Stroke is a huge part of the health and social care landscape in Scotland, that has long been under-served and that has never received the attention it deserves. Our poor outcomes reflect that. Too many people in Scotland have strokes. Too many of those people die or do not receive the right support, quickly enough and to a sufficient level.
To its credit, the Scottish Government has recognised that a new approach to stroke is urgently needed and kick-started an ambitious stroke improvement programme. A hugely significant outcome of this is the newly published Progressive Stroke Pathway for Scotland. This sets out a clear vision of what stroke services and support must be, from action to prevent strokes, through to the emergency response and acute medical care and on to the rehabilitation journey, first in hospital and then in the community.
This Progressive Stroke Pathway was developed by our clinical and health policy experts – the right people, who have consulted with all the right stakeholders, from charities such as the Stroke Association to stroke survivors themselves. The process has been carried out with genuine commitment and ambition, and the end result reflects this.
This new vision for stroke services offers enormous collected expertise, evidence and insight. It is a positive and detailed presentation of what stroke services and support must be if we are no longer to fail the 10,000 Scots who have a stroke each year and the 128,000 people living with the effects of their stroke. With the destination of our journey clearly set, we are so much better equipped for the effort now required to take us there.
Let us be under no illusion that while this is a necessary step on the road to improving stroke performance, a policy vision alone does not change the experience or outcomes for those affected by stroke. Focus must quickly shift to the practical steps necessary to turn these aspirations into reality on the ground in all of our communities.
Stroke is officially designated a “clinical priority” in Scotland. We need the Cabinet Secretary for Health and Social Care to now spell out what prioritising stroke actually looks like, and to direct, and enable, our health and social care services to act accordingly.
Delivering on the new stroke pathway sets challenges for health boards in particular. It has taken a heroic effort on the part of frontline staff for stroke services to stand up as well as they have done throughout the Covid-19 pandemic. Yet they cannot make the sometimes significant changes proposed in the Progressive Stroke Pathway document, and only the senior leadership of health boards can make the necessary decisions around policy and resourcing. Each health board must designate one named individual answerable for their performance in delivering the new stroke pathway, and they too must account for what they are doing to prioritise stroke.
For our part, the Stroke Association is happy to give our support to the new vision for stroke in Scotland. We will be doing everything we can to see it translated into real change on the ground, and to improve the lives of people affected by stroke. But this is a vision we can all get behind, and the change we need will not be achieved unless everyone plays their part.
John Watson, Associate Director, Scotland