Public Health England (PHE) today launches the Act FAST stroke campaign which urges the public to call 999 if they notice even one of the signs of a stroke in themselves, or in others:

• Face – has their face fallen on one side? Can they smile?
• Arms – can they raise both their arms and keep them there?
• Speech – is their speech slurred?
• Time – to call 999

In England, one in six people will have a stroke in their lifetime, and new statistics released by PHE show that 57,000 people had their first-time stroke in 2016. It is estimated that around 30% of people who have a stroke will go on to experience another stroke.

Stroke is a leading cause of death and disability in the UK. There are around 32,000 stroke-related deaths in England each year. Deaths related to stroke have declined by 49% in the past 15 years. This has been accredited to a combination of better prevention, earlier treatment and more advanced treatment. Getting an NHS Health Check, for those aged 40 to 74 years, can identify early if you are at risk of a stroke.

While the majority (59%) of strokes occur in the older generation, PHE’s figures also found that over a third (38%) of first time strokes happen in middle-aged adults (between the ages of 40 to 69). More first-time strokes are now occurring at an earlier age compared to a decade ago. The average age for males having a stroke fell from 71 to 68 years and for females, 75 to 73 years between 2007 and 2016.

Awareness is crucial, so the campaign reaches out to people of all ages to highlight the risk of stroke and reiterates the signs and how vital it is that people call 999 and get to hospital as soon as possible. Around 1.9 million nerve cells in the brain are lost every minute that a stroke is left untreated, which can result in slurred speech and paralysis. If left untreated, a stroke can result in permanent disability or death.

The Stroke Association’s latest State of the Nation report reveals that in the UK almost two thirds (65%) of stroke survivors leave hospital with a disability. Around three quarters of stroke survivors have arm or leg weakness, around 60% have visual problems and around a half have difficulty swallowing and loss of bladder control. Communication is also affected in around a third of stroke survivors.

Professor Julia Verne, Public Health England Director, said:

Stroke is still one of the leading causes of death in England. While it’s often associated with older people, the latest research shows that people are having strokes at a younger age. Everyone needs to be aware of the signs.

Calling 999 as soon as you see even one of the symptoms develop – in the face, arms and speech – is essential. Speedy treatment will help prevent deaths and disability.

Tony Rudd, National Clinical Director for Stroke with NHS England and stroke physician at Guy’s and St Thomas’ NHS Foundation Trust, comments:

Thanks to improved NHS care, stroke survival is now at record high levels. Urgent treatment for strokes is essential, so friends and family can play a key part in making sure their loved ones receive care as quickly as possible.

Every minute counts and knowing when to call 999 – if you see any one of the signs of stroke – will make a significant difference to someone’s recovery and rehabilitation.

Steve Brine MP, Parliamentary Under Secretary of State for Public Health and Primary Care, said:

Strokes still claim thousands of lives each year, so the message of this Act FAST campaign remains as relevant as ever. The faster you act, the greater the chance of a good recovery. That’s why I’m urging everybody, and we must remember stroke can hit at any age, to familiarise themselves with the signs of a stroke and be ready to act fast.

Martin Flaherty OBE, Managing Director of the Association of Ambulance Chief Executives said:

We fully support Public Health England’s Act FAST stroke campaign. This is an important message and we urge people to call 999 immediately if they notice the signs or symptoms of a stroke in themselves or in others. Even if it is not a stroke, it is likely to be something that needs medical advice and attention, so calling the ambulance service is the right thing to do.

Juliet Bouverie, CEO of the Stroke Association, said:

As the UK’s leading stroke charity, we have said time and again that stroke devastates lives in an instant. Almost two thirds of stroke survivors leave hospital with a disability, but it doesn’t have to be this way. The faster you seek and receive emergency specialist treatment for stroke, the better your chances of making a good recovery. Knowing the signs of stroke and being able to Act FAST could save a life – your life.

The FAST (face, arms, speech, time) acronym has featured in the advertising for a number of years and is a simple test to help people identify the most common signs of a stroke.

Background

1. The Act FAST campaign videos and pictures can be found on Dropbox.
2. Interview opportunities with PHE, healthcare professionals and case studies are available upon request

3. The Act FAST campaign will run nationally from 1 February. The campaign includes advertising on TV, press, radio, bus interior posters and digital, supporting PR and a social media drive. Some activity will specifically target black and minority ethnic audiences because African, African-Caribbean and South Asian communities have a higher incidence of stroke. Twitter: @ActFAST999, Facebook: www.facebook.com/ActFAST999

4. A stroke is a brain attack that happens when the blood supply to the brain is cut off, caused by a clot or bleeding in the brain. A mini stroke is also known as a transient ischaemic attack (TIA). It is caused by a temporary disruption in the blood supply to part of the brain.

5. The Stroke Association is a charity that believes in life after stroke and together we can conquer stroke. It works directly with stroke survivors and their families and carers, with health and social care professionals and with scientists and researchers. They campaign to improve stroke care and support people to make the best recovery they can. They fund research to develop new treatments and ways of preventing stroke. The Stroke Helpline (0303 303 3100) provides information and support on stroke.

6. The One You campaign is a nationwide programme that supports adults in making simple changes that can have a huge influence on their health. Changes that could help prevent diseases such as type 2 diabetes, cancer and heart disease and reduce risk of suffering a stroke or living with dementia, disability and frailty in later life

7. People aged over-30 are being encouraged to take Public Health England’s online ‘Heart Age Test’ to find out their ‘heart age’ which will show their potential risk of having a heart attack or stroke and gives them the opportunity to take action. To calculate someone’s heart age, they will need to share some lifestyle information, including weight, height and smoking habits. They will then be able to see how their real age compares to their heart age and find out how many years they can expect to live without developing cardiovascular disease

8. Adults aged 40 to 74 are eligible for a free NHS Health Check which is designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia. As we get older, we have a higher risk of developing one of these conditions. An NHS Health Check helps find ways to lower this risk. Those in the age group can expect to receive a letter from your GP or local authority inviting you for a free NHS Health Check every 5 years.

9. Additional symptoms of stroke and mini stroke can include sudden:

• loss of vision or blurred vision in one or both eyes
• weakness or numbness on one side of the body
• memory loss or confusion
• dizziness, unsteadiness or a sudden fall, especially with any of the other symptoms

Celebrity campaign supporters

Celebrity supporters of this campaign include Shelley King, Gloria Hunniford, Marcus Birdman and Alastair Stewart. Quotes from the celebrities are included below and interviews are available upon request.

Shelley King, actress who plays Yazmeen Nazir on Coronation Street and supporter of the Stroke Association, said:

Both my mother and grandmother have been affected by a stroke so it’s something incredibly close to my heart and I want to do anything I can to encourage people to be aware of the signs of a stroke and to act quickly if you notice them, either in yourself or in other people around you. Back in the 90s when my mother had a stroke, there was very little awareness – many people wouldn’t have spotted the signs or known what to do, delaying action that could have saved lives. But today, with campaigns like Act FAST, we can be empowered to do more. A stroke can strike at any time – it might be someone just walking down the street who needs your help – so it’s crucial that all of us take notice of the FAST acronym and know to call 999 immediately if we see any single one of the signs.

Gloria Hunniford, television and radio presenter and supporter of the Stroke Association, said:

I know first-hand the importance of recognising signs of stroke and acting fast, having had to do so for my husband, Stephen. I was about to head out of our home to work, when Stephen stumbled into the house from the garden saying his left arm felt like cotton wool. My dad had suffered a series of strokes, so recognising the warning bells, I knew I had to act fast. Not many of us realise how quickly the clock is ticking for someone who is suffering stroke – thankfully Stephen got to the hospital in time to receive clot-busting treatment within the crucial 3-hour time window. Whether it’s just one symptom or more, and no matter how subtle, it’s absolutely essential to call 999 at the first signs of a stroke. I dread to think what could have happened if Stephen was too late – his outlook could have been much worse. Fortunately, he fully recovered.

Alastair Stewart OBE, journalist and newscaster and supporter of the Stroke Association, said:

My father had a stroke and it was devastating for my family. He was my hero and to see him struggling with disabilities afterwards was heart-breaking. I’d encourage everyone to familiarise themselves with the Act FAST acronym so they can act quickly when they see a stroke happening and hopefully avoid someone experiencing the same difficulties as my father.

Markus Birdman, stand-up comedian and supporter of the Stroke Association, said:

I considered myself to be fit and healthy, so when I was 40 and had a stroke it was a shock. I woke up one morning and found it really hard to see; I had absolutely no idea what was going on. You never think it’s going to happen to you, especially not when you’re young, but strokes can happen at any age so it’s important that people know the signs to look out of so they can act quickly. The faster you act, the less damage that is done and the better the person’s chance of a good recovery.”

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Twitter: @PHE_uk, Facebook: www.facebook.com/PublicHealthEngland.

Mr Grant Polson, aged 30 of Cheltenham, was sentenced at Gloucester Crown Court today following a guilty plea on seven counts of the unlawful importation and distribution of medicinal products.

MHRA investigators seized more than 80,000 doses of steroids, and unlicensed and counterfeit erectile dysfunction medicines as well as illegal slimming tablets. They are estimated to be worth more than £38,800.

Importing the medicines from India and Turkey, Polson was selling them illegally online through social media like Twitter and Facebook, investigators discovered. He had customers across the UK, as well as Europe and North America.

Polson received an 8-month sentence, suspended for 18 months. In sentencing the judge noted he was only spared prison because of his early guilty plea. Polson was also ordered to pay £10,000 towards investigation costs.

Alastair Jeffrey, MHRA Head of Enforcement said:

Make no mistake, we are committed to identifying and prosecuting criminals who put peoples’ lives at risk by selling medicines illegally.

Medicines purchased outside the regulated supply chain can be dangerous, and there is no assurance of quality and standards. There can be devastating consequences to your health.

Criminals have no interest in your health and wellbeing; they are only concerned about making money at your expense.

We are cracking down on perpetrators to make sure this type of crime does not pay.

MHRA is currently running the #FakeMeds campaign to warn people against buying potentially dangerous or useless unlicensed medicines sold by illegal online suppliers.

Visit www.gov.uk/fakemeds for tips on buying medicines safely online and how to avoid unscrupulous sites.

The Medicines and Healthcare Regulatory Agency (MHRA) is cracking down on the diversion of Prescription-Only Medicines (POM) onto the criminal market, after first becoming aware of a significant diversion of benzodiazepines and other hypnotics/anxiolytics in 2016.

During 2017 MHRA expanded operations to 19 active investigations and have made more than 40 arrests. Our investigations have revealed an extensive network of criminality involving businesses such as wholesale dealers and a small number of registered pharmacies throughout the UK diverting medicines.

Between 2013 and 2016 an estimated £115-200m of medicines were diverted from the legitimate supply chain onto the criminal market, putting thousands of vulnerable people at risk.

The independent review into dependence and addiction to prescription drugs, recently announced by the Department of Health and Social Care, highlights the scale of the problem. The review will be looking into the results of a recent Home Office survey which found 7.6% of adults had taken a prescription-only painkiller not prescribed to them.

Arrests have been made for offences such as possession with intent to supply a controlled drug, and offences under the Proceeds of Crime Act.

The focus of our investigation is Prescription-Only Medicines such as benzodiazepines and anxiolytics including Diazepam and Zopiclone as well as the painkiller Tramadol.

These medicines are being sold through websites acting illegally, and people should be careful when buying medicines online. Criminals are known to exploit vulnerable people by selling medicines through unregulated websites and stealing their credit card details.

Self-diagnosis and self-medication can be dangerous. All of the Prescription-Only medicines currently being investigated have the potential to result in addiction. However, when these are appropriately prescribed there are measures in place to reduce this risk including restrictions on the dose or duration of treatment.

There is no indication this criminality has led to medicines shortages or issues with the legitimate supply of medicines to the public and medicines supplied with a prescription, through registered pharmacies, are unaffected.

Alastair Jeffrey, MHRA Head of Enforcement, said:

Selling medicines outside of the regulated supply chain is a serious criminal offence and we are working relentlessly with regulatory and law enforcement colleagues to identify and prosecute all those involved in this activity.

The medicines being sold are potent and should only be taken under medical supervision.
Criminals involved are exploiting people when they are at their most vulnerable; their only objective is to make money.

We will continue to concentrate our efforts on identifying the criminals involved and ensure they are prosecuted through the courts.

Victoria Atkins MP, Minister for Crime, Safeguarding and Vulnerability said:

I welcome this investigation by the MHRA, which shows there is no hiding place for criminals who try to sell prescription drugs illegally.

Drug misuse can cause untold harm and devastate lives and this Government will take whatever action is necessary to keep our families and communities safe.

Our Drug Strategy sets out a balanced approach which brings together police, health, community and global partners to tackle the illicit drug trade, protect the most vulnerable and help those with a drug dependency to recover and turn their lives around.

Duncan Rudkin, Chief Executive of General Pharmaceutical Council:

We are working closely with the MHRA on the ongoing investigations into these very serious criminal offences. We have already taken action to suspend five pharmacists under interim orders and are actively reviewing at each stage of the investigations whether we need to take further action to protect the public.

We would also strongly urge people not to take any prescription medicines unless they have a valid prescription, as they could be putting their health at serious risk.

People wishing to report criminal activity relating to the diversion of these medicines should report this to us to our case referrals email address: CaseReferrals@mhra.gov.uk. You may also provide information anonymously through Crimestoppers

Routes to Diagnosis now includes 10 years’ worth of data, covering more than 3 million cancer cases, making it the most comprehensive dataset of its kind in the world.

The data shows a dramatic improvement in the way some cancers are being diagnosed across England, but also pinpoints areas where improvements could still be made.

Key findings from the latest Routes to Diagnosis data include:

• diagnoses from emergency presentations, where outcomes are the worst, have improved falling from 24% to 20% between 2006 to 2015
• diagnoses through urgent GP referrals – 2 week waits – have increased significantly from 25% in 2005 to 37% in 2015, meaning that around 110,000 cases are now diagnosed this way
• diagnoses of pancreatic cancer through emergency presentation – with the very worst outcomes – has fallen by 6%, a significant drop
• diagnoses of colorectal cancers through the national bowel screening programme – the route with the best survival rate – remain under 10%
• the number of cancer cases diagnosed in Accident and Emergency varies across the country , ranging from 8% of all cases in the Peninsular Cancer Alliance to 20% of all cases in the London Cancer Alliance – this is despite similar cancer incidence levels

This latest update includes a new interactive tool which, for the first time, shows trends in cancer diagnosis for 53 different types of cancer. By using the tool doctors and managers will be able to quickly and easily see the differences between cancers and understand where survival rates are improving.

Dr Jem Rashbass, Cancer Lead at Public Health England said:

Diagnosing cancer earlier is one of the most important ways to improve cancer survival and we know that those patients who have their cancer diagnosed as an emergency have poorer outcomes. In England we have pioneered the analysis of routes to diagnosis data which allows us to highlight where we are making an impact and where challenges still remain.

Health Minister Steve Brine said:

With cancer survival rates at a record high it’s imperative that we continue to see a greater awareness of the signs and symptoms of cancer.

These figures demonstrate that our healthcare professionals are making a real difference by giving patients quicker referrals so they can access the best treatment available.

Sir Harpal Kumar, Cancer Research UK’s chief executive, said:

The earlier cancer is detected, the greater the chance that treatment will be successful. This Routes to Diagnosis data is an invaluable tool to see how we can diagnose cancer earlier.

We’re pleased to see that the proportion of people who are diagnosed as an emergency has fallen, but with 40,000 cancers still diagnosed in A&E each year in England we know that more improvement is needed.

The main reason the number of cancer diagnoses are increasing is because people are living longer and risk is of developing cancer increases with age. Lifestyle factors, such as the increase in obesity over the last few decades have also contributed to the rise in cases.

Case study

Earlier diagnosis leads to more successful treatment, so this data also highlights the importance of our cancer screening programmes in detecting cancer early.

Julia was diagnosed with stage 2a cervical cancer after her GP quickly referred her as a 2 week wait following post-coital bleeding; however she knows that it would have been detected earlier if she had attended her routine cervical screening appointments.

Julia Tugwell, cervical cancer survivor said:

I believe that if a GP or other healthcare professional had questioned me directly about my lack of screening attendance, over many years, I would have been more likely to have attended.

The new data shows that 3-year survival for cervical cancer following a screening diagnosis is 95%, compared to 65% when picked up through the 2 week wait – when symptoms might indicate a later stage cancer.

Background

1. National Cancer Registration and Analysis Service (NCRAS) is part of Public Health England and works to drive improvements in standards of cancer care and clinical outcomes by improving and using the information collected about cancer patients for analysis, publication and research.
2. Routes to Diagnosis groups patients into 1 of 8 routes:

• screen detected
• emergency presentation
• 2 week wait
• GP referral
• other outpatient
• inpatient elective
• death certificate only
• unknown

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Twitter: @PHE_uk, Facebook: www.facebook.com/PublicHealthEngland.

Three of the UK’s leading construction companies have been chosen to create Public Health England’s (PHE) new state-of-the-art public health science campus and headquarters at Harlow, Essex.

They have been selected for the 4 key elements of the £400 million capital spend programme to create the campus. This includes building and refurbishing new and existing laboratories and office areas; construction of a new arrivals area and logistics centre; and site-wide infrastructure including car parking.

The appointments, creating thousands of construction-related jobs, sees the end of an 18-month procurement process, with work expected to start next month.

The successful companies bid for 4 lots:

• lot 1 – new build of specialist bioscience laboratory building – Kier Group
• lot 2 – refurbishment of main building, including laboratories and offices – Wates Construction
• lot 3 – arrivals, administration and logistics buildings – Wates Construction
• lot 4 – site-wide infrastructure, external works and energy centre – VolkerFitzpatrick (Royal VolkerWessels)

The appointment of all 3 contractors provides a boost to local employment – particularly in the case of VolkerFitzpatrick, whose head office is located in the neighbouring town of Hoddesdon.

The next steps will see the contractors working with the existing design teams and preparing the site for major construction. This is planned to start in 2019, with phased occupation starting in 2021.

PHE Harlow, as the campus will be known, is expected to employ up to 2,750 people by 2024, with scope for further expansion.

Facilities from Porton in Wiltshire and Colindale in north London, as well as PHE’s central London headquarters, will be relocated to the single centre of excellence for public health research, health improvement and protection.

The campus is critical to the future of PHE, ensuring we will be able to use the latest scientific advances to deliver our world-leading science and evidence for issues such as smoking, alcohol, diabetes, dementia, infectious diseases, environmental hazards and climate change nationally and internationally.

Richard Gleave, PHE Deputy Chief Executive, said:

PHE is delighted to have secured 3 of the leading construction companies in the UK to deliver what will be a world-leading national and international resource.

Much of the work to create PHE Harlow is highly specialised so it’s especially pleasing to have secured 3 of the best companies in their fields to deliver that work. This is yet another milestone for PHE and we can now look forward to the chosen contractors coming on board and bringing their considerable wealth of experience and skills to our programme.

We are also delighted at the very significant opportunities that the construction of PHE Harlow will offer in the surrounding area.

Nigel Brook, Kier Group Executive Director, Construction and Infrastructure Services, said:

This £160 million project is another significant award for Kier in bioscience, building on our track record as a specialist delivery partner in the sector with projects including biomedical research facilities for the University of Cambridge with Project Capella and the Sainsbury laboratory as well as the state-of-the-art Derriford Research Facility for Plymouth University.

We’re looking forward to providing a state-of-the-art facility which will help Public Health England to keep improving the nation’s health and wellbeing.

Ian Vickers, Managing Director, Wates Construction Home Counties, commented:

PHE Harlow will play a pivotal role in improving public health, providing state-of-the-art facilities for industry-leading scientists and doctors to address some of the most pressing medical and environmental challenges the world is currently facing.

It is therefore a particular privilege for Wates to be awarded 2 of the 4 lots. It is also a huge responsibility, and over the next year we will be working closely with PHE and other partners as we prepare to start on site in early 2019.

Richard Offord, Managing Director of VolkerFitzpatrick said:

We are delighted to be working with PHE on such a forward-thinking project. The new public health science campus will support the growth of the local area and we are looking forward to starting work on this exciting opportunity.

Background

1. PHE submitted an Outline Business Case to government in July 2014. An interim decision was taken in September 2015 to move the majority of PHE functions from Porton to Harlow. In November 2015 the government supported a further proposal to move PHE science facilities at Colindale to Harlow to create a single integrated campus. The government has committed £400 million capital investment for the project.

2. Today’s announcement comes less than 3 weeks after PHE was granted outline planning permission by Harlow District Council to create its centre of national and international scientific expertise.

3. It is hoped the public health science campus will be fully operational by 2024, with the first building work expected to start in 2019 and a phased occupation from 2021.

4. The campus will allow PHE to fully embrace the new technologies of whole genome sequencing, public health interventions and ‘big data’ and transform the delivery of public health science for many years to come. Whole genome sequencing is the mapping of a person’s unique DNA and enables more accurate, sophisticated and cost-effective genetic testing.

5. Kier Group plc is a leading property, residential, construction and services group which operates across a range of sectors including science, defence, education, housing, industrials, power, transport and utilities. Among the schemes it has been involved in, the most relevant are Project Capella, a large biomedical research facility, and the Sainsbury Laboratory both in Cambridge.

6. Wates Construction has a long track record across both the public and private sectors and has worked on projects across a variety of areas, including education, commercial, heritage, local authority frameworks and mixed-use. These have included the delivery of major projects for both the Pirbright Institute in Surrey and the Quadram Institute in Norwich.

7. VolkerFitzpatrick is a multi-disciplinary contractor working in the civil engineering, building, rail, waste and energy infrastructure sectors. The head office is at Hoddesdon in Hertfordshire just eight miles from the PHE Harlow site. Founded in 1921, the company has grown to become one of the top contractors in the UK. VolkerFitzpatrick constructed a third berth at the UK’s new deep-sea hub port, 25 miles from central London at Stanford-le-Hope and was appointed by Siemens to design, build and commission two train care depots in Hornsey, north London and Three Bridges near Crawley, West Sussex. VolkerFitzpatrick is part of VolkerWessels UK, a multi-disciplinary construction and civil engineering group.

8. Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Twitter: @PHE_uk, Facebook: www.facebook.com/PublicHealthEngland.