Meeting of the Parliament 21 November 2024
I, too, thank Roz McCall for bringing this important debate to the chamber. I echo the thanks to the Bundy family for their campaigning efforts after their own tragedy. I have had the privilege of being invited to their fundraisers and have seen their passion on this topic. Anyone who has listened to James and his mum talk about Anthony would find it difficult to disagree with the real impact that BE FAST would have had in their situation.
As we have heard already, stroke is the leading cause of disability in Scotland, with thousands of individuals and families affected each year. Public health campaigns have proven effective in raising awareness and driving behavioural change, and I echo the thanks that others have given to Chest Heart & Stroke Scotland and the Stroke Association for their work.
To increase stroke awareness, we must invest in targeted campaigns that address specific barriers such as language, cultural differences or misinformation. Working with local authorities and third sector organisations on a local level can amplify their reach and impact. Figures provided by Chest Heart & Stroke Scotland show that, each year, nearly 11,000 people in Scotland suffer a stroke, with around 136,000 people living with the on-going effects.
Stroke remains one of the leading causes of disability in our country, yet public awareness of its symptoms remains worryingly low. Research by Chest Heart & Stroke Scotland shows that 39 per cent of adults in Scotland are unfamiliar with the FAST test, which is an essential tool for recognising stroke symptoms. Alarmingly, that figure rises to 53 per cent among younger adults aged 18 to 24. That is especially concerning because quick medical intervention is crucial, as it significantly reduces long-term damage and improves outcomes. That highlights why raising public awareness of stroke signs and the urgency of seeking immediate help must remain a priority.
The Scottish Government’s progressive stroke pathway and the UK-wide national clinical guideline for stroke emphasise the importance of campaigns such as FAST, which play a vital role in saving lives and improving health outcomes.
Campaigns such as FAST and BE FAST play a crucial role in raising awareness of symptoms. FAST focuses on face drooping, arm weakness, speech difficulties and the need for time to call emergency services, while BE FAST expands that to include balance issues and eyesight changes as additional warning signs.
Although BE FAST aims to capture a broader range of stroke symptoms, there is disagreement on the implementation of FAST versus BE FAST, with many people citing a lack of research on the efficacy of BE FAST and how using it might affect capacity in A and E departments. That is why I believe that further research and a further pilot scheme are needed to determine whether that expanded approach can improve overall outcomes. We can learn from the previous pilot, and I do not think that some of the issues that have been raised are entirely insurmountable, so they should be worked on. A consensus on the best way forward has to ensure that we maximise the impact on saving lives.
The Stroke Association has shared data that paints a stark picture of the challenges that Scotland faces in stroke care after people have had a stroke. In 2023, only one in seven eligible patients received a thrombectomy. Thrombectomy is 100 per cent cost effective and saves Scotland’s NHS £47,000 per patient. The Stroke Association’s report, “Scotland’s Stroke Improvement Plan—One year on. How’s it going?”, highlights key areas of concern arising from the Scottish stroke care audit. It shows that basic care delivery is falling short, with only 51 per cent of patients in 2023 receiving the stroke care bundle within the national standard, down from 64 per cent in 2019, and with NHS Forth Valley performing at a level of just 40.6 per cent. It also shows that we must invest in more psychological and rehabilitation support for stroke survivors, with all health boards currently falling into amber or red in delivery ratings and too many patients left without six-month recovery plan reviews.
In conclusion, we must ensure that investment in stroke care is improved. Better prevention, faster treatment and stronger recovery services will save lives, reduce costs and ensure better outcomes for patients and their families.
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