Stroke is the third biggest cause of death in the UK and the largest single cause of severe disability. Each year more than 110,000 people in England will suffer from a stroke which costs over £2.8 billion in direct costs to the NHS, £2.4 billion of informal care costs (e.g. the costs of home nursing borne by patients’ families) and £1.8 billion in income lost to productivity and disability (Public Health England).
Stroke is a ‘brain attack’ caused by a disturbance to the blood supply to the brain. The most common form of stroke, Ischaemic, is caused by a clot narrowing or blocking blood vessels so that blood cannot reach the brain, which leads to the death of brain cells due to lack of oxygen. Haemorrhagic stroke is caused by a bursting of blood vessels producing bleeding into the brain, which causes damage. Transient Ischaemic attacks (TIA), occur when stroke symptoms resolve themselves within 24 hours
Stroke has a devastating and lasting impact on the lives of people and their families. Individuals often live with the effect for the rest of their lives. A third of people who have a stroke are left with long-term disability. The effects can include aphasia, physical disability, loss of cognitive and communication skills (e.g. leading to aphasia), depression and other mental health problems (Public Health England).
Risk factors resulting from lifestyle choices, (smoking, diet, physical activity, alcohol consumption, blood pressure, blood cholesterol levels, obesity and diabetes) are known to be modifiable risk factors that can lead to Stroke.
Stroke continues to be a leading cause of adult disability (Stroke Association, 2013). More than half of all stroke survivors are left dependent on others for everyday activities. In 2010 stroke was the fourth largest cause of death in UK; causing almost 50,000 deaths a year. In Yorkshire and the Humber 10,600 people had a stroke and 91,600 are living with a stroke (Stroke Association).
People with disability after stroke should receive rehabilitation in a dedicated stroke inpatient unit and subsequently from a specialist stroke team within the community (NICE, 2013, Stroke Rehabilitation: clinical guideline 162).
Modelled estimates of stroke prevalence for York in 2011 suggest that the prevalence should be in the region of 2.25% (Public Health England, 2011), with general practitioner data suggesting that the recorded prevalence during 2010-2011 was 1.9% compared to an England rate of 1.7% (Health & Social Care Information Centre). This data should be viewed with similar cautions as the coronary heart disease data. The standardised mortality ratios for stroke for men and women are not significantly different to the England average (Health & Social Care Information Centre).
The Stroke Association believes that stroke can and should be prevented. The York service is working with stroke survivors and their families to encourage people to take action to reduce their stroke risk. It does this by providing information, advice and support.
The Stroke Association Information, Advice and Support service in York was established in October 2009 and has provided a service to nearly 1000 stroke survivors and their families. The work has included advice on stroke prevention to stroke survivors and their families; working with the York Hospital medical stroke team on the acute and rehabilitation ward; working with Adult Social Care teams; working with other statutory and voluntary organisations in York; Age UK York and York Carers Centre. The service has also provided a number of ‘Know Your Blood Pressure’ events within York.
The City of York currently funds a part time information, advice and support co-ordinator (18 hrs) and administrator (11 hrs). Originally the contract provides 36 hrs co-ordinator and 15 hrs administration. The current funding was until end of March 2014; it was been reduced in the last 12 months to provide 50% of the original service.
Stroke: Key Priorities
- working with stroke survivors and their families; complimenting and supporting the work of the Stroke Unit at York Hospital; providing information, advice and support.
- working with carers to enable them to support the stroke survivor
- working with adult social care teams to provide information and expertise on stroke
- working with general practitioners to provide information and support on stroke to their patients
- supporting and recruiting volunteers
- supporting York Stroke Club and encouraging stroke survivors and their families to attend.
The Stroke Association (2014) York Information, advice and support
York Information, advice and support
The Stroke Association (2014) Know your Blood Pressure
Know your Blood Pressure
The Stroke Association (2013) Stroke Statistics Resource Factsheet
Stroke Statistics Resource Factsheet
The Stroke Association (2013) Feeling overwhelmed: the emotional impact of stroke
Feeling overwhelmed: the emotional impact of stroke
National Institute for Health and Care Excellence (2013) Stroke rehabilitation: Long-term rehabilitation after stroke
Stroke rehabilitation: Long-term rehabilitation after stroke