Meeting of the Parliament (Hybrid) 10 November 2020
I too thank Alexander Stewart for securing this evening’s important debate and for the quality of his speech. It is crucial that we pay attention to the care of victims of strokes and that we be clear on the symptoms if we are to prevent some of the life-changing ordeals that individuals endure.
The excellent briefing provided by Chest, Heart & Stroke Scotland raised the issue that improvements to stroke care have stalled since Covid-19 arrived in the country, and that will be the sad story across many areas of health. Problems with access to support and rehabilitation because of delays to non-urgent and outpatient appointments have led stroke survivors to report that their recovery has not only stalled, but gone backwards.
The strong campaign on the alert message of FAST—face, arms, speech and time—has been a positive way to make communities aware of the signs of a stroke, and I hope that it has meant that more victims have been able to get help in time. It is now more critical than ever that we spread the message, as evidence suggests that Covid-19 increases the risk of blood clots and strokes.
As previous speakers have said, strokes are the third most common cause of death in Scotland and the most common cause of disability. That is why it is so important that we help to make more people aware of how to help, and also that we call for increased support, both through the national health service and through the important work that is being done by the third sector.
Again as we have heard from previous speakers, the chances of having a stroke are sadly higher in Scotland than in other parts of the United Kingdom. Strokes are also more likely in younger people, as the average age for having a stroke in Scotland is four years below that in the rest of the UK. People are more likely to die from a stroke in Scotland than in the rest of the UK, and Scotland has the largest percentage of population who are stroke survivors. Those are some pretty sobering facts.
It is estimated that the number of stroke survivors in Scotland will increase by a whopping 50 per cent over the next 20 years. It is vital that we put in the resources now to ensure that the NHS is able to support victims and families in the years to come.
We have also heard about the importance of thrombectomies, which are an innovative surgical technique that removes blood clots from arteries and veins. Some pioneering work has been done on that in NHS Tayside. Thrombectomy is not currently a national service but, as we have heard from previous speakers, it has been suggested that it will be rolled out to other parts of Scotland; that is crucial.
Alexander Stewart made a very important point when he mentioned the stroke care bundle. Its aims include reducing the risk of death from stroke; increasing the likelihood of people returning home to recover; quick admission to a stroke unit; and fast access to vital interventions such as brain scans, swallow screens and the administration of aspirin. The bundle was set a compliance target of 80 per cent across NHS health boards. Although compliance went from 59 per cent in 2018 to 64 per cent in 2019, it still fell significantly short of that target. It should be noted, however that four health boards improved their compliance, including my board, which is NHS Highland.
A joined-up approach by the NHS, social care services and charities is needed, to ease pressures on stroke services and staff so that the quality of stroke care can improve and so that community-based holistic support can be provided.
I thank the dedicated NHS staff who are working flat out in these trying and complicated times. I thank the charities and third sector organisations that dedicate their time to supporting this work, and I thank social care providers and community pharmacists and physiotherapists, who are all part of it. I thank the families and the thousands of unpaid carers who are giving their time, energy and love to those who need it through the trauma and the often lasting effects of strokes. Finally, I thank Alexander Stewart for taking the initiative to secure tonight’s debate.
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