When an individual experiences a stroke a series of clinical decisions are made (either implicit or explicit) about the most appropriate setting for their care. These decisions can be considered in the form of four main issues, recognising that each individual stroke patient presents a unique set of problems and potential solution. Efficient and effective management of patients depends on a well organised expert service that can respond to the particular needs of each individual patient. To achieve this, the organisation of stroke services must be considered at the level of the Health Board, Primary, and Acute Trusts and in the patient's own home or care home.