A population health approach to stroke awareness

The term population health is an approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people, while reducing health inequalities within and across a defined population. It includes action to reduce the occurrence of ill-health, including addressing wider determinants of health, and requires working with communities and partner agencies.

Since undertaking my Fellowship research, I have been working within the NHS in the North East of England as a lead physiotherapist on an acute stroke unit. So, the opportunity to apply for a Population Health Fellowship, funded by Public Health England, in stroke pathways felt like a very natural progression to my work.

I started this Fellowship in 2022 and it has enabled me to gain a better understanding of health inequalities and how the method of population health can be used to positively influence changes within established healthcare systems.

In partnership with the Fellowship sponsor organisation, North Tees and Hartlepool NHS Foundation Trust, I have been working to apply a population health approach to a Transient Ischemic Attack (TIA) pathway.

TIA’s, or mini-stroke, are caused by a clot in the brain that temporarily blocks the blood supply to the brain. It has the same symptoms of a stroke, but the symptoms resolve as the clot moves away from the brain and the blood supply is restored.

TIA’s are a warning that an individual is at risk of having a stroke. With the risk higher in the first days and week after TIA symptoms, it is important that people experiencing stroke symptoms seek medical advice urgently.

The area where I work, North East of England, has the highest prevalence of stroke and TIA in England, with an estimated 62,000 people diagnosed as having had a stroke or a TIA (State of the North East 2019).

TIAs/ stroke is the fourth single leading cause of death in the UK as well as being one of the largest causes of complex disability. The Stroke Association estimates that 100,000 people have a stroke in the UK each year. But TIAs/ stroke are a preventable disease, and by improving population awareness through developing a holistic approach, we hope this may contribute towards reducing disability caused by stroke.

It is paramount that individuals experiencing stroke symptoms are able to access the right healthcare at the right time. This fellowship project is built around collaborating within established acute sector pathways and primary care providers, using data to determine gaps within services.

This will enable awareness and education resources to be used in the best way to promote stroke awareness working with local authority public health teams. The Act F.A.S.T campaign, being relaunched by NHS England with the Stroke Association, will be used to promote stroke awareness.

The important message is:

Think and Act F.A.S.T. if you see any single one of these signs of a stroke:

• Face – has their face fallen on one side? Can they smile?
• Arms – can they raise both arms and keep them there?
• Speech – is their speech slurred?
• Time – even if you’re not sure, call 999.

When Stroke Strikes Act F.A.S.T. Call 999.

The use of an existing well-established campaign to raise awareness of stroke on a local population level may contribute to reduction in stroke, enabling a healthier population within the Tees Valley area.

My hope is that this work will contribute towards raising awareness of TIA and stroke on a local population level and that findings of my Population Health Fellowship could be used to inform at a national level a population approach for other TIA services.

More information on symptoms of stoke can be found at the Stroke Association and NHS websites.