Hansard

I refer members to my entry in the register of members’ interests, which states that I am a practising GP.

I thank my colleague Roz McCall for bringing the crucial issue of stroke awareness to the chamber. We have already heard that, each year, 11,000 people in Scotland suffer a stroke, with more than 136,000 people living with its lasting effects.

Stroke is a medical emergency, and recognising the signs early is essential. Stroke happens when blood flow to the brain is interrupted, which leads to a sudden loss of brain function. Quick action can make all the difference, helping people recover with less brain damage and reducing long-term disability.

As a doctor who worked at the hyperacute stroke unit in the Glasgow royal infirmary, I have seen at first hand how critical early recognition of stroke symptoms is, and how vital early treatment and rehabilitation is. In response to what Evelyn Tweed said, we saw only confirmed stroke cases and the people who came in the front door were reviewed by a clinician. It is essential that it is our job to do the evaluation and that we do not rely on patients’ googling abilities.

When people seek medical help immediately, their chances of recovery are much higher but, unfortunately, awareness of stroke symptoms remains worryingly low. According to recent research, 39 per cent of adults in Scotland do not know FAST. In younger adults, that figure rises to more than 50 per cent. That simply is not good enough, and we need to do more. A lack of public knowledge can lead to delayed help and devastating outcomes for individuals and families, and that is why raising awareness is essential.

Thanks to Chest Heart & Stroke Scotland, we have the FAST campaign, which is Scotland’s first public stroke awareness initiative since the pandemic and I applaud it for that. The campaign promotes the FAST acronym to help people to recognise quickly the three most common stroke symptoms—facial drooping, arm weakness and slurred speech. The T stands for time, and it reminds us of the urgency of calling 999, as time is brain cells.

Although the FAST campaign has helped many people to recognise stroke symptoms and act quickly, it does not cover all possible indicators. Some people experience symptoms beyond the FAST guidelines, and their stroke goes undiagnosed. One example that we have already heard about today is Tony Bundy. Last year, Tony became seriously unwell while out shopping in Glasgow. His symptoms included balance issues, visual problems, cold sweats and vomiting. Obviously, none of those matched the FAST symptoms. Because of that, stroke was not diagnosed, and Tony went hours without receiving proper treatment. Tragically, he lost his life due to the undiagnosed stroke.

Since his passing, Tony’s son, Councillor James Bundy, has been advocating for expanding Scotland’s stroke guidelines to BE FAST, which would add balance and eyes as additional signs to watch for. We know about the danger of false negatives, where stroke goes undiagnosed because it does not match the FAST symptoms, and Councillor Bundy believes that BE FAST would lead to fewer false negatives. The Bundy family believes that, if BE FAST had been in place, Tony’s symptoms might have been recognised sooner, potentially saving his life. Some argue that BE FAST could lead to emergency services handling more non-stroke cases, but it potentially saves lives and spares families from heartbreak.

Roz McCall spoke about evidence. A meta-analysis of BE FAST shows that it has a higher diagnostic value, with a specificity of 0.85. If I might be indulged, BE FAST symptoms of balance and eyes are things that concentrate on the posterior circulation, and centres in the United States use BE FAST.

It is crucial that clinicians are aware of BE FAST, as it increases stroke awareness. As a general practitioner, I want people to come to me when they experience problems with their balance and eyes in an acute way, because that is my job. It is the job of a doctor to make the decision on whether somebody needs a CT scan.

Expanding BE FAST could help to save lives. Every moment in stroke counts, and, with increased awareness, we can ensure that more people get the help that they need.