Together we can conquer stroke - Stroke Association Strategy April 2017 - March 2019
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stroke.org.uk Together we can conquer stroke Stroke Association Strategy April 2017 – March 2019
Contents Foreword
Twenty five years ago stroke was seen as unpreventable, untreatable.
If it didn’t kill, it shattered lives. But things have changed, with new
research leading to improvements in the way stroke is treated in
Foreword 3 hospital. New medical advances such as mechanical thrombectomy
Ambition One: Preventing avoidable strokes 4 and active support in the community mean that more people than
Ambition Two: Advocating for best care and support 6 ever are able to make a significantly better recovery.
Ambition Three: Expanding the network of services and 8 The Stroke Association is the second largest stroke To achieve our goals we will deliver an operational
support organisation (SSO) in the world, the only plan focused on expanding our reach and improving
long-term support across the UK SSO operating across the whole of the UK, and has the quality of support for people affected by stroke,
been at the forefront of many of these advances. testing new models, and continuing to influence
Ambition Four: Building research and promoting knowledge 10 We deliver amazing life-changing support to over positive changes in policy, research and practice.
to improve stroke care 60,000 stroke survivors and their families each year, The plan is described in our five Ambitions.
are supported by nearly 5,000 talented committed
Ambition Five: Contributing to a well-trained and resourced 12 volunteers and staff, and enjoy strong relationships We will invest in building foundations for long-term
with the stroke clinical and research community. growth so that we have the systems, processes
health and social care workforce and capabilities needed for a step-change in
However, there are challenges for our work. The income and impact. These are described on the
Ambition Six: Building the foundations for long-term growth 14 2007 National Stroke Strategy for England is coming final page. We will clarify our future five-year
to an end and the Government insists that it has strategy post 2019 and create a compelling
no plans to renew it in 2017 despite stroke being picture of our vision, how best to deliver it, and the
the fourth biggest killer in the UK. Momentum intended impacts of our work.
behind the reorganisation of acute services is
slowing, with significant variations in the speed The Stroke Association’s Trustees are fully behind
and quality of treatment you receive depending this two-year strategy and have committed to
on where you live. Post-acute care continues to increasing investment to fund our ambitions.
be neglected despite evidence that long-term
support improves recovery and reduces disability. We are working to improve the lives of stroke
Local Stroke Association services are being cut, survivors and their families who deserve the very
funding reduced, and the postcode lottery of best treatment and care. Together we can
commissioning means that we are only able to conquer stroke.
support half of newly diagnosed people with stroke.
We are operating in an increasingly competitive and
regulated environment for fundraising, our brand
recognition remains low, and our infrastructure
needs modernising.
Juliet Bouverie
To respond to these challenges we will need to Chief Executive
test new approaches to delivering and funding March 2017
our long-term service offerings and partnering
with new organisations. We need a step-change
in our income and brand profile so that more
people engage with us, take action, and benefit
from our support. We must continue to push UK
governments to prioritise stroke, otherwise we risk
more people needlessly dying or becoming disabled.
2 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 3
Ambition One:
Preventing avoidable strokes
Stroke is the fourth single leading cause of death in the UK, but it is often preventable. There are many
causes of a stroke, but there are two in particular that concern us. High blood pressure contributes
to around half of all strokes in the UK. There are 9.5 million people in the UK diagnosed as having high
blood pressure. Atrial fibrillation (AF, a heart condition that causes an irregular and often abnormally fast
heart rate) is a contributing factor to around 20% of strokes. Like high blood pressure, AF often goes
undiagnosed, and it has been estimated that if AF were adequately treated, around 7,000 strokes would
be prevented each year.
People who have had a stroke are at higher risk Our focus for the next two years
of having another one. That’s why ‘secondary We will continue to provide information to the
prevention’ is so important. Everyone who has had public about how to prevent a stroke. We will
a stroke should get the advice and support they work with others to improve the detection and
need to lower their risk of having another stroke. management of high blood pressure and AF and
ensure that our approach reflects best evidence
Our work to date and the optimal use of technologies. We also
Last year we ran 2,000 Know Your Blood Pressure consider our longer-term approach to preventing
events, and after testing people’s blood pressure stroke to ensure that our future strategy is
we referred 24% of them to see their GP. We based on evidence of what works and maximizes
developed partnerships with organisations opportunities to influence public health policy.
including the Rotary Club of Great Britain and
Ireland and Royal Mail to ensure that staff had their
blood pressure checked. We produced resource Our workstreams
packs for GP practices called How we can do better • Continue to influence the development of
to help them identify and manage patients who UK stroke prevention policies
have AF. Since developing the ActFAST campaign • Maintain our existing Know Your Blood
in 2005 we have worked in partnership with Pressure support and review the volume,
Public Health England and others to continue this impact and resource associated with it
campaign to raise awareness of the symptoms of • Integrate AF and Know Your Blood Pressure
stroke. work through pilots
• Continue to press the case for effective
management of AF in primary care
• Continue our support for FAST
• Continue to promote the secondary
prevention of stroke through our Stroke
Recovery Service and new services including
emerging digital health solutions.
4 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 5
Ambition Two:
Advocating for best care
and support
Over the last twenty five years we have seen significant improvements in the treatment of adult strokes,
and deaths have halved. Most hospitals now have a dedicated stroke unit which can vastly improve
outcomes for patients, and clot-busting thrombolysis is used widely across the NHS. However, there is
real danger that these gains will be eroded if we do not keep up the pressure and advocate for best care
and support. We know from UK national stroke audits that many hospitals are under-performing in areas
such as psychological support. Patients are not routinely getting a review six months after their stroke,
and many feel that after they leave hospital they ‘fall off a care cliff’. Without continued leadership and
momentum through a new national stroke strategy, patients’ lives will be put at risk.
Our work to date Our focus for the next two years
We have pressed the case for a new national We will maintain our aim that every stroke survivor
stroke strategy in England. We worked with receives the best treatment and care, regardless
parliamentarians to ensure a debate in the House of where they live and what type of stroke they
of Lords, a question in Prime Minister’s Question have, and that ongoing support continues in the
time and engage the Health Select Committee. community for as long as people need. We will
We launched a petition calling for a new strategy continue to campaign to keep stroke a priority
and achieved 55,000 signatures. We met with the for policy makers at national level and work
Medical Director for NHS England and worked locally to ensure that our vital Stroke Recovery
in partnership with NHS England and others to Service is commissioned widely, providing tailored
secure a national review and agreement to a one- support. We will express our views about required
year commissioning period of the new game- improvements in stroke treatment and care with
changing procedure, mechanical thrombectomy. confidence, consistency and authority.
(It physically removes a clot from a blocked artery
and can significantly reduce disability and costs to
the NHS and social care for those who are eligible). Our workstreams
We were keen to ensure that the 2004 national • Develop a strategy and policy positions to
guidelines for child stroke are updated to reflect influence UK policy makers on key issues in
the latest scientific evidence. So we commissioned stroke prevention, treatment, care and long
the Royal College of Paediatrics and Child Health to term support
update the guidelines and to include haemorrhagic • Continue our campaign for a new national
stroke for the first time. stroke strategy in England
• Campaign to improve stroke treatment and
care in the devolved nations
• Support activity to ensure that all eligible
patients have access to thrombectomy
• Develop a local campaigning strategy and
continue to campaign locally to advocate
for the best rehabilitation support for
stroke survivors.
6 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 7
Ambition Three:
Expanding the network of services
and long-term support across the UK
Coping with life after stroke can be challenging in many ways. Many people leave hospital feeling
frightened, confused and having to face physical, psychological, financial and practical challenges. Some
will need access to information; others need the confidential ear of a Helpline adviser. For some, peer
and social support can provide the lifeline to cope with feelings of isolation. Many will need face-to-face
support with someone who can assess and support their needs and help them navigate the range of
issues that they have to face.
Our work to date Our workstreams
Core to our work has been the evolution of our life • Transition services as appropriate to the
after stroke services into a new model of provision SRS model
called the Stroke Recovery Service (SRS). SRS • Develop and evaluate alternative support,
identifies the practical, emotional and physical and funding models, working in partnerships
needs of stroke survivors and carers, and provides and across different long-term conditions
coordinated support. Initial evaluation shows that • Defend and where possible expand our
the SRS is effective. We have commenced a five network of commissioned contracts
year programme to expand the quality and quantity • Deliver the five year Lottery-funded peer to
of peer support groups in the community. We are peer support programme
introducing a dedicated carer support programme • Expand the content on My Stroke Guide,
to meet the significant unmet needs of carers and building new content for family and friends
have started our first emotional support service. and launch it as a free-to-all service
We’ve designed and piloted My Stroke Guide, a • Work to help stroke survivors to improve
digital self-management tool to support recovery their recovery and physical activity through
and ensure people are never alone. We reviewed our The Moving Forward After Stroke
our Helpline service and made new investments programme.
to extend our reach and support to a greater • Provide innovative services for Stroke
number of callers. Survivors, care givers and the wider
stroke community by developing the new
Our focus for the next two years Operations Centre in Sheffield
We will embed the SRS model as appropriate
across all of our commissioned services. We will
take steps to understand better the needs and
preferences of people affected by stroke and
explore how best to integrate our service offerings.
Our aim is to ensure that we can reach everyone in
ways that best meet their needs. This will include
an expansion of our digital strategy to bring
together information, support and self-help tools.
We will pilot new ways of delivering and funding
support to stroke survivors and their families and
explore new partnerships to extend our reach and
maintain our commissioned income.
8 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 9
Ambition Four:
Building research and promoting
knowledge to improve stroke care
Research is vital to determining how best to prevent strokes, reduce deaths, treat people in hospital
and support them in their rehabilitation and recovery. Stroke is still a relatively new area of medicine
compared with cancer or heart disease, so building a strong evidence base and growing the next
generation of stroke research leaders is essential. Over the last 25 years the Stroke Association has
awarded more than £50 million through research grants, leading to many advances in stroke treatment
and care. We have helped to cultivate a vibrant and diverse community of researchers, funding more than
100 research fellows.
Our work to date Our focus for the next two years
We made a commitment to developing the next We will continue to help build a strong stroke
generation of stroke research leaders by launching research community and focus funding on our
the Stroke Association Lectureship Programme. priority areas. We will use our research funds to
So far we have funded seven posts through two stimulate funding from others and continue to
rounds, and donations of just over £1.5m have press the case that the UK’s spend on stroke
resulted in a total of £5.5m being invested in stroke research is low relative to comparable diseases.
research as a direct result of this programme. We will invest in improving internal and external
We also decided to focus funding in three areas understanding of the impact of our work through
of unmet need – haemorrhagic stroke, vascular strong robust evaluation which drives innovation
dementia and the psychological consequences and improvements in support and care. We will
of stroke – and secured £2.1m commitments of continue to support the development of SSOs
additional money through partnerships and donors and ensure that the views of stroke survivors and
to help us address critical gaps in the evidence. We carers are well represented within the World Stroke
will continue with funding project grants. Through Organisation.
our international programme, we have also
provided capacity building support to 47 Stroke
Support Organisations (SSOs) across the world Our workstreams
and secured four research grants from the EU • Maintain our current grant programme
Horizon 2020 Programme. focus on capability building and priority
programmes
• Launch a fundraising campaign for an
increase in spend on stroke research
• Work with the Royal College of Physicians to
pilot a tool for capturing patient-reported
outcomes and experience
• Increase our investment in building
evaluation capability and capacity within the
organisation
• Contribute to building the capacity of
Stroke Support Organisations across the
world (in partnership with the World Stroke
Organisation) and create opportunities for
knowledge exchange internationally.
10 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 11
Ambition Five:
Contributing to a well-trained and
resourced health and social care
workforce
To ensure that every stroke survivor gets the best quality care and support we need a health and social care
workforce of sufficient numbers and skills to provide the best treatment and care and confidently drive
forward improvements. We are heading towards a crisis point where there won’t be enough stroke-specific
clinicians to provide hospital care. While stroke professionals receive stroke education and training from
their professional bodies, support workers are often not offered this. In social care the situation is worse,
as there are no mandatory stroke training requirements. It is estimated that 11% of stroke survivors are
discharged to care homes where the quality of support they receive is often inadequate.
Our work to date Our focus for the next two years
We offer a portfolio of training opportunities, The potential market for stroke training is huge
ranging from one day courses and masterclasses, and our reach has been small. We will continue
through to teaching on undergraduate courses with our existing portfolio, focusing on areas of
and providing qualifications in stroke awareness training where we can add real value, especially for
and stroke management under the Qualification non-stroke professionals, whilst we determine a
Care Framework (QCF). In 2016/17 we will have longer-term stroke workforce strategy. Our initial
trained 1726 social care staff (490 received evaluation of the Care Award shows that we have
qualifications) and 708 health care staff (100 proof of concept and we want to develop some
received qualifications). In 2015 we launched further piloting as well as consider how best to
the Care Award, a pilot programme which uses scale-up the programme.
five standards to to help care home staff and
residents adopt a culture that understands the
needs of stroke survivors, helps to promote ways Our workstreams
of preventing stroke, and reacts quickly to the • Undertake a scale up of the Care Award and
warning signs of stroke. In addition, the Stroke scope up a potential model of wider scale up
Association hosts the UK Stroke Forum, the • Continue with existing training portfolio
largest multi-disciplinary stroke conference in the • Work with key strategic partners across the
UK and we have led dedicated training days for Health and Social Care workforce to identify
researchers, social care staff and GPs. workforce and training needs
• Continue to host the UK and NI Stroke
Forum conferences.
12 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 13
Ambition Six:
Building the foundations for
long-term growth
We are ambitious. We want to extend our reach to support every person affected by stroke, through
information, service provision, research and by advocating for stroke to be a high health and social
care priority across the UK. To achieve this we will need to create a step-change in our income and
our impact, and to do that will require investment to build the foundations for long-term growth. We
will also need to consider how we organize and optimise our people, resources and systems within a
financially sustainable business model so that we can increase our effectiveness and grow our impact
in the future.
Our approach to income generation needs Our workstreams
to strike the right balance between tried and • Initiate a ‘Best Value’ programme to
tested traditional approaches to fundraising and strengthen the financial sustainability of our
developing new ones, including those that take business model and organisational structure
advantage of digital technology. We will explore that enables us to grow our reach and impact
ways to strengthen and grow in-country and • Develop a bold and innovative income
regional fundraising. To support these goals we generation strategy which invests in winning
need the right capabilities and capacity, supported products
by effective systems. • Improve our approach to innovation in
fundraising
Our brand visibility is low with the general public • Invest in an integrated strategy for insight,
and limits our ability to engage with potential measurement and impact
supporters and to raise funds. We also want to • Improve our approach to new product
ensure that our strategy and business decisions development
are based on the best insight, data and analysis – • Develop and implement an organisational
for example, insight about the needs of different marketing strategy, building our brand
stakeholders, data on the financial performance visibility and creating a single compelling
of our products and services, and evidence of our brand proposition
impact. • Invest in a new financial management
system
Our staff and volunteers represent our most • Improve staff and lifetime volunteer
important asset. We want to ensure that they are engagement and invest in infrastructure for
engaged, skilled and supported to deliver our short supporting volunteers
and long-term strategy ambitions. • Embed our competency framework and
strengthen leadership capabilities
At the same time as putting in place these • Build our capability and governance for
foundations, we will develop our future five-year making transformational change
strategy post-2019 and create a compelling • Clarify our future five-year strategy.
picture of our vision, how best to deliver it, and the
intended impacts of our work.
14 The Stroke Association Strategy | April 2017 – March 2019 The Stroke Association Strategy | April 2017 – March 2019 15We are the Stroke Association
We believe in life after stroke. That’s why
we support stroke survivors to make the
best recovery they can. It’s why we campaign
for better stroke care. And it’s why we fund
research to develop new treatments and
ways of preventing stroke.
We’re here for you. Together we can conquer
stroke. If you’d like to know more please get
in touch.
Stroke Helpline: 0303 3033 100
Website: stroke.org.uk
Email: info@stroke.org.uk
From a textphone: 18001 0303 3033 100
We are a charity and we rely on your support to
change the lives of people affected by stroke and
reduce the number of people who are struck down
by this devastating condition.
Please help us to make a difference today.
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Twitter @TheStrokeAssoc
Together we can conquer stroke
© Stroke Association 2017, JN 1718.050
Stroke Association is a Company Limited by Guarantee, registered in England and Wales (No 61274).
Registered office: Stroke Association House, 240 City Road, London EC1V 2PR. Registered as a Charity in England and Wales (No 211015)
and in Scotland (SC037789). Also registered in Northern Ireland (XT33805) Isle of Man (No 945) and Jersey (NPO 369).You can also read
