The research faces challenges due to: the different timings of the reconfigurations; the retrospective
nature of the evaluation; and the current organisational turbulence in the English NHS. However, these issues reflect
the realities of major systems change and its evaluation. The methods applied in the study have been selected to
account for and learn from these complexities, and will provide useful lessons for future reconfigurations, both in
stroke care and other specialties.