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Background and Policy

Stroke

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Background & Policy

Coronary Heart Disease (CHD) & Stroke

CHD is a disease of the heart and coronary arteries caused by the build up of fatty materials in the blood vessels that supply the heart with oxygen. This can cause a heart attack, chest pain or angina. Cerebrovascular Disease, which includes cerebrovascular accident/stroke and transient ischaemic attack (TIA), is responsible for the deaths of more than 4,000 people in Scotland every year. A stroke or TIA happens when the blood supply to part of the brain is interrupted and the brain cells are starved of oxygen. This usually occurs because a blood vessel becomes blocked. Stroke is more common in older people.

Risk factors associated with CHD & Stroke

The main preventable risk factors for coronary heart disease and stroke are smoking, lack of exercise and a poor diet. Research also indicates a strong relationship between social deprivation and these risk factors.

Detailed information on the prevalence of these risk factors is available from the Scottish Health Survey.

Policy Context

NHSScotland service provision for patients with coronary heart disease and stroke operates within the framework of policy devised by the Scottish Government. A chronology of policy documents that steer service provision for CHD & stroke patients is outlined below.

Data Quality

The ISD Data Quality Assurance team is responsible for evaluating and ensuring SMR datasets are accurate, consistent and comparable across time and between sources.

The DQA team’s previous projects web page contains details of past Data Quality Assurance Assessments, including final reports and findings.

The most recent report "Assessment of SMR01 Data 2010-2011" [350kb] was published in May 2012. This report includes feedback on clinical coding accuracy, sensitivity and completeness within defined groups and includes commonly encountered conditions including Ischaemic Heart Disease, Cerebrovascular Disease and Myocardial Infarction.

An earlier report, "Towards Better Data from Scottish Hospitals: An Assessment of SMR01 and Associated Data 2004-2006" [1.77Mb], contains sub-sections on specific conditions and interventions, including some related to CHD and stroke.

In hospital discharge data, clinical information for diagnoses and operations/interventions is currently recorded using ICD10 (the International Classification of Diseases 10th Revision maintained by the World Health Organization) and OPCS4 (the Office of Population Censuses & Surveys 4th Revision Classification of Surgical Operations and Procedures maintained by NHS Connecting for Health (CfH)).

Lists of ICD10 codes are available at http://www.who.int/classifications/icd/en/. OPCS4 codes are available from http://systems.hscic.gov.uk/data/clinicalcoding/codingstandards/opcs4.

Independent & voluntary sector

Although there are a number of independent & voluntary sector organisations involved in the provision of information and services to CHD & stroke patients, two of the main ones, with links to NHSSCOTLAND, are the Stroke Association, British Heart Foundation (BHF) and Chest, Heart & Stroke Scotland (CHSS). Each organisation is involved in the funding of research and provide extensive information for patients and carers on their respective web sites at www.stroke.org.uk, www.bhf.org.uk/ and www.chss.org.uk/.

Further Information

Our Links to other sources section offers a few examples of other information sources.

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