World Stroke Day

Stephen Kinnock Excerpts

Tuesday 29th October 2024 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I congratulate the hon. Member for Glastonbury and Somerton (Sarah Dyke) on securing a debate on this vitally important issue. It is important not only for her constituents but for her personally, I think, given her family circumstances; I know she really spoke from the heart and we appreciate that.

Good health should be fundamental to all of our lives, but sadly that is not the case for too many people. Over 100,000 people have a stroke in the UK every year—one person every five minutes. One third of them will be left with some form of long-term disability. As the fourth largest cause of death for adults, stroke has a devastating impact on individuals, their families and wider communities across our country.

For decades the NHS has served us well, and it is one of the proudest achievements of the Labour party that we were at the foundation of our NHS. Our staff have tremendous expertise and dedication; they are working hard every day to make a difference. But we have to face up to the reality that we have had 14 years of neglect and incompetence on the part of the Conservative party. We are now facing a very significant set of challenges in looking to get our health and care system back on its feet and fit for the future. That is the important context for this debate.

I am very grateful to the hon. Member for Glastonbury and Somerton for giving me the opportunity to inform her and the House of the work that the Government have been doing since we came into office on 4 July, and particularly as today is World Stroke Day. The House will have seen that we have set out the three transformative shifts that we want to deliver in health and care, moving from care in hospitals to care at home, prioritising prevention over treatment, and advancing from analogue to digital solutions. These three strategic shifts will be the building blocks of our health mission, reducing time spent in poor health, tackling health inequalities and reducing lives lost from the biggest killers, which include cardiovascular disease.

We have to change the NHS so that it is no longer just a sickness service but a prevention service too. Prevention is always better and cheaper than cure. So we have to take preventive public health measures to tackle the biggest killers and support people to live longer, healthier lives. That is why in our health mission to build an NHS that is fit for the future, we have committed to reducing deaths from heart disease and strokes by one quarter within 10 years. The NHS health check, England’s flagship cardiovascular disease prevention programme, aims to prevent heart disease, stroke, diabetes, kidney disease and some forms of dementia. Each year the programme engages over 1.3 million people and, through behavioural and clinical interventions, prevents around 500 heart attacks or strokes.

To improve access to and engagement with this life-saving programme, we are developing a new digital NHS health check, which will be ready for testing in early 2025. It will enable people to undertake a check at home. We are also trialling more than 130,000 life-saving heart health checks in the workplace. These checks can be completed quickly and easily by people at work so that they can understand and act on their cardiovascular risk and reduce their future risk of a stroke.

Around 50% of heart attacks and strokes are associated with high blood pressure. Community pharmacies are providing a free blood pressure check service for anyone over the age of 40. In cases where this results in a high reading, pharmacists can make sure people receive the right NHS support to reduce their blood pressure. We know that there is more to do to prevent the causes of stroke, and the Department and NHS England are working together to tackle this issue.

I am also pleased to announce that on Monday 4 November NHS England is launching a new Act FAST campaign to increase knowledge of the main signs of a stroke and to encourage people to dial 999 immediately in response to any sign. The new campaign builds on the success of the previous Act FAST campaign and uses a revised call to action:

“Face or arm or speech, at the first sign, it’s time to call 999”.

[Tessa Munt (Wells and Mendip Hills) (LD)]

I pay tribute to a young man who lived in Shepton Mallet named Will. He spotted what was happening to his father. He is a young man with some difficulties himself, but he recognised FAST. He had seen it on television, and it is testament to the power of television and radio campaigns in making sure that those messages get through, because that young man has difficulties in communicating and moving, but he managed to get the rest of his family to realise what was happening to his father sitting there across the breakfast table. I just wanted to mark that.

[Stephen Kinnock]

I thank the hon. Lady for that telling intervention. She is absolutely right: so much of the challenge and the opportunity before us is about how we use traditional media, social media, all forms of communication and awareness-raising campaigns and techniques. By definition, we are dealing with a situation in which speed is of the essence. It is truly a public health challenge, because it is only the public who can do what Will did in that circumstance. I certainly pay tribute to Will for acting so quickly and to the Act FAST campaign. I am sure Members will welcome that we are looking to build on the success of Act FAST and to replicate and renew it.

That campaign will run in England across TV, radio, social media, national press and ethnic minority TV and radio stations. The campaign includes specific communications for multicultural and disabled audiences. A higher reduction in mortality rates over the next 10 years will require a focus on NHS England stroke priorities, including rapid diagnosis and increasing access to time-dependent specialist acute stroke care. We know that so many deadly diseases can be avoided if we seek help in enough time. That is why we are working to improve access to treatments. Current targets include increasing thrombectomy rates to 10% and thrombolysis rates to 20% through facilitating ambulance service use of pre-hospital video triage and use of AI decision support tools for brain imaging in comprehensive stroke centres. I know that my hon. Friend the Member for Mid Cheshire (Andrew Cooper) has a keen interest in that issue.

[Andrew Cooper (Mid Cheshire) (Lab)]

Building on the point made by my hon. Friend the Member for York Central (Rachael Maskell), does the Minister agree that stroke patients should have the highest priority for ambulance call-outs—as high as cardiac arrest, for example?

[Stephen Kinnock]

I am a little wary of generalising too much, because I know that so many decisions have to be made in real time by our skilled ambulance drivers and paramedics and the many others involved, but my hon. Friend makes a valid point. In a general sense, he is absolutely right that stroke needs to take priority. The red thread going through this entire debate is the need for speed. It is all about prioritising and acting quickly; he is absolutely right about that.

In the past year, we have seen a 30% increase in the number of thrombectomies delivered in England. Alongside that, our 20 integrated stroke delivery networks are looking to optimise care pathways. The General Medical Council is addressing critical workforce gaps through its thrombectomy credentialling programme, and our national optimal stroke imaging pathway is improving information sharing.

I am aware of the reconfiguration in the constituency of the hon. Member for Glastonbury and Somerton. NHS Somerset integrated care board has decided to close the hyper-acute stroke unit at Yeovil hospital and to establish a single hyper-acute stroke unit at Musgrove Park hospital in Taunton to provide 24/7 emergency treatment. All service changes should be based on clear evidence that they will deliver better outcomes for patients. A high bar is set out in guidance for intervening in contested reconfiguration cases, and the reconfiguration of services should be a matter for the local NHS. I would expect all avenues of local resolution to have been exhausted before a call-in request is made. The Department has received a formal request to call in NHS Somerset ICB’s decision, and Ministers will make a decision on whether to use their call-in powers in due course.

Unfortunately, there is still significant variation across the country in access and outcomes in relation to stroke. For example, the percentage of suspected stroke patients who received the necessary brain scan within an hour of arrival at hospital varies from 80% in Kent to only around 40% in Shropshire. That variation needs to change, and we need to bring the best of the NHS to the rest of the NHS. That will be one of the central challenges for the Government going forward.

The Government have a profound ambition to improve the lives and health outcomes of people who survive a stroke. At this point, I would like to pay tribute to my hon. Friend the Member for Stratford and Bow (Uma Kumaran) and to the man in the Public Gallery for what they have been through and for their fortitude. It was certainly not easy for my hon. Friend to come to this place and to have to go through the extremely difficult situation that she did. I also pay tribute to all the key partners and stakeholders who worked with her and her family to get through it. That really is a tribute to the immensely important work they do.

[Rachael Maskell]

As well as looking at acute triage to rapidly diagnose people who have had a stroke, it is important to invest in rehabilitation—something I did for 20 years in the NHS. I would be grateful if the Minister could set out how he proposes to have integrated rehabilitation teams that not only see people through the immediate aftercare, but continue to provide a top-up for them so that they do not backslide in their rehabilitation.

[Stephen Kinnock]

I can say a word about our national service model for an integrated community stroke service, which involves a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work and improved quality of life, and I would be more than happy to discuss it further with my hon. Friend.

Before I close, I want to recognise the remarkable work of the charities that help people across the country to rebuild their lives after a stroke. Once again, I thank the hon. Member for Glastonbury and Somerton for this important debate, and I encourage every Member of the House to go to change.nhs.uk and to get involved in the biggest conversation about our health and care service since its foundation in 1948.

Question put and agreed to.