A consultation on the future of urgent stroke services in Kent and Medway opens today (February 2).
The NHS in Kent and Medway, Bexley in south east London and the High Weald area of East Sussex is asking for people’s views on proposals to create three new 24/7 hyper acute stroke units in Kent and Medway, meaning the removal of services from sites including the QEQM Hospital in Margate.
The consultation runs from today for 10 weeks until midnight on Friday 13 April .
To take part, people can read the consultation document, take part in public meetings and events, and complete an online or postal questionnaire. There will also be specific engagement through focus groups and other work with people whose views are less likely to be heard, and people whose age, ethnicity or other factors puts them at higher risk of a stroke.
Hyper acute units
General stroke services are provided in all the hospitals across Kent and Medway, including the QEQM, but there are currently no specialist hyper acute units.
NHS bosses in the region say larger, specialist units in other parts of the country have been shown to improve outcomes for people who have had a stroke.
The hyper acute stroke units will each have a multi-disciplinary team of specialist stroke clinicians, seven days a week. The units will care for all stroke patients across Kent and Medway and from some neighbouring communities in Sussex and South-East London, in the critical first 72 hours after a stroke.
The NHS says as staff in the new hyper acute stroke units see and treat more stroke patients, they will become even more expert in their care. This is also expected to improve the recruitment and retention of staff, as it will give them greater job satisfaction, and greater opportunities to progress their careers.
In London, hyper acute stroke units have reduced deaths from stroke by nearly 100 a year.
A proposed shortlist of possible options has now been created which reveals the hyper unit in east Kent will almost certainly be based at the William Harvey Hospital in Ashford.
The shortlist is:
A. Darent Valley Hospital, Medway Maritime Hospital, William Harvey Hospital
B. Darent Valley Hospital, Maidstone Hospital, William Harvey Hospital
C. Maidstone Hospital, Medway Maritime Hospital, William Harvey Hospital
D. Tunbridge Wells Hospital, Medway Maritime Hospital, William Harvey Hospital
E. Darent Valley Hospital, Tunbridge Wells Hospital and William Harvey Hospital
The East Kent Hospitals University Foundation Trust runs stroke services at QEQM and was asked if it could set up and run more than one hyper acute stroke unit. EKHUFT concluded it would be difficult to attract enough specialist stroke staff to safely run two units. This meant options with a hyper acute stroke unit at both the William Harvey Hospital and the Queen Elizabeth the Queen Mother hospital (the two sites managed by EKHUFT) were evaluated more poorly than the other options.
Dr Mike Gill, Independent Chair of the Joint Committee of Clinical Commissioning Groups for Kent and Medway Hyper Acute and Acute Stroke Services said, “This consultation is an opportunity to make your voice heard and help us design the best stroke services in Kent and Medway. We encourage everyone to respond, whether you have been involved in the earlier work or not; whether you work in the local NHS or are a resident; whether you have first-hand experience of stroke or not. All views are important to us.”
NHS bosses say changes to stroke services are being proposed because currently hospitals are not able to consistently deliver the standard and quality of stroke care that people should be able to expect. The proposals have been developed by stroke doctors and other stroke specialists.
Dr David Hargroves, clinical lead for the stroke review and senior stroke consultant at East Kent Hospitals University NHS Foundation Trust, said: “We know that patients might currently be able to get to an A&E fairly quickly and the thought of travelling further seems to go against the ‘Act F.A.S.T.’ advice. With stroke, what counts is the total time it takes from calling 999 to having a scan and starting the right treatment. Spending 15 minutes in an ambulance but waiting three hours in A&E is worse than an hour in an ambulance going to a specialist unit that can scan you and start treatment within 30 minutes of arrival. It is also vital for patients’ recovery that over those first three days they are seen by a stroke consultant every day, and regularly assessed by specialist therapists – something we can’t always offer at the moment.”
Creating the hyper-actute units will cost some £40million but NHS bosses say it costs less overall when patients are treated in hyper acute stroke units because more patients can leave hospital sooner, and with less disability, they need less support in the long-term.
However parliamentary researcher, Dr Rebecca Gordon-Nesbitt, who lives in Thanet and is a specialist on health policy, said: “The new proposals will mean that Thanet stroke victims would have to travel to Ashford rather than Margate. This much longer journey would exceed the one-hour maximum that most authorities say is essential to a stroke victim’s outcomes.”
Dr Gordon-Nesbitt argues that high levels of poverty mean Thanet is in greater need of stroke services than other areas. She said: “Evidence shows a direct relationship between levels of poverty and the likelihood of stroke. Thanet suffers from the worst deprivation in the county. There are 50,000 people living in the most deprived conditions with an average life expectancy up to 18 years shorter than that found in more affluent wards. Thanet needs to improve its services for stroke patients, not lose them altogether. If implemented, these new and unfair proposals will put local people at risk.”
Save Our NHS In Kent
A spokesperson for the Save Our NHS In Kent said: “We are calling for the best possible service for stroke patients across Kent. Why not have hyper active stroke units both in Ashford and in Thanet? We should have services where there is patient need. We suspect that behind these proposals there are financial considerations — which is disgraceful.”
A demonstration protesting the removal of stroke services from QEQM, organised by Save Our NHS in Kent, will take place outside the hospital’s main entrance on Ramsgate Road, Matgate, tomorrow (February 3) between noon and 2pm.
The NHS in Kent and Medway, Bexley in south east London and the High Weald area of East Sussex will hold a consultation event at Minster village hall, in the High Street, on March 7 from 2pm to 4pm.
To register attendance click here
To find out more about how to respond to the consultation visit www.kentandmedway.nhs.uk/stroke.