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Kevin Walsh of the Rotary Club and Julie Clayton, Head of Communications and Engagement at NHS North Cumbria Clinical Commissioning Group, explain how they have helped identify people at risk of stroke:
In a number of wards in Copeland, North Cumbria, people are at a much higher risk of stroke than the national average, with residents in one area being 104% more likely to have a stroke.
It is estimated that some 300 people in Copeland have untreated abnormal heart rhythms, while 7,000 – 10% of the population – live with undiagnosed high blood pressure.
Research suggests that stroke is largely preventable, with figures varying from 80 to 90%. High blood pressure causes a two-to-four-fold increase in the risk of stroke before the age of 80 and atrial fibrillation increases a person’s risk of stroke 5 times.
This coupled with Copeland’s at-risk population not accessing treatment in the traditional way, we set about finding a different way to reach them.
Building on earlier NHS and Rotary work, we decided to develop a community-led, NHS-enabled initiative to explore opportunities for preventing and raising awareness of stroke. It would be shaped by the community and delivered in partnership with patients.
To lead this work, we formed a steering group of health and care representatives from the Rotary, the West Cumbrians’ Voice for Healthcare, the Stroke Association, North West Ambulance Service, Healthwatch Cumbria, Public Health, Community Pharmacy Cumbria and the North Cumbria Integrated Care System, with active participation from patients with lived experience.
We identified community events where we could get a stroke prevention and awareness messages across to high-risk populations who don’t usually seek health advice. We piggy-backed on two established community events and took ‘health in a tent in a field’ to the Whitehaven Traders Market and the Distington Vintage Rally.
We worked with our community pharmacy colleagues to offer a blood pressure test and an irregular pulse test alongside a team sharing advice on simple ways people can improve their own health, such as healthy eating, exercising and giving up smoking, which are also key to reducing the chances of stroke.
We tested 227 local community members aged 19 to 80. Of these, we referred 20% to a pharmacy for another check and the chance to take part in some home monitoring or to their own GP, while one person was directed to A&E.
By liaising closely with public health teams and partnering with existing community events, we managed to target some of the population who had more potential of being at-risk of stroke, including many older men. Although tellingly we had a lady who had brought her husband over for a test because he ‘never goes to the GP’, it turned out she was the one who was advised to seek further assessment.
Through these community events we developed a successful collaborative local model between the voluntary, community and social enterprise sector and the NHS for raising awareness to vulnerable groups, helping prevent ill health and supporting people to ‘live better for longer’.
Everyone – from our volunteers to senior NHS staff – is committed to the same goal: “Community-led activity to help prevent stroke in Copeland”. This shared vision, and recognising that everyone’s contribution was vital, helped us build a genuine partnership.
Getting the right people involved from all parts of the system and being community-led are key to our success. Having a champion at the highest level within the NHS in Professor John Howarth, Deputy Chief Executive of the North Cumbria Integrated Care NHS Foundation Trust and local GP, also greatly benefited the project.
Many of the community members we tested informed us they don’t visit their GP regularly. Many had existing medical conditions and took the opportunity for a check-up; others wanted peace of mind. By offering our health checks in the community – where people live and feel comfortable – and away from medical settings, we helped normalise conversations about stroke and other health issues. Having friendly and approachable volunteers helped reach those who might otherwise avoid a check-up.
With support from the Cumbria Learning and Improvement Collaborative we will continue to develop this work and we are now planning to run stalls at a series of community events, while exploring how to extend our offer across North Cumbria and to other health conditions.
We are also reaching out to new partners, such as local academies, with the outlook of opportunities to engage whole families. We are connecting into the local Integrated Care Communities and Primary Care Networks to make sure this becomes part of the approach to healthcare in our area.
We want to spread this way of working to other geographic areas and for other health conditions across North Cumbria. If you can help us, please contact firstname.lastname@example.org. You can also access support to start, continue or improve collaboration between health, care and VCSE sector leaders on the Institute for Voluntary Action Research (IVAR) website.