India has only 35 stroke units for its one billion people, and this partnership aims to change that. Stroke is now the most common cause of death globally, and India is among the three countries with the highest number of stroke deaths worldwide. People in India typically suffer their first stroke at a much younger age than in the UK, creating a severe socio-economic burden. This research group will bring together the University of Central Lancashire’s Stroke Research Unit with Indian colleagues to develop and test practical, low-cost improvements to stroke unit care that work within India’s existing health systems. The focus is on smart solutions that can be implemented at scale, such as reorganising ward routines or training nurses to deliver early rehabilitation. If successful, this could reduce death and disability from stroke across India, and the findings would be relevant to other low- and middle-income countries facing similar challenges. The project also builds research capacity through joint appointments, training, and shared infrastructure, aiming to sustain this work long after the initial funding ends.
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a)UCLan's research strategy is to develop and delivering world-class research with real world impact, by increasing research activity and delivering a step-change its quality. Our focus is on delivering patient-centred applied research that is relevant to local, national and international challenges. Several UCLan research teams are recognised as delivering world-class research (1), one of which is the Stroke Research Unit (SRU) within the Faculty of Health and Wellbeing (FHW), led by Prof Dame Caroline Watkins (CW). The SRU has developed and delivered large-scale collaborative national and international studies. The creation of this GHRG aligns with our research ambitions. This genuine partnership, the available support, and our real-world approach will create an environment to enable development of high quality stroke research with India. b) UCLan can make this application as we have the required knowledge, experience, skills, support mechanisms and staff to deliver the project. We will build on our previous achievements to develop capacity in research aimed at addressing global health challenges with LMICs. We are committed to the success of the partnership ensuring building for sustainability. The UCLan team draws on those with clinical and research expertise accessing staff from the large Stroke Research Unit(n=18), methodologists (n=7), and the Research Support Team; a flexible resource of research administrative and academic staff (n=20) who can be assigned to the programme or can initiate work whilst new appointments are made. UCLan Faculty's Lancashire Clinical Trials Unit (CTU, n=10) has experience of developing, delivering and supporting delivery of multi-centre studies, including national coordination and trial management across multiple sites for global studies. c)Formation of the GHRG will be the first opportunity for the collaborating organisations and individuals to develop and deliver stroke research on global challenges faced by India and other LMICs. We will build on successful collaborations that have effectively supported practice-changing research over many years. These include joint appointments, jointly held funding awards, research support infrastructure and centres, shared support for postgraduate research students, internships, research training and clinical networks. We will extend and formalise our existing connections to strengthen the partnership. We will work with research funders, policy and decision makers, commercial and non-governmental organisations to identify, create and benefit from opportunities to extend and sustain stroke research beyond the end of the award period. d)Stroke is a recognised global health challenge; cardiovascular disease including stroke is now the most common cause of death globally(2). India is one of the three countries with the greatest number of recorded stroke deaths worldwide (3), and people typically suffer a first stroke at a much younger age than in the UK (5) leading to significant socio-economic burden (6). With only 35 stroke units serving India’s one billion population, there is enormous unmet need (7). Stroke unit care has great potential to reduce mortality and morbidity as it is the most widely applicable effective intervention (8). We will work in partnership with colleagues in India to develop, support and undertake relevant needs-led research around stroke unit care that is suited to current services and systems, and supports improved stroke care through smart solutions workable in LMICs. We will deliver outcomes that reduce the burden of stroke in India, and that have global relevance. Together, we have already identified key priorities in stroke care, and thus research opportunities in India. We have begun to develop criteria for understanding what is desirable and feasible to maximise clinical and cost-effectiveness, including potential for large-scale implementation; patient numbers who may benefit; and low-cost interventions with
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