Better Heart Disease and Stroke Care Action Plan

Foreword by the Cabinet Secretary for Health and Wellbeing

As the Government made clear in Better Health, Better Care, heart disease and stroke continue to be clinical priorities for NHSScotland.

I very much welcome the wide range of contributions received as a result of the consultation which I launched in July 2008. I'm sure that those who wrote in, and those who attended the consultation event in December last year, will see that we have paid great attention to the responses in developing the Action Plan. We have also worked closely with the three main voluntary sector organisations - the British Heart Foundation, Chest, Heart & Stroke Scotland and the Stroke Association in Scotland - in finalising the Action Plan's contents.

The Action Plan aims to offer comprehensive coverage of all the issues relating to heart disease and stroke. As it now includes inherited cardiac conditions, we've broadened the title beyond Coronary Heart Disease and are referring to it as our 'Heart Disease and Stroke Care Action Plan'. The stroke section has a much-overdue emphasis on the longer-term support people need to help them recover from the effects of the stroke in their own communities, the aspect of the consultation that generated more responses than any other.

As well as its many recommendations for improving the services needed by people with established heart disease, or who have had a stroke, the Action Plan emphasises the importance the Government attaches to preventing cardiovascular disease (the collective name for heart disease, stroke and diabetes). It also reflects our determination to tackle the unacceptable health inequalities associated with cardiovascular disease.

As a result of our policies, healthcare in Scotland is shifting from a reactive system that treats illnesses to one that anticipates and prevents health problems before they develop, as well as one that promotes a positive sense of wellbeing. The risk factors dealt with in this Action Plan are common to a wide range of diseases. Policy and services have too often been developed in separate silos, with activity fragmented according to disease, stage of disease, risk factors or the way in which services are delivered. In taking forward this Action Plan, the Government will therefore seek to make links to policy and delivery such as targeted primary prevention, the Long Term Conditions Action Plan, the revised Diabetes Action Plan and the work on mental health. All of this work is being brought together in the context of the Healthcare Quality Strategy which we announced at this year's NHS Conference. It is complemented by the CHD Improvement Management Programme which NHS Quality Improvement Scotland has just issued - the first ever nationally-coordinated quality improvement programme for heart disease in Scotland.

Most of the responsibility for actions falls on NHS Boards, but the cardiac and stroke Managed Clinical Networks in each Board are the main vehicles in enabling them to take these actions forward. Like all Networks, they allow managers, planners, clinicians, the voluntary sector, people with a personal interest in the services concerned and NHS Boards' local partners to work together on improving the care and support needed by people with heart disease or who have had a stroke.

Naturally, we will want to make sure that the actions in the Action Plan are being implemented. NHS Boards' performance will be monitored by the Scottish Government Health Directorates ( SGHD) through scrutiny of NHS Boards' Local Delivery Plans, and through the HEAT target process. The National Advisory Committees on Heart Disease and Stroke will provide general oversight in monitoring progress and will be responsible for reporting to SGHD.

This Action Plan sets out a clear list of focussed pieces of work for taking forward the next phase of the work in tackling the burden of heart disease and stroke which has blighted our population for too long. We firmly believe that implementation of the Action Plan will allow Scotland to continue to reverse its current reputation and become a world leader in tackling cardiovascular disease.

Nicola Sturgeon, MSP
Deputy First Minister and Cabinet Secretary for Health and Wellbeing