A consultation on changes to stroke services, which could mean the closure of the unit at QEQM Hospital in Margate,closes on April 20.
Health chiefs want to create three hyper acute stroke units for Kent and Medway. A shortlist of options for the specialist units lists only the William Harvey Hospital in Ashford for east Kent.
The NHS says hyper acute stroke units will reduce deaths as each will have a multi-disciplinary team of specialist stroke clinicians, seven days a week caring for patients in the critical first 72 hours.
But Thanet campaigners say isle lives will be at risk because of journey times to Ashford. Members of Save Our NHS in Kent (SONIK) have launched a formal challenge and say they may seek a judicial review over the proposals.
Here Tara Galloway, Head of Stroke Support for the Stroke Association, gives her view on the proposals:
I am I am Head of Stroke Support for the Stroke Association. I see first-hand the devastating impact that stroke can have on people and that is why the Stroke Association supports this reorganisation of acute stroke services. Stroke brings with it massive social and economic cost. It remains the fourth biggest killer in the UK and almost two thirds of stroke survivors leave hospital with a disability.
Reorganising services to a more centralised model, as is proposed in Kent and Medway, has been proven to save lives and improve recoveries because, put simply, it gives patients a better chance of receiving the best quality care. In the places where reorganisation has already taken place, patients spend less time in hospital and are less likely to die as a result of their stroke.
Despite the hard work that stroke team at all the hospitals in Kent and Medway do, too many patients are not getting the world class care they should expect. For example one in three stroke patients are not getting crucial diagnostic brain scans in the recommended time after arriving at hospital, meaning their treatment is being delayed. Access to potentially life-saving clot-busting drugs also varies depending on the hospital you get treated at.
We firmly believe that centralising acute care into three hyperacute stroke units or HASUs will help to address this postcode lottery and ensure more people are able to be treated in a way which improves their likelihood of a good outcome after stroke.
We understand how worrying it is to hear that local stroke units could be closed or repurposed or that patients will have to travel further for treatment. But the evidence is clear that getting people to a HASU, where patients have a better chance of being treated by stroke specialists round the clock, can save lives and reduce the chance of stroke survivors ending up with a serious disability. That’s why we’re working hard across the UK to press for all areas to look at the evidence and take urgent steps to centralise their stroke services.
Stroke service reconfiguration isn’t something that’s been limited to big urban areas. It has been successfully done in areas such as the South West of England and reconfigurations are planned in Northern Ireland and Wales. Travel time to hospital is only one of several factors affecting speed of treatment. Lack of access to fast brain scanning, thrombolysis and access to specialist units can also create unnecessary delays and these delays are less likely in a HASU.
This is an important time for stroke services in Kent and Medway and it’s important that everyone has the chance to make their views known. I’d encourage stroke survivors, families and anyone else interested to respond to the consultation before it closes at midnight on Friday, April 20.
To respond, please visit www.kentandmedway.nhs.uk/stroke
Read here: Save Our NHS in Kent: The proposed closure of QEQM’s stroke unit
In this article, Tara Galloway successfully confirms that patients are better able to survive a stroke if treated in a specialist stroke unit, as proposed for William Harvey hospital in Ashford. And that QEQM does not have the top-class equipment that Ashford would have.
But this just means that, to be effective, QEQM must be similarly equipped, NOT abandoned. I accept the need for specialist stroke units with better staff and kit than QEQM, but that just means that QEQM, and other Kent hospitals that lie within a safe distance for all patients, should be re-equipped with the right stuff.
The government are deliberately reducing the funds available to keep the NHS on top of all new medical approaches.That is what lies behind the plan to close the stroke unit at QEQM. They are reducing the number of stroke units in Kent overall, NOT improving the service(except for those people lucky enough to live within a few minutes of one of the three new units.)
Britain already spends less per head on health than most other ,comparable, European economies. “Austerity” is a con. Most of us suffer cuts and service reductions, but the wealth of the top 1% has been increasing completely unchecked. Britain is NOT short of money. It is just in the wrong hands.
The consultation process has been flawed from the start and those running it appear to have been found to be lying over and over again, does anyone really believe that this administration would provide anything ‘world class’? Even with fantastic resources, Ashford is too far to travel for people in Thanet to receive this treatment in time
The stroke review plan is about two things: 1. the improvement to stroke services that will be brought about by speeding up of brain scans and also treatment with clot busting drugs plus more consistent specialist care and 2. the attempt to centralise services into fewer units with shorter hospitals stays, halving the number of hospitals that provide urgent stroke care in Kent from 6 to 3; this will save NHS hospital trusts money but could cause more deaths in ambulances, cause more long term disability in patients due to longer ambulance journey times, cause a deterioration of the district general hospitals that lose their acute services, and put pressure on the ‘closer to home’ services as the 3 new HASU units that are proposed will aim to send patients back to their local area swiftly. These two things have been deliberately partnered together so that one can disguise the other.
The improvements in ‘door to needle time’ (hospital door to receiving a clot busting drug) may not be enough to counteract the substantial increases in ambulance journey times which will adversely affect more deprived areas of Kent such as Thanet and Sheppey. For these populations, the ‘call to needle time’ (calling 999 to receiving clot busting drugs) will in many cases increase, meaning that patients may die en route to hospital or may suffer so much damage on that long ambulance journey that little can be done when they reach hospital. It means that patients from the outlying areas could suffer more mental impairment and physical disability, being sent back to areas like Thanet and Sheppey needing much more long term care.
In earlier iterations of this plan, 30 or 45 minutes have been seen as the ‘critical’ or ‘safe’ time limits for ambulance journeys for stroke, which is an extremely time critical condition.
The stroke review plan takes in the population of Kent (1.8m) and some ‘border areas’ (parts of southeast London and E Sussex), making the total population 2m. With all 5 options, there is a percentage outside the ambulance journey time of 45 minutes – in all cases, that is a approximately 180,000 people. 141,000 of those people are in Thanet, which is the only area in Kent which currently knows exactly where it stands, as all five options leave Thanet very poorly served, having to travel one hour to Ashford. The remaining 39,000 are in different areas of Kent, according to which option you’re looking at. This is 10% of Kent’s population, that’s 180,000 people who have been sidelined in this plan – a huge number.
Crazy response from the stroke association spokesperson. Has she not read how patients in Thanet will suffer irreparable damage and death by travelling over 40 miles and potentially over an hour away. Privately paramedics believe the 45 minute journey isn’t achievable. Many doctors feel the decision to move QEQM Stroke services is flawed and dangerous. Be a patient advocate Stroke Association and not the voice of the STP.
In the Stroke Association literature on this they also say:
“We know that reorganisation may not work in all areas” and “ we urge healthcare leaders to……explain, after looking at the evidence, why they are not able to do so”
Kent and Medway must be one of these areas if they cannot provide more than 3 HASUs.
The lady from thre stroke association mentions that HASUs have been trialed in rural areas but she does not quote where and what evidence. The evidence from London where of course the patient is much closer to hospital is not very impressive, with only a 1.5 reduction in mortality . Nor does the evidence from mManchester impress as that showed no reduction in mortality beyond that which was seen throughout the UK as a whole. A nurse at a Kirklees and Calderdalelistening event commented that no evidence had been submitted supported the case for change
If it’s all so clearly a good thing why are they holding so many “listening” events and asking us what we think and hoping people in Thanet will support the proposed changes? We’d be mad to! It looks as if Thanet people are being sacrificed in favour of north Kent residents who will get to the new super stroke units much faster than we will! It takes an hour or more to Ashford from where i live even in a blue light ambulance – I’ve done it recently! It takes ten minutes to Margate hospital. We all need a good hospital near where we live!
Very sad that a representative of the Stroke Association is condoning worsening of services for 141;000 people. If she had looked at the consultation documents fully, would have seen that QEQM already has the same level of care as WHH. All that is needed ito improve the service is swallowing and physio coverage for Saturday and Sunday_ and this is not 24 hour, and for access to more specialist cover on the weekends, this could be via telemedicine. My uncle was admitted YESTERDAY with a possible stroke. 15 minute ambulance time to QEQM, admitted immediately to the stroke unit, assessed then had scan. All well within the ‘golden hour’ which patients in Thanet will be denied with closure of the unit.