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Why the stroke strategy is so important

Stroke, the loss of brain function due to a blood clot or bleed in the brain, is the third leading cause of death in the UK. Each year 150,000 people have a stroke and of those, 67,000 people will die. Stroke is also the single largest cause of adult disability in England with over 300,000 people living with moderate to severe disabilities as a result of stroke.

Stroke, the loss of brain function due to a blood clot or bleed in the brain, is the third leading cause of death in the UK. Each year 150,000 people have a stroke and of those, 67,000 people will die. Stroke is also the single largest cause of adult disability in England with over 300,000 people living with moderate to severe disabilities as a result of stroke.



This month the Government launched a public awareness campaign to help people recognise the signs of a stroke and to treat stroke as a medical emergency. The campaign is informing the public about F.A.S.T. – Face, Arm, Speech, Time to call 999. F.A.S.T. is a simple test to help people to recognise the signs of stroke and understand the importance of fast emergency treatment.

Campaign adverts, on TV, radio, online and in print, show stroke ‘spreading like fire in the brain' to illustrate that swift emergency action can limit damage and dramatically increase a person's chances of surviving and of avoiding long-term disability.

Most stroke progression occurs within the first 24 hours with the majority of stroke patients requiring high-dependency care on an acute stroke unit during these crucial first hours. Timely access to stroke units which are able to provide high-dependency care including physiological, neurological monitoring and rapid treatment of stroke and associated complications, early rehabilitation and palliative care is key. If this was available to 75% of stroke patients, over 500 deaths per year would be prevented and over 200 individuals would be more independent per year.

In addition, investigating and treating high-risk patients with TIA (Transient Ischaemic Attack) within 24 hours could produce an 80% reduction in the number of people who go on to have a full stroke. And if 10% of acute stroke patients were able to receive thrombolysis (which needs to be administered if appropriate within 3 hours), over 1,000 people per year would regain independence rather than die or be dependent in the long term. All of these outcomes rely on people being able to spot the signs of a stroke and react quickly.

GPs can help to educate patients that although the risk factors such as age, family and medical history and ethnicity are largely non-modifiable there are lifestyle changes that can be made to reduce the risk of stroke. As with many illnesses the best way to reduce your risk of stroke is to eat a healthy diet, exercise regularly and avoid smoking and excessive alcohol consumption. Ensuring that medication for other cardiovascular diseases and diabetes are being taken correctly also helps to manage risk.

Raising awareness of the signs of stroke is just one aspect of the Government's Stroke Strategy, a ten year plan launched in December 2007 to improve stroke services across England. Alongside additional funding for Primary Care Trusts and £105 million additional central funds, the strategy aims to raise standards by providing guidance and advice around awareness, emergency specialist assessment and treatment and joined-up rehabilitation care. £16 million has also been allocated to fund training for one stroke specialist physician in each Strategic Health Authority.

Since the Stroke Strategy was published progress has been made in stroke services; from better organisation of acute stroke care, to long-term support for stroke patients and training of more stroke specialist physicians. 96% of hospitals in England now offer specialist acute stroke care, and 94% are able to manage minor strokes on site. Services are improving.

The cost saving to the NHS as a result of this campaign will be significant. Direct stroke care costs the NHS £2.8 billion a year, and the wider economy a further £1.8 billion in income and productivity losses as a result of disability. The informal care cost is a further £2.4 billion. But it is not just about saving money it is about saving lives.

As a result of the Stroke Awareness campaign together with the implementation of the National Stroke Strategy the Department of Health hopes to achieve a 50% reduction in the stroke death rate and that would transform the lives of many thousands of people.

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