Meeting of the Parliament (Hybrid) 10 November 2020
I congratulate Alexander Stewart on securing valuable debating time on a matter that affects so many of us.
A stroke can happen to anyone, anywhere and at any time. Stroke is the most common cause of disability and the second most common cause of death worldwide. According to the World Stroke Organization, globally 14.5 million people have a stroke each year and, sadly, 5.5 million people die as a result, although research shows that almost all strokes can be prevented.
Here in Scotland, about 15,000 people have a stroke each year and hospital care for stroke patients accounts for 7 per cent of all NHS beds and 5 per cent of our NHS budget.
Despite the frequent occurrence of strokes, many people are unaware of the numerous and often life-changing challenges that are faced by patients who survive a stroke, which include communication difficulties, physical disability, changes in how they think and feel, and loss of employment, income and social contacts. It is fortunate that research has proved the effectiveness of organised specialist stroke care in improving outcomes.
However, in its report, “Stroke recoveries at risk”, the Stroke Association reported that almost all aspects of stroke treatment and care have been impacted by the Covid-19 pandemic. The pandemic is affecting the lives of stroke survivors and their families across all stages of their recovery, and in all countries of the United Kingdom. The association found that because of the Covid-induced severe pressure on the national health service, more than half of all stroke survivors in Scotland had had their therapy cancelled or postponed during lockdown. Other survivors’ stroke-related appointments were conducted over the phone or online to protect them from contracting Covid-19.
It is encouraging that people reported being reasonably satisfied with their virtual or phone appointments, although people felt that there was room for improvement. Some 58 per cent of stroke survivors in Scotland were satisfied with virtual methods of rehab and healthcare, compared with the UK average of 52 per cent. That underlines the innovation and dedication of our fantastic NHS workers, even in the most challenging of times. I also welcome the report’s finding that, compared with the UK average, a high percentage of stroke survivors in Scotland felt that they had been given enough information about how lockdown guidance applied to them.
However, stroke survivors’ mental health has, unfortunately, worsened significantly in Scotland and across the UK. Many survivors have reported feeling more stressed and depressed during lockdown, and carers are also feeling additional pressures. I therefore agree with the report’s conclusion that
“Now is the time to deliver stroke improvements, from prevention through to long-term support.”
It is encouraging that the Scottish Government continues to implement what is in “Stroke Improvement Plan”, which reaffirmed stroke as a clinical priority for NHS Scotland. In the past decade, the number of people in Scotland who have died from stroke has decreased by a heartening 42 per cent. Although that progress makes me optimistic, we must continue to improve care and outcomes.
I therefore welcome the fact that, after the delay that has been induced by the coronavirus pandemic, a pilot thrombectomy service is due to launch at Ninewells hospital in Dundee. I also welcome the Cabinet Secretary for Health and Sport’s announcement that similar services will be available in Edinburgh and Glasgow in 2021 and 2022 respectively. It must be our goal to have thrombectomy available for everyone who needs it by 2023. For that to be workable, a strong supporting framework also needs to be in place for all stroke patients before and after their stroke.
It is promising that the latest Scottish stroke care audit report showed a 5 per cent increase in stroke care-bundle compliance. That means that a growing number of hospitals and units now meet the standards of basic care that every stroke patient should receive when they arrive in hospital, including access to swallow testing, aspirin and brain scan.
However, the remaining variations in how stroke units and health boards meet those standards must now be addressed, as the Scottish Government continues to progress its ambitious 2019-2020 programme for government commitments.
I am confident that we will not only carry on reducing the number of deaths from stroke, but that we will make a positive difference to the lives of survivors and their carers, while easing the growing burden of stroke on our health and care system in the years ahead. I thank Alexander Stewart for bringing the debate to Parliament.
17:31