The Scottish Government

This item was published during the term of a previous administration that ended in April 2007

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Launch of strategy to tackle CHD and strokes

03/10/2002

It will also support work to reduce maximum patient waiting times for angiography from 12 to eight weeks by 2004, and for surgery or angioplasty from 24 to 18 weeks by 2004.

Launching the Strategy, Jack McConnell said

"Improving the shameful health record of Scots, to create a Scottish society fit for the challenges of the 21 century, is one of the key issues facing us as a nation.

"It demands the high level of investment and reform we are making in the NHS to enhance patients' treatment, improve services and support the efforts of NHS staff. It is simply unacceptable to invest record amounts of money and still have one of the worst health records in Western Europe.

"However, I want to do much more to help Scots take better care of their health and prevent people from ever reaching hospital.

"Scotland's first Heart Disease and Stroke Strategy will do both, cutting the number of people dying from two of our 'Big Three' killers. Much has been done. Around 6000 fewer people are dying from coronary heart disease than 20 years ago and the average waiting time for a bypass graft is down by over three months since early 1999. But much remains to be done.

"We will bring a new focus to giving children a healthy start in life and encourage a lifetime of healthy habits as part of our health improvement programme. We will also tackle health inequalities in poorer communities where higher rates of smoking and poorer diets increase the risk of health disease and strokes.

"The emphasis on prevention and treatment in this Strategy sets the tone for the White Paper on health reform which we will publish this winter. Our commitment is to a healthier health service and a healthier Scotland."

Key features of the new Strategy will include:

- creation of local Managed Clinical Networks for CHD and Stroke in each every NHS Board area by 2004, which will put clinicians and patients at the heart of the planning and delivery of services;

- creation of national databases for CHD and stroke. This will provide detailed information about the care patients are receiving from their GPs so that the Clinical Standards Board for Scotland can assess this care and help drive forward quality improvements. It will also ensure patient services' are planned against detailed information on needs and that waiting times can be fully monitored;

- a commitment to create additional specialist stroke units to treat 5000 more patients a year, prevent 200 fewer deaths and provide support to 300 more patients returning home after stroke. Professor Martin Dennis, based at the Western General in Edinburgh, will oversee the development of the Stroke elements of the strategy through a new National Advisory Committee for Stroke.

In addition, the Scottish Executive will be discussing with NHS Education for Scotland and the new Advisory Groups of CHD and Stroke, training for existing and new NHS staff to support the implementation of the Strategy.

Malcolm Chisholm said:

"Too may lives are still being lost prematurely to CHD and Stroke. Preventing and treating these conditions will therefore remain a priority for the Executive and NHSScotland for the foreseeable future. Through the new MCNs, we will put clinicians and patients at the heart of the planning and delivery of local services. And in adopting a similar approach to our Cancer Strategy - and not dictating centrally how all today's £40m of additional investment will be spent, we will enable patients and health professionals, to decide how best to use these funds to improve local services.

"They will also help NHS Boards deliver the standards for secondary prevention after a heart attack set by the Clinical Standards Board for Scotland, and further standards covering stroke care which the Board is currently developing. Together these will help drive up standards of treatment and care in all parts of the country for the maximum benefit of patients - improvements which will not only enhance people's quality of life but also save lives."

Dr Nick Boon, Chair of the CHD/Stroke Reference Group said:

"The highly successful Dumfries and Galloway MCN for cardiac services and the Stroke (neurology) MCN linking Lanarkshire with the Institute of Neurological Sciences in Glasgow have paved the way for the development of MCNs across the country. Together they will help break down traditional boundaries between GP and hospital care, to improve the delivery of services to patients.

"Patients will also benefit from improved integration of services through the new national databases for CHD and stroke. Covering primary and hospital care, these will help supplement the information currently collected by the Information and Statistics Division of NHSScotland, to help monitor progress against the Strategy, improve service planning and enable patient care to be measured against nationally-agreed standards.

"I welcome the new funding which Ministers have announced today, and as chairman of the Reference Group, will want to ensure it allows the introduction of new, more innovative treatments such as implantable defibrillators and drug-coated stents, which have been shown to improve the long term outlook of angioplasty."

Dr Bill O'Neill, BMA Scottish Secretary said:

"The success of the Action Plan - and progress in the prevention and treatment of CHD and stroke - cannot be achieved without a commitment to increase staffing and training. We welcome the commitment to train additional cardiologists, cardiac surgeons and stroke physicians together with specialist nurses and others. We now need the courage to look beyond the boundaries of Scotland to achieve our targets. Recruitment of additional staff will be a major immediate challenge and will require commitment and innovation.

"Smoking, poor diet and lack of physical exercise are undisputed risk

factors for CHD and stroke, and we have a long way to go in Scotland before we achieve acceptable targets for smoking cessation and improvements in diet. Commercial interests, particularly from the tobacco industry constantly destroy our efforts; tackling this requires courage and conviction."

Chest, Heart & Stroke Scotland's Chief Executive David Clark welcomed the strategy:

"This strategy has the potential to make a real difference to tackling two of Scotland's "Big Three" killers. Between them they kill more Scots than all forms of cancer combined, but we still have major gaps in services for these conditions.

"We particularly welcomes the emphasis on increased stroke unit care, which we have long campaigned for. We also strongly support the priority given to staff training, particularly for nurses, and for long-term support of patients after discharge from hospital. These are both areas which patients and carers have told us they would wish to see developed, and where we have already pioneered new services in Scotland in partnership with the NHS."

The launch today of the CHD/Stroke Strategy follows the publication last September of the Scottish Executive's CHD Task Force Report on CHD and Stroke. It was issued for consultation to enable health professionals and patients to have their say in the development of the Strategy.

The £40m announced today from Scotland's Budget (£10m in 2003-04, £15m in 2004-05, £15m 2005-6) will support the creation of:

- MCNs for both CHD and Stroke in each NHS Board area

- the Scottish Cardiac Intervention Network - linking MCNs and hospitals which undertake surgery or angioplasty, to maximise the use of existing facilities; and support our efforts to reduce patient waiting times; and

- the national data-base for CHD/Stroke, as well as funding improvements in direct patient care.

The Dumfries and Galloway MCN was launched on 20 July 2001. Led by CHD Task Force member and GP, Dr Chris Baker, it received £100,000 from the Scottish Executive towards the salary of a project administration and project evaluation. The Executive has also been funding a three-year evaluation of the Lanarkshire/Glasgow national demonstration MCN in Neurology with particular reference to stroke.

In addition to investment £40m to support the implementation, the Scottish Executive is carrying out a range of work to tackle CHD and Stroke throughout Scotland, and address the risk factors associated with these conditions, for example:

- investing £6m over three years in the national health demonstration project, Have a Heart Paisley, which is leading the way in CHD and stroke prevention.

- providing new additional investment of more than £170m over the next years three years to accelerate health improvement throughout Scotland;

- working through the Food and Health Co-ordinator to drive forward the Scottish Diet Action Plan and improve access to healthy foods in schools and communities, and

- working through the Physical Activity Co-ordinator to make Scotland more active and take forward the recommendations of Physical Activity Task Force report.

Angioplasty is the insertion of a balloon into a blocked artery, followed by a stent to keep the walls of the artery open.