2. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Getting Stroke on the agenda in a time of change and cuts 28 June 2011 Joe Korner Director of Communications The Stroke Association

3. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Over the last six years stroke survivors, stroke researchers and health professionals and stroke organisations have all worked together, with the Department of Health and the NHS nationally and locally, to improve stroke services. We have seen real, dramatic improvements. And, as a result, stroke has risen dramatically up the health and political agenda. Stroke on the agenda

4. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk In Northern Ireland, Scotland and Wales there are stroke strategies and plans which we need to continue to support and work to get implemented. But the financial squeeze on health and social care will have impacts across the UK. And in England, the Stroke Strategy continues, but the whole of the NHS is being reformed… Cuts and changes…

5. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Last October, Secretary of State for Health, Andrew Lansley, said in a speech: “Together with the community of doctors, nurses, therapists, and carers who care for stroke survivors, I am determined that we will look after them better and better in the future” Stroke as a political priority

6. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk And a couple of weeks ago, David Cameron made a speech about the NHS from University College Hospital in London. He said: “I have heard such great things about the way we treat stroke patients in London and the role that this hospital plays and I wanted to come to see it for myself. “The figures really are outstanding and show that if you have the right pathway for patients you can save lives and improve people’s quality of life.”

7. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Five years ago, you would never hear politicians, let alone the Prime Minister, talk about stroke. So stroke really is “on the agenda”. But, the great irony of the Prime Minister’s praise for stroke care in London is that the type of transformation achieved in the capital may be impossible elsewhere after his NHS reforms go through. Stroke on the agenda

8. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Now, more than ever, we all need to work together to make sure that the gains we have made in putting stroke on the agenda are not lost. There is a huge momentum for change and improvement in stroke care but there remains a lot to be done. Defending our gains

9. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk “I spoke to a lady the other day who had been caring for and trying to access help for her mum since she was 10 years old. She had been meeting with brick walls at every turn - her mum was only allowed a short-term wheelchair loan (but couldn’t stand), no benefits, no adaptations, no carers. We had a service in the area and although they shouldn’t really have been involved because this was many years post- stroke, the lady was in such desperate need that they agreed to pop in and see her. Suddenly, with the mention of The Stroke Association everything began to change for the family. Their requests for help have since been taken seriously, assessments carried out, a wheelchair provided and so on.”

10. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk There are real problems with the current system but we do know how to influence it. So the uncertainty brought about by the Government’s reforms of the NHS present us with real problems. We can, and must influence the existing NHS and the new NHS that will emerge from the reforms. NHS reforms

11. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk We have very strong evidence and arguments for what a good stroke service should look like. We need people to understand what increases their risk of stroke – that means more prevention campaigns. We need Atrial Fibrillation to be recognised and treated to prevent stroke. We need TIA to be recognised and treated as urgent. We need everyone to remember and act on FAST. What we need

12. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk We need every stroke to be treated as an emergency, with a brain scan within 3 hours. We need everyone to get straight onto a stroke unit and to spend all of their time there. We need everyone to have access to as much specialist stroke therapy as they need, for as long as they need it. We need for there to be specialist long term support services available for all. And we need the resources to make sure that peer support is available to everyone as well. What we need

13. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk As funding gets reduced there is a real danger that specialist rehabilitation and long term support services will be cut and replaced with generic services – no more stroke physiotherapy but just a general physiotherapy service. Specialist stroke services

14. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk As more competition is introduced different services may be provided by different organisations, leading to fragmentation. As Primary Care Trusts are abolished, the hard won knowledge and commitment to commissioning good stroke services may be lost. With the abolition of Strategic Health Authorities, the chance to carry out major re-organisation of stroke services, such as we have seen in London or Manchester, may be lost too. The challenges of reform

15. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk For local and national stroke charities, what guarantee is there that our vital services will continue to be funded by the new commissioning bodies? And what about the danger that with more and more decisions being taken locally, the inequalities in stroke provision from area to area will get worse? The challenges of reform

16. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk

17. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk

18. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk There will be many ways that we can influence decisions. Nationally and locally we can get involved in: Health and Wellbeing Boards for each Local Authority area; “Clinical Commissioning Groups” which will decide what services should be commissioned and will include patient and lay representatives; How we can influence

19. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Commissioning “senates” made up of patient and clinical representatives where we could have a role. We can try to influence local and national Healthwatch committees which will provide the “patient” voice; And patients will be able to legally challenge bad or inadequate services, so we can get involved there too. How we can influence

20. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk We are not alone: we can work with stroke professionals in our areas; we can work with the Stroke Improvement program and the stroke networks; and we can work with each other, as individuals and as organisations. How we can influence

21. Stroke helplineWebsite 0845 3033 100www.stroke.org.uk Stroke is high on the agenda and we intend to keep it there. In a time of changes and cuts, it is vital that we raise our voices. Our successes over the last few years have been down to working together. If we carry on doing that, I am sure we can defend the stroke provision that exists. But we can also campaign for the expansion and improvement in stroke services that is still so desperately needed. Conclusion