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Jill Palmer is a former Medical Correspondent for the Daily Mirror.
She wrote and edited the Department of Health’s official NHS 60 commemorative brochure. |
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The three-year £12 million communications campaign to promote public awareness around stroke announced this month by Health Minister Ann Keen should be warmly welcomed.
The campaign will be launched in February 2009, and will be supported by advertising, public relations and direct marketing communications.
Stroke affects 150,000 people a year in the UK and is the third leading cause of death. It is the single largest cause of adult disability in England.
But while our knowledge about the diagnosis and treatment of heart attacks has improved dramatically we are still lagging behind in regard to strokes. As Roger Boyle, the National Clinical Director for Heart Disease and Stroke, told me earlier this year "Powerful clot busting drugs have dramatically improved survival of heart attack patients and by 2012 few people under the age of 65 will be dying of a heart attack. Where we are now with stroke care is where we were in the 1990s with heart conditions. We have got a long way to go. Stroke has been a Cinderella area for too long. It is the real challenge of the future."
The National Stroke Strategy mandated the establishment of Stroke Care Networks to ensure that health and social care services for stroke are better integrated and better planned. One year on, all services in England now fall within a Stroke Care Network.
The Networks ensure that patients experience a seamless transition across stroke services within and between health and social care, and help the NHS and Local Authorities to work together effectively to drive forward improvements in care.
Yet most of the public and many of the medical profession still fail to spot the early warning signs and time is of the essence. The majority of strokes (80 per cent) are caused by a clot and administering a clot-busting drug can mean the difference between life and death, or the difference between minor and major disabilities post stroke. The crucial factor being that the drug must be administered within three hours of onset.
The awareness campaign will teach the public and NHS staff to remember FAST - Face Arm Speech Time to call 999 - to help them recognise the symptoms of stroke and understand that prompt emergency treatment can reduce the risk of death and disability.
FAST is used by paramedics to assess three specific symptoms of stroke prior to a person being admitted to hospital:
Facial weakness - can the person smile? Has their mouth or eye drooped?
Arm weakness - can the person raise both arms?
Speech problems - can the person speak clearly and understand what you say?
Time to call 999.
South East Coast Ambulance Service has developed the system even further in collaboration with Clinical Stroke Networks across Kent, Surrey and Sussex.
The FASTrack system allows ambulances to quickly identify those patients that may be eligible for clot-busting treatment and immediately transfer them to an acute stroke centre with specialist facilities where they will be seen and treated immediately by a stroke team.
Prior to the implementation of these pathways and services suspected stroke patients were simply taken to A&E. There was no FASTtrack for immediate intervention.
It was pioneered by paramedic David Davis, stroke care development lead at South East Coast Ambulance Service and there are now more than a dozen hospitals offering thrombolysis for stroke patients in the South East compared with none in the spring of 2007. The aim is to have a hyper-acute stroke team available somewhere 24 hours a day, seven days a week in the area.
David in collaboration with his counterpart Adrian South at South West Ambulance Service is now developing a similar system for patients who have suffered TIAs (mini-strokes) who do not need emergency transfer to hospital but would be referred directly to the stroke team’s TIA clinics by paramedics.
In the future they hope that paramedics will be provided with equipment that enables them to confirm diagnosis of a stroke in the ambulance and give clot busting drugs on the way to hospital in the same way paramedics thrombolyse heart attack patients.
Thanks to strategic developments such as the National Stroke Strategy and dedication of front line staff such as David Davis stroke is now being treated with the priority it deserves, the same urgency as heart attack.
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