Dudley Strategy for Tackling Health Inequalities 2010-15

with, or at high risk of vascular disease to call 999 should they experienceunexplained chest pain.Continue to embed delivery of expanded services for acute myocardial infarction(MI) diagnostics and revascularisation and review the equity of provision in afurther 5 years time.Repeat the cardiac rehabilitation equity audit with larger numbers to establish afuller picture and implement recommendations made from this. This shouldinclude a review of Did Not Attends (DNAs) and Do Not Responds (DNRs) forcardiac rehabilitation and the establishment of routine procedure to follow-upthese groups.Actions for Acute Stroke/Transient Ischaemic Attacks(TIA)The NST identified a number of priority areas for action:Continue Facial weakness, Arm weakness, Speech problems, Time to call 999(FAST) awareness programmes with an emphasis on segmentation and use ofsocial marketing to ensure the message reaches all communities, to include thedevelopment of targeted campaigns for minority ethnic groups and the over 65sContinue implementation of current stroke/TIA workstreams to increase speed ofaccess to diagnostics and treatment to meet the national targets set out in theaccelerating stroke improvement programme in all cases, specifically:If any metrics remain significantly below target, consider equity auditing tocompare demographics of patients receiving optimum versus not optimum care.Audit GP TIA referrals data for consistencyReview GP practice performance for outlying practices in relation to admissionsdataActions for Chronic Obstructive Pulmonary Disease(COPD)Although the HINST did not hold a specific workshop on COPD when they visited us,they have since produced a series of recommendations on delivering bettermanagement of COPD based on the experiences of the Spearhead PCTs. Theserecommendations have been reviewed and concur with the COPD pathway that isimplemented in Dudley.The local priorities for development are:-As part of the National COPD Strategy and to increase prevalence numbers inDudley a „Missing Millions‟ (previously undiagnosed COPD) pilot that hascommenced: Audit of 800 patients via GP surgeries, community pharmacists,Dudley Stop SmokingImplement the new NICE guidelines for COPD Mild, Moderate, Severe and VerySevereThere is an application via Strategic Health Authority (SHA) End of life workforceprojects for an end of life care lead/nurse for COPDThere is a concerted focus to improve under diagnosis and increase prevalenceof asthma in Dudley via an education and training programme. There will also beactions to reduce the numbers of recurrent admissions with asthma14