Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012

Development, delivery and evaluation of this Action Plain is managed by members of the Steering Group for the Atrial Fibrillation (AF) and Stroke
Prevention Special Interest Group (SIG) with support from staff and volunteers in the Scotland office of the Stroke Association, which is the host
organisation.

The aims and objectives of the SIG and more information about its Steering Group are set out in its terms of reference.

More information about the work of the SIG and it steering group is available on the SSKIA website
http://www.knowledge.scot.nhs.uk/sskiacommunity

Anyone with an interest in AF and stroke can join and participate in the AF and Stroke Prevention SIG through the SSKIA website.

For more information please contact AFScotland@stroke.org.uk
Improvement Area 1: Public Awareness
Priority
Activity
Who
When
Resources
Impact & Outcomes
High
1.
AM
From
March
2013


Will provide baseline, trend and
evaluation data on public
awareness of AF & links to
stroke in Scotland.
Public Awareness Data
Page
1
1.1 Stroke Association UK
Ipsos Mori Poll
Monitor Scottish public
awareness of AF and related
stroke risk through inclusion
of relevant questions.

Staff time
Stroke Assoc. UK
market research
budget.
May need to
secure additional
funding.
Progress to date (as of
Dec. 2012)
Have requested regular
inclusion of a standard
AF question in the Stroke
Assoc. Poll – awaiting
confirmation in Jan 2013.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 1: Public Awareness cont.
Priority
Activity
High
1.2 Public Awareness
Activities
1.2.1 Current Activities
SIG members to support
improved delivery of member
organisation’s AF public
awareness activities in
Scotland.
Who
AM
AC
JM
All
When
From
Jan
2013
onwards
Resources
Impact & Outcomes
Current staff
and cash
resources.
Impact:
 Increased Scottish public
awareness of AF and stroke
risk.
May need to
secure
additional
resources.
2
Information
NHS Inform:
Memorandum of
Improved diagnosis and
Agreement signed in Dec
treatment of people with AF. 2012 between NHS
Inform, SA and CHSS.
Outcomes:
 Better management and
MH to send email to NHS
reduced stroke risk for
Inform re BHF input
patients with diagnosed AF. around CVD information.


Page
Progress to date (as of
Dec. 2012)
Reduced Scottish
population incidence,
morbidity and mortality from
AF-related stroke.
See Appendix 1 re current
information provision.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 1: Public Awareness cont.
Priority
Activity
Medium- to high
1.2.1 Additional
Awareness Activities
Page
3
Identify and progress
opportunities for members
of the SIG to support
additional AF public
awareness activity in
Scotland. E.g. through:
 NHS Inform
 primary care
 community pharmacies
 social media
 AF and stroke risk
“app”.
Who
AM
and all
When
Start: Nov.
2012
March 2013
Resources
Impact & Outcomes
Progress to date (as of Dec.
2012)
tbc
Impact:
 Increased Scottish public
awareness of AF and
stroke risk.
Materials
Consider re-branding ‘Ask
First’ leaflet with AF SIG’s
members’ organisation logo.
Make a decision to go ahead
once funding is confirmed.
Group discussed preparing a
poster for GP surgeries that is
more ‘visual’. Group members
were positive about the
‘visuals’ in SA’s ‘Ask First’
leaflet.
Group discussed producing
wallet sized cards to have in
GP Surgeries (Dec 2012
meeting.)

Improved diagnosis and
treatment of people with
AF.
Outcomes:
 Better management and
reduced stroke risk for
patients with diagnosed
AF.

Reduced Scottish
population incidence,
morbidity and mortality
from AF-related stroke.
Community Pharmacy
Scotland could consider doing
an AF poster in Community
pharmacies. Application has
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
to be approved by the Scottish
Government. (end March
2013).
Facebook/Twitter: wait until
there is a ‘newshook’ around
AF.
Page
4
Apps to detect pulse
Keep a ‘watching brief’ on
apps, but have decided they
are not particularly beneficial
at the moment.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Page
5
Improvement Area 2: Professional Awareness and Practice
Priority
Action
Who
When
Resources
Impact & Outcomes
Progress to date (as of Dec. 2012)
High
2.1 Data on
Professional
Practice
Capture baseline
information on
Scottish
professional
awareness and
practice re. AF and
stroke prevention
through a specially
commissioned
survey. Repeat as
an appropriate
Health
Inequalities
Alliance
tbc
Funding being
sought
Will provide baseline,
trend and evaluation data
on professional attitudes
and practice on AF in
Scotland.
MH to produce proposal for AF
questionnaire/survey to share with JF and CoChairs followed by group members.
Draft survey questions have been circulated to
Steering Group members for comment.
Funding will be sought to develop and deliver
the survey.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 2: Professional Awareness and Practice cont.
Priority
Action
Who
When
Resources
Impact & Outcomes
Progress to date (as of Dec. 2012)
High
2.2 Continuing
Professional
Development
(CPD)
AK
Dec.
2013
AK’s time
Impact
 Improved clinical
practice in diagnosis
and management of
AF and related stroke
risk.
The stroke pharmacy pack is primarily targeted
towards
community pharmacists and includes training
material on stroke, warfarin, other related
information and case studies on stroke
issues.
Outcomes
 Improved patient
outcomes re. AF
management and
reduced stroke risk.
 Reduced Scottish
population incidence,
morbidity and
mortality from AFrelated stroke.
A pack can be downloaded from NHS NES
website:
Page
6
2.2.1 Pharmacy
CPD
Develop and
improve AF section
of the Scottish
national stroke pack
for hospital and
community
pharmacists
(check)
http://www.nes.scot.nhs.uk/education-andtraining/by-discipline/pharmacy/about-nespharmacy/educational-resources/resources-bytopic/cardiovascular-system/stroke.aspx
AK plans to include information on AF for Dec
2013 pack.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 2: Professional Awareness and Practice cont.
Priority
Action
Who
High
2.2 CPD cont.
Review: Clinical
members of Steering
Group
Page
7
2.2.2
Primary
Care

Review current
AF and stroke
CPD resources
and provision for
GPs’ and
Practice Nurses
and recommend
improvements.

Promote AF and
stroke risk CPD
opportunities to
primary care
staff to increase
uptake.
Promotion:
 NHS Educat.
Scotland
(SSKIA partner)
 RCGP Scotland
 Royal Pharma.
Society Scotland
 Scottish Practice
Nurses Assoc.
When
Resources
Impact & Outcomes
Review:
Clinicians time
Impact
 Improved clinical practice in
diagnosis and management
of AF and related stroke risk.
Promotion:
Existing
resources
within these
Outcomes
 Improved patient outcomes
re. AF management and
reduced stroke risk.
 Reduced Scottish population
incidence, morbidity and
mortality from AF-related
stroke.
Progress to date (as of
Dec. 2012)
See Appendix 3
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 2: Professional Awareness and Practice cont.
Priority
Action
Medium 2.3 Clinical
Standards and
Guidance
2.3.1 Review
 AF indicators in
UK Quality and
Outcomes
Framework for
GPs’
 Scottish AF
clinical
guidelines and
standards.
Who
When
Clinical
tbc
members
of
Steering
Group
Resources Impact & outcomes
Clinicians’
time
Impact (potential –
subject to changes
being agreed and
implementation being
resourced)

-

Page
8

Improvements in:
UK QOF
requirements for AF
Scottish AF clinical
guidelines/standard
s
Improved clinical
practice.
population
incidence, morbidity
and mortality from
AF-related stroke.
Progress to date (as of Dec. 2012)
QOF: AR updated group members on current QOF data and
proposed changes. Group members were broadly happy
with data.
1. Quality Outcomes Framework
Go to ISD website: http://www.isdscotland.org/HealthTopics/General-Practice/Quality-And-OutcomesFramework/
2. Scottish Heart Standards, April 2010
See: http://www.healthcareimprovementscotland.org
3. Audit Scotland’s report on cardiology services
See:
http://www.auditscotland.gov.uk/docs/health/2012/nr_120223_cardiology.pdf
European Guidance?
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 2: Professional Awareness and Practice cont.
Priority
Action
2.3.2 Improvement
recommendations
to NICE, Health
Improvement
Scotland and
Scottish Govt.
Who
When
Resources Impact & outcomes
Outcomes
•
Improved
patient outcomes re.
AF management and
reduced stroke risk.
Reduced Scottish
Page
9
(Recommendations
would include
opportunistic
screening for AF in
primary care.)
Progress to date (as of Dec. 2012)
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 3 : Support to People diagnosed with AF
Priority
Action
Who
When
Resources
Impact & Outcome
High
3.1 Data about People
living with AF
Health Inequalities
Alliance
tbc
Funding being
sought
Will provide baseline
and trend data on AF in
Scotland. Will support
evaluation of impact
and outcomes or AF
improvement activities
supported by the SIG
and others.
3.1.1 Survey
Capture baseline information
of experiences, priorities and
opinions of people in
Scotland with diagnosis of
AF through a survey.
Repeat survey as a
appropriate
Page
10
High
3.1.2
Patient
Satisfaction
Data
Share aggregated
anonymous findings from
patient satisfaction surveys
from North Lanarkshire rapid
access AF clinic and other.
MD
Tbc
Staff time
tbc
Progress to date
(as of Dec. 2012)
Draft survey
questions have been
circulated to
Steering Group
members for
comment.
MH to write proposal
for conducting
survey.
Data has been
shared with group
members and
posted on SSKIA
website.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 3 : Support to People diagnosed with AF
Priority
Action
High
3.1.3 Pharmacy NES
learning pack data
Share results on
how many pharmacists had
completed the
'Pharmaceutical care of
stroke patients' national NES
learning pack.
Who
When
Resources
Impact & Outcome
Progress to date
(as of Dec. 2012)
AK
Oct. 2012
AK’s time
Will provide information
on the effectiveness of
the learning tool.
Course attendances
during 2008-9 when
it was a core pack =
589
Numbers completed
the Multiple Choice
Questions (MCQs)
for the pack - = 172
Page
11
Hits to the stroke
resource webpage
from 2011 = 300
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Improvement Area 3 : Support to People diagnosed with AF
Priority
Action
High
3.2 Service Improvement Stories
Use SSKIA template (under
development) to capture AF service
improvement stories to promote
replication.
Each improvement story needs to
collect following info.

Page
12




key features of service
design/arrangements
no. of people using service
outcomes for service users
cost of service
cost effectiveness/benefit.
Who
When
Resources
Impact & Outcome
Comment/Progress to date
(as of Sept. 2012)
tbc
MH
Dec 2012
Staff time
MH to discuss with members
at Mar 2013 meeting.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
MD
3.2.1
North Lanarkshire Rapid
Access Nurse-led AF clinic
Feb 2103
SIG
Feb 2013
members onwards
MD has a story and will send
to AM.
Others tbc
Improvement Area 3 : Support to People diagnosed with AF cont.
Priority
Action
High
3.3 Stories by People affected by AF
Gather and share stories of people living
with AF.
Use Stroke Association “It Happened to Me”
personal story workbook.
Could also promote use of Patient Opinion.
Page
13
High
3.4 Information for people with AF and
their families.
 Identify unmet needs and baseline
through above survey and mapping of
current provision.

Who
MD and AM
Health
Inequalities
Alliance
When
Resources
Impact & Outcome
Start by
Oct. 2012
and
ongoing
Staff time
Impact
 Improved
understanding of
experience living
with AF
Outcomes
 Peer support
 Information to
guide service
improvements.
tbc
tbc
tbc
Staff and
Support improvements to current
tbc
Progress to date (as of
Sept. 2012)
DR has shared story for
media purposes. Story will
be considered by media
with an additional
‘newshook’.
MD is trying to identify a
patient.
MH will address these
issues in her proposal for
conducting a survey.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
provision through:
- Voluntary sector
- NHS Inform
- Primary care
- Secondary care
members’
time
Co-ordinator
with members
of Steering
Group and
SIG
See Appendix 1.
Improvement Area 3 : Support to People diagnosed with AF cont.
Priority
Action
Medium
3.5 Self Management Support
3.5.1 self-monitoring for anticoagulation medication
 Identify patient interest and
preferences in improved
access to self-monitoring for
anti-coagulation medication
through above survey and
other research.
Page
14


Assess current evidence of
cost effectiveness of
improved access.
Based on above, make
recommendations to Scottish
Govt., Health Technology
Who
When
Resources
Impact & Outcome
tbc
Health Inequalities
Alliance
Tbc
Tbc
BIVDA Rep
Tbc
Tbc
Steering Group
members and
supporters.
tbc
tbc
Progress to date (as of
Dec 2012)
Draft survey questions
have been circulated to
Steering Group members
for comment.
MH will address these
issues in her proposal for
conducting a survey.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Board Scotland, Health
Improvement Scotland.
4. Co-ordination and Evaluation of SIG and Steering Group
Priority
Action
Who
When
Resources
High
4.1 Co-ordination of Steering
Group
 Prepare agendas, papers and
minutes for Steering Group
meetings and distribute
through SSKIA website.

as
required
but usually
quarterly

Page
15

Support communication
between Steering Group
members.

Monitor progress in
implementing Action Plan

Secure funding for a part-time
co-ordinator to do most of this
work in future.

Stroke Assoc.
Staff & vol. (to
date)
- Maddy
Halliday,
Director
Scotland
- Angie
McLeod (AM)
Comms
manager
Scotland.
Steering Group
Co-chairs:
- Prof. Andrew
Rankin
(cardiologist)
- David Rosier
(person with
AF)


Stroke
Assoc. Staff
and vol.
Time.
Steering
group
member’s
time.
Funding for
a part time
co-ordinator
(might be
graduate
intern.)
£tbc
Impact &
Outcome
ImpactEffective
functioning of the
Steering Group.
Outcome
Effective
management and
delivery of
improvement
priorities within the
Action Plan.
Progress to date
(as of Sept. 2012)
Five meetings organised to
date:
 March 2012
 July 2012
 Sept. 2012
 Dec 2012
 March 2013
Once funding for a coordinator is secured, they will
be hosted and managed by
Stroke Assoc. Prepare
funding bid.
Ensure members are using
SSKIA website (by Dec
2012).
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Co-ordination and Evaluation of SIG and Steering Group cont.
Priority
Action
High
4.2 Development of wider
SIG participation
4.2 1 Online
 Manage AF and Stroke
Prevention SIG pages
on SSKIA website.

Page
16
Medium
Support communication
with SIG participants
through the website.
4.2.2 Events
Organise a national,
Scottish seminar on AF and
stroke prevention.
(Following this event
consider if future national
and/or regional events
would be useful.)
Who
When
Resources


Staff and vol.
time




Vol. AF and
Stroke web
administrator
By Oct.
2012
SIG Co tbc
ordinator once
in post.
Spring/summer
Co-ordinator
2013
Members of

Steering
Group

Stroke Assoc.
Staff.
Impact &
Outcome
tbc
Progress to date
(as of Sept. 2012)

SIG pages established on
SSKIA website

All information uploaded
up to Sep 2012
tbc
Staff time
Venue
and other
costs tbc.
Plan for an awareness event
at the Scottish Parliament
has been written and
circulated to group members.
AM to confirm date in
March/April 2013 for event
MH/DR to agree sponsor.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Budget for catering will be
covered by SA budget.
Educational event/s to be
organised once we have
part-time co-ordinator in
place.
Page
17
5. Co-ordination and Evaluation of SIG and Steering Group cont.
Priority
Action
Who
When
Resources
High
4.4 Evaluation of SIG
Monitor, evaluate and report
on progress of the SIG



Since January
2012
Staff time
High
4.5 Fundraising
Fundraise to secure income
to support co-ordination and
development of SIG and
steering group and delivery
of improvement priorities.
From Sept.
2012
Stroke Assoc.
And steering
group
members’
time.
Co-ordinator
MH and AM
Co-chairs &
members of
Steering
Group
Iain Waller,
Stroke
Association
Scotland
Partnerships
Manager
With support from
other Stroke
Assoc. staff and
members of the
Steering Group.
Impact &
Outcome
tbc
tc
Progress to date
(as of Sept. 2012)
Monitoring and reporting
through minutes of Steering
Group meetings.
Participant feedback from
Dec 2012
Other evaluation tbc
Seeking funding for a part
time AF and Stroke SIG Coordinator.
Applied to Heart National
Advisory Committee.
Awaiting response
Other funding needs tbc.
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
6. Co-ordination and Evaluation of SIG and Steering Group
Priority
Action
Who
When
Resources
Medium
4.6 Public Relations
Steering Group
Co-chairs and
other members
as appropriate
Ongoing as
appropriate
Members time
AM with support
of Steering Group
Co-chairs and
other members
as appropriate
Ongoing as
appropriate
AM time
Members time
4.6.1 Third Party Events
Attend key third party events
to represent the work of the
SIG and raise the profile of
AF and stroke.
Page
18
Medium
4.6.2 Media
Secure media coverage on
AF and the work of the SIG
Impact &
Outcome
tbc
Progress to date
(as of Sept. 2012)
Approach Scottish
Arrhythmia Group about
involvement in their annual
conference from 2013
onwards (AR)
Increased public
awareness of AF
and link to stroke.
Increased
awareness of the
work of the AF and
Stroke Prevention
SIG.
n/a
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Draft prepared by Maddy Halliday and Angie Macleod, Sept. 2012 for discussion at Sept. 2012 AF and Stroke Prevention SIG Steering Group meeting.
Appendix 1
AF Public /Patient Information available in Scotland
Organisation
Atrial Fibrillation
Association
Description (content)




Page
19
British Heart
Foundation

Patient Information booklets,
AF Checklists and pamphlets
Patient Days held throughout
England and Wales (not
Scotland?)
Patient Charter.
Website also includes
personal stories.
Format
Print, electronic
available
Events/days (face to
face)
Print, electronic
Factsheets, website,
available
discussion forum and know
your pulse video guide on ‘how
to check your pulse’.
Date
Current
distribution or
usage
Comment
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Stroke Association
NHS Inform
Page
20
Chest, Heart and
Stroke Scotland

provides public information
materials on-line, in print and
through its helpline
 offers pulse checks as part of
its public stroke
awareness/Know Your Blood
Pressure events
supports ongoing media activity
 Is planning phase 2 of its UK
“Ask First” campaign. (It is
unlikely that our current UK
budget will cover further radio
advertising in Scotland so may
need to raise supplementary
funding
Website covering all aspects of atrial
fibrillation: symptoms, diagnoses,
treatment, complications etc.

provides public information
materials on-line, in print and
through its helpline
Print, electronic
available
Electronic
Print, electronic
available
Memorandum of
Agreement
signed in Dec
2012 with NHS
Inform, SA and
CHSS
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Appendix 2
Current Apps available that are related to AF and Stroke Prevention
Name of App
Produced by
Date
available
Heart rate App
Azumio Inc.
12/03/2012
ipulse
https://itunes.apple.com/app/ipulse/id304641975?mt=8
BIC
29/05/2009
iHeart - Pulse Reader
Anatoly Butko
16/08/2010
iHeartRate - for health, wellness, fitness and workouts
Endloop
14/12/2010
https://play.google.com/store/apps/details?id=si.modula.android.instantheartrate&hl=en
Development
Systems Inc.
BeatMonitor
Surich
Page
21
Technologies
29/10/2009
Atrial Fibrillation and Stroke Prevention Special Interest Group Action Plan 2012-2015
Dec. 2012
Appendix 3
Page
22
Primary Care Information available in Scotland
Organisation
Description (content)
AFA
BHF
SA

NHS Inform
CHSS
provides public information
materials on-line, in print and
through its helpline
 offers pulse checks as part of
its public stroke
awareness/Know Your Blood
Pressure events
 supports ongoing media activity
Is planning phase 2 of its UK “Ask
First” campaign. (It is unlikely that
our current UK budget will cover
further radio advertising in Scotland
so may need to raise
supplementary funding
Format
Date
Current distribution Comment
or usage