Agenda item

To receive a presentation from Homaira Khan, Stroke Prevention Officer, Stroke Association on the work of the organisation and key messages for stroke prevention work.

Work currently being undertaken is funded by a Section 64 Department of Health statutory grant.

Funded for 3 years.

Project is about getting people to act on their risk factors.

Four pilot areas: Brent, Ealing, Hillingdon and Tower Hamlets.  These areas were chosen due to their ethnic diversity and the fact that they have divides in outcomes.

Starting point is mapping local Wards and working out which Wards have a higher prevalence.

Partnership working is key to success in stroke prevention.

Need to find out what health promotion work is going on in the area and ensuring that stroke is covered.

Any targeting needs to be specific and and people need to be careful not to group ethnicities together based on false assumptions.

Some areas have ‘Health Trainers’ which sit under the Public Health umbrella.  The role of the Health Trainers is to educate the population on health and aspects of their lifestyles which impact their health by going into the Community.  This is a different role to that of Community Matrons.

It is important to have local ownership to projects.

Examples of Projects:

Healthy Recipe Cards.

·        These recipes were put together by students of Thames Valley University.

Patient Toolkit from April 2009.

·        This feeds into the forthcoming Vascular Checks.  

·        Patients will be given a toolkit after they have had their Vascular Check. 

·        The toolkit is locally owned e.g. it has the PCTs mission statement on it.

·        Will include a card with information on Blood Pressure, for example what is ‘good’ and what is ‘high’.

·        Will have a range of contact numbers in for example smoking cessation, dietary advice etc.  Local GPs are engaged in the process and start by picking out which contact numbers of relevant for each patient.

All projects aim to be sustainable – they will be available regardless of which posts are in place at the Stroke Association.

Strategic Development

•         “Assessing need and prioritising

•         Engaging with local community organisations, existing networks and the third sector

•         Setting up focus groups; talking to stroke survivors and at risk groups about gaps in stroke prevention

•         Training:- The recent publication of the National Stroke Strategy talks of the role of primary care and highlights the lack of knowledge even amongst health professionals

•         A shift from an NHS centred approach to more involvement from local authorities, with a more “pro-active approach to preventing ill health” (commissioning framework for health and well being)

•         Use of terminology:- The difference between ‘hard to reach’ and ‘don’t know how to reach’

•         Don’t expect people to come to you

•         What do you/they do once you’ve reached them?”

(Stroke Association Slide 8)

Nationally 62% of people are able to identify what a stroke is from a multiple choice list.  This is believed to be lower in London.

Sickle Cell Aneamia is a big risk factor for stroke.  This is especially the case for children aged 2-10years where there is a big risk of multiple strokes.

Teachers should be aware of FAST.

Points of discussion

Pre-registration appointments at Surgeries are a useful tool in identifying risk factors.  This includes a Blood Pressure check and questions to assist in identifying risk factors.  The check does not have to be carried out by a Dr or a Nurse, it can be carried out by a Healthcare Assistant.  Follow ups for a transient population, such as Haringey, are difficult.

Need to ensure that all of the risk factors are known by people.  The issues for strokes are the same as those for heart disease and diabetes.

Oberoi Software is being used by a number of practices across the borough. This is a system which identifies those who are at risk by analysing the whole patient register.  A letter inviting those at risk in for follow up appointments is then generated.

Issues include:

Some readings may be very out of date as they rely on the last time a person attended. 

Resource issues for example the increased workload and possible increase in prescription costs to treat those needing treatment.

There are lots of ‘unknowns’ – without all fields being populated the system is not as effective as it could be.

Oberoi is not a compulsory system for GPs.