Dr Dick Symonds: A fourth hyper acute stroke unit should be sited at QEQM Hospital

Photo Lillian Constantine

A consultation event will be held in St Peter’s on March 24 on plans to create a hyper-acute stroke unit at the William Harvey Hospital in Ashford.

The hyper acute unit would serve east Kent and so mean the removal of the stroke service at Margate’s QEQM Hospital. It is part of a wider proposal by the NHS in Kent and Medway, Bexley in south east London and the High Weald area of East Sussex to create three new 24/7 hyper acute stroke units in Kent and Medway, meaning the removal of services from other sites.

Consultation on the plans runs until April 13. A listening event will be held at St Peter’s Church hall in Hopeville Avenue, St Peter’s, at 10am on Saturday, March 24.

Semi-retired NHS psychiatry consultant and chair of the Broadstairs Labour Party Dr Dick Symonds  speaks about the view of members from the Campaign for Stroke Care in Thanet by the Thanet Labour Parties and ‘Save Our NHS in Kent’ (SONIK), that a fourth hyper acute unit should be situated at the QEQM:

“We entirely agree the need for Hyperacute Stroke Units (HASUs) in Kent. They have worked well in improving stroke outcomes in London. But Kent, the largest county, is not London, and this is not entirely a medical problem, but is as much a public health problem.

The key questions of a ‘stroke’ are: is the stroke a brain clot, a brain bleed or a brain tumour, or something milder? ‘Clot-busting ‘ drugs improve the outcome in clots: but may worsen the outcome in bleeds and tumours. To decide when to use the drugs, expert clinical examination and crucially, radio-imaging, must be used very rapidly. ‘Time is brain’. Brain cells damaged by the clot are lost, but the area surrounding them can be saved and is vital in recovery. The brain can make new connections, if taught to do so, by specialist physiotherapists and other therapies. All this means expert teams.

The stroke service in Queen Elizaabeth the Queen Mother Hospital (QEQMH) has been blindly assessed in the near past and found to be the best performing in Kent. The basis of that expert team is there, but they need more facilities to become a HASU.

Thanet is a deprived area of Kent with a higher risk of stroke. Approaching 150,000 population on the rim of Kent, it is over an hour best travel time to the nearest proposed HASU, William Harvey Hospital. The M20 is the main route from channel ports, often blocked by accidents and ‘Operation Stack’. Conventional public education and medical literature all suggest an hour as the crucial time from stroke (not ambulance arrival) to assessment, in order for the assessment and treatment to be implemented within a total of 4 ½ hours.

Only Thanet Clinical Commissioning Group (CCG) has the legal power to implement major service changes, and so far the decision has not been made. We respect the physicians’ expertise but they can only advise on a service, not implement it. This why it is a public health issue for our NHS authority, Thanet CCG, which has to ensure that our citizens are treated equally with the rest of Kent, for an equal chance of a good outcome.

Siting a HASU, in the QEQMH, is the way to achieve this and should have been obvious, but such developments are being pruned back through lack of government funding and this is the real reason for not covering the whole of Kent with 4 HASUs. HASUs are the sort of welcome improvement which makes for inflation in the NHS. The government’s slightly increased funding for the NHS does not meet the inflation.

If you are poor in London, your stroke will be treated rapidly: however rich you are in Thanet, you might be treated too slowly. You cannot fall back on private medicine. They don’t handle acute stroke care because there is no profit in it. For emergencies, only the NHS will save you. Our NHS.”

A different view: Stroke service proposals: Consultant Dr David Hargroves

To find out morewww.kentandmedway.nhs.uk/stroke – to read the consultation document and find meeting dates.

To find out about the SONIK campaign go to  www.saveournhskent.org.uk


  1. So we now have one consultant telling us that Thanet doesn’t need a HASU one telling us that it does . . .

    Perhaps these very clever people need to sit down at the same table at the same time and agree to tell us which version is actually best for us mere mortals ?

  2. There is no confusion amongst the medical consultants.The closure of the QEQM Stroke Unit is a Political/Financial decision, based on the current governments determination to reduce the money spent on the wider population.
    Medically, Thanet needs a Stroke Unit, but, as I say, the needs of the population are not taken into account. The decision is based on a political philosophy that involves transferring money up the chain to the wealthiest. Why punish Thanet in particular ? Because the population has chosen to keep voting Tory or,even the “Tories-in-exile” , UKIP. So we are an easy touch. We won’t complain. In fact, we just go on voting for our own worst enemies as long as they wave the Union Jack enough.

  3. It would make great sense to have an HASU at the QEQM in Margate to serve a wide population without having to travel for an hour or longer to reach Ashford. Whoever decided not to include Thanet in the list of Hyper Acute Units needs to look again at populations and transport, roads, etc, then change their minds.

  4. Of course it makes more sense to have a Stroke Unit at QEQM because of the distance to Ashford. But “sense” doesn’t come into it. It’s all about money and the belief in “austerity”. This is what “austerity” gets us. There’s no point in thinking that the medical authorities are just a bit confused or didn’t notice something important. They know exactly what they are doing. They are “saving money” in order to reduce taxes for the wealthy. That is what they are employed to do.

  5. Centralisation of services is the new mantra amongst the NHS hierarchy; as the NHS is being funded less than in previous years, money must be saved, and centralisation into fewer units is one way to begin that process, but it has been shown in studies that moving services further away from populations that need it can have a detrimental effect on outcomes (Kelly, Hulme, Farragher et al, BMJ Open research paper, 2016). Save Our NHS in Kent are concerned about the weakness of evidence being used to roll out this change to stroke care, and about the fact that ‘time is brain’, as mentioned here by Dr Symonds. We are also concerned about how this ties in with the A&E reconfiguration, also coming up this year. We have been told that where the A&E goes, the HASU goes…so this doesn’t bode well for 2 A&Es in East Kent. If QEQM loses A&E, maternity and paediatrics are likely to follow, as those services rely on A&E availability. We have to challenge this push to centralisation as it ultimately it could mean far fewer hospitals, and to fight against this effectively, we need the public to join with us, protest with us, sign petitions and send emails. Please get involved with SONIK at http://www.facebook.com/SaveOurNHSKent/

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