraising efforts.
Vulnerabilities: The model's greatest strength is also its greatest potential weakness. The reliance on a small number of dedicated volunteers, who are often older stroke survivors themselves or their carers, creates a significant risk to sustainability. Burnout, illness, or the retirement of a key organiser can place an entire group's existence in jeopardy. Funding is often precarious and hand-to-mouth, which limits the group's capacity to access professional input (e.g., therapists), invest in volunteer training, or conduct effective outreach to new members. This fragility means that the patchwork quilt of provision can fray easily, with clubs closing down and leaving gaps in local support.
The structure of London's support system presents a significant navigational challenge for a person who has recently had a stroke, or for their family. In the aftermath of such a life-altering event, individuals are often overwhelmed and lack the cognitive and emotional resources required to research and compare dozens of different providers across multiple websites and boroughs.
The emergence of professional roles such as the "Stroke Navigator" , "Information Advice and Support Coordinator", and "Stroke Recovery Service Coordinator" represents a promising adaptation to its own inherent fragmentation. However, there is much scope for more.
These roles function as human interfaces and system linchpins. They bridge the gap between the demand beyond capacity, clinical pathway and the disparate community support landscape. A single, knowledgeable point of contact can perform a personalised needs assessment and then make tailored, "warm" referrals to the most appropriate services—directing an individual to a social club to combat loneliness, an aphasia group to practice communication, or a welfare rights advisor to address financial hardship. The Islington Stroke Navigator Service and the Stroke Association's Recovery Service Coordinators are clear case studies of this function in action. They visit people in their homes, provide holistic support that considers practical, emotional, and social needs, and effectively act as the glue that holds the local system together for the user. Therefore, for a health or social care commissioner seeking to maximise the impact of their investment, funding and scaling these human linchpin roles is arguably the single most effective intervention to improve access, equity, and the overall efficiency of the entire peer support ecosystem.
Equally, Stroke-survivors.org could evolve into something similar
Identified Gaps and Opportunities in London's Provision
This analysis (whilst admittedly, probably not complete) of the available data on peer support services in Greater London reveals several critical gaps and opportunities for strategic improvement.
Geographical "Cold Spots": The above directory highlights a significant disparity in the documented provision of in-person services across London's boroughs. While some boroughs like Islington and Havering appear to have a relatively rich mix of options, many others have few or no easily identifiable groups. A critical question for commissioners is whether these areas represent true service deserts or "digital deserts." The latter refers to a situation where viable, active groups may exist but are invisible online due to a lack of digital skills or resources, a failure of information management that constitutes a significant barrier to access in the 21st century.
Demographic and Service-Type Gaps: The predominant model of peer support is the daytime, social-focused club, often attended by an older demographic. While invaluable, this model may not adequately meet the needs of all survivors. There is a clear opportunity to support the development of more evening groups to accommodate working-age survivors, for whom daytime attendance is impossible. The Chingdale Stroke Club's evening meetings serve as a rare but important example. Furthermore, in a multicultural metropolis like London, there is a pressing need for more culturally-tailored services. The provision of an "Asian vegetarian lunch" by a group in Barnet is a notable, yet isolated, example of the kind of culturally competent service design that should be more widespread. Finally, there is a potential gap in provision for groups that offer more structured therapeutic input, bridging the gap between informal socialising and formal rehabilitation.
Recommendations for Healthcare Professionals and Commissioners
Based on the preceding analysis, here’s a number of recommendations the following proposed to strengthen the peer support ecosystem in Greater London.
- Fund a Centralised, Professionally-Maintained Directory. Integrated Care Boards (ICBs) across London should collaborate to commission and maintain a single, reliable, public-facing digital directory of all stroke support services (both statutory and voluntary) within their footprints. This primary source would replace the current reliance on fragmented, often outdated sources and provide an essential tool for social prescribing teams, discharge coordinators, GPs, and the public.
- Scale the Navigator Model. The most effective investment to ensure equitable access and navigation of the complex system is to commission "Stroke Navigator" or "Support Coordinator" roles across all London boroughs. For example, the services in Islington and those run by the Stroke Association could be used as blueprints for this expansion. These roles are critical for providing personalised support and making the system work for the individual.
- Formalise Hospital-to-Community Pathways. To ensure no survivor falls through the gap upon leaving hospital, ICBs should mandate formal partnership agreements between all hospital stroke units and Early Supported Discharge teams (e.g., at the Royal Free or Central London Community Healthcare NHS Trust) and the designated Navigator/Coordinator for their geographical area. This would operationalise an efficient and effective handover process, ensuring every survivor is connected to long-term community support before their clinical care concludes.
- Establish a Voluntary Sector Sustainability Fund. A small grants programme should be established at a London-wide or ICB level, specifically for the independent, volunteer-led stroke clubs. These grants would support core operational costs (e.g., venue hire, insurance, activity materials) and, crucially, fund capacity-building initiatives such as volunteer training, digital skills development, and succession planning. This would enhance the resilience and sustainability of these vital community assets.
Some thoughts for Stroke Survivors and Carers
For stroke survivors and their families, navigating the path to recovery can be daunting. Peer support can be a powerful part of that journey. Here I offer some practical advice for finding the right support.
Finding the Right Fit: Not every group will be the right fit for every person. It is important to consider what you are looking for. Think about the format (do you prefer in-person meetings or the flexibility of an online group?), the focus (are you looking for informal social chat, or a group with more structured activities and exercise?), and your specific needs (are you a younger survivor, do you have aphasia, are you a carer seeking support?). Don't be discouraged if the first group you try isn't right for you; the variety of provision means there is likely another option that will be a better match.
Key Points of Contact: The first step can be the hardest. Here are two national points of contact:
- The Stroke Association Helpline: 0303 3033 100
- Different Strokes Information Line (for younger survivors): 0345 130 7172
Crucially, you should also speak to your GP or the hospital team managing your care. Ask them for a referral or for information on local support services they recommend.
The Power of Proactivity: Rebuilding a life after stroke takes courage and determination. Taking the step to connect with others who have been through a similar experience can be transformative. Be an active agent in your own recovery. Reach out, try a group, and remember that building a supportive community is not just a social activity—it is a fundamental and powerful part of the healing process.
I don’t under-estimate the challenges in all of the above. The above is not a panacea of solutions nor a complete guide or recommendation of services on offer.
However, I do know, through my own experiences in London and elsewhere, contact with other stroke-survivors is a vital pathway to a better outcome, regardless of your individual prospects of recovery. Contact with fellow survivors improves mental health and increases well-being. It’s a fantastic resource to participate in and to contribute to.
It needs to be more widely offered and used.