Exploring inter-professional roles in the provision of UK outpatient transient ischaemic attack services

Background: Suspected transient ischaemic attack is a diagnostic challenge, yet requires timely diagnosis for secondary stroke prevention. Aims: To understand variability of organisational processes, roles, education and clinical decision making in the UK's transient ischaemic attack services. Methods: Healthcare professionals were surveyed online in 2021 with descriptive data analysis. Interviews were conducted with a purposive sample. Three researchers thematically analysed interview data. Findings: Survey responses were received from 43 transient ischaemic attack services. 70% conducted remote consultations, 28% face-to-face, and 2% mixed. Clinicians with varying roles, skills and experience provided transient ischaemic attack services. All services involved a consultant physician with experience in stroke. Ten interviews confirmed the survey results and highlighted variability regarding clinical decision making, service composition, resources, learning opportunities and mode of consultation. Conclusions: Variability in transient ischaemic attack service workforce and service organisation influenced diagnostic decisions. The possible impact of such variability on clinical outcomes and approaches to reducing it require further research.