ObjectivesTo describe the current landscape of UK electronic health record (EHR) databases and considerations of access and use of these resources relevant to researchers.Design & settingNarrative reviewData sourcesInformation was collected from the Health Data Research Innovation Gateway, publicly available websites and other published data and from key informants.Eligibility criteriaPopulation-based open-access databases sampling EHRs across the whole population of one or more countries in the UK.Data extraction and synthesisWe extracted and summarised published database characteristics and corroborated these with resource providers. Results were synthesised narratively.ResultsNine large national primary care EHR data resources were identified and summarised. These resources are enhanced by linkage to other administrative data to a varying extent. Resources are mainly intended to support observational research though some can support experimental studies. There is considerable overlap of populations covered. Whilst all resources are accessible to bona fide researchers, access mechanisms, costs, timescales, and other considerations vary across databases.ConclusionResearchers are currently able to access primary care EHR data from several sources. Choice of data resource is likely to be driven by project needs and access considerations. The landscape of data resources based on primary care EHRs in the UK continues to evolve.

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Visuospatial neglect (VSN) adversely impacts both the length of rehabilitation and activities of daily living (ADL) of patients after stroke and can reduce their participation in community activities. Therefore, it is important to assess VSN after stroke in neurorehabilitation facilities. The process of assessing VSN comprehensively in current geriatric rehabilitation remains unclear. This study examined the process of VSN in post-stroke assessment emphasizing the details of the (systematic) routines and structure of VSN assessment in current geriatric rehabilitation facilities in the Netherlands and rehabilitation facilities in the United Kingdom (UK). Health care professionals in geriatric rehabilitation facilities in the Netherlands (n = 6) and in stroke and neurorehabilitation facilities in the UK (n = 6) were interviewed. VSN was not routinely assessed in any of the geriatric rehabilitation facilities in the Netherlands, and only in half of the neurorehabilitation facilities in the UK. Healthcare teams in the Netherlands detected no patients with VSN over a two month period. Several VSN assessment tools were employed. Neuropsychological tests were most frequently used. Nine interviewees indicated the need to improve the process of VSN assessment in actual practice. The suggestions focused on improving the process of assessing VSN and developing relevant knowledge development and training. This study showed that in current rehabilitation practice, VSN was not always assessed in a routine (every stroke patient) and structured (who, when, and, which tests) manner. VSN was not routinely assessed with more than one test (neuropsychological and during daily activities), contrary to best practice recommendations. VSN remains probably underrecognized, especially in geriatric rehabilitation facilities. It is important to improve the current process, including selecting the most appropriate tools for assessing VSN.

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