Stroke: policy context

From their peak in the 1970s, incidence rates of stroke have steadily declined in Scotland, but not at the pace of neighbouring northern European countries. Stroke will remain a major public health problem in Scotland for several decades to come.

The Scottish Office white paper Towards a healthier Scotland set a target to halve the rate of death from cerebrovascular disease in those aged under 75, in the 15 years between 1995 and 2010 (see section Data: Scottish data).

In light of Scotland's poor record on coronary heart disease (CHD) and stroke, the Scottish Executive published the CHD and stroke strategy for Scotland in October 2002 following the publication of the CHD and Stroke Task Force report a year earlier. The strategy represents the culmination of 4 years' work, based upon extensive consultation with patients, clinicians and managers.  The report highlighted CHD and stroke as the major causes of ill-health and death in Scotland, and set out the priorities for stroke treatment: accurate diagnosis, rapid assessment and improved rehabilitation.

Progress of the strategy was reviewed in a supplementary report, Coronary heart disease and stroke in Scotland - Strategy update 2004. One of the strategy recommendations was for all health boards to have managed clinical networks (MCNs) for stroke services, and these have been established.

Following consultation, in 2009 the Scottish Government published an updated strategy in the Better heart disease and stroke care action plan.

There have been a number of SIGN guidelines on CHD and stroke, and Guideline 108 'Management of patients with stroke or TIA: Assessment, investigation, immediate management and secondary prevention' was published in December 2008.