A final decision on the location for three hyper-acute stroke units (HASUs) across Kent & Medway has been confirmed by the Joint Committee of Clinical Commissioning Groups (JCCCG) at the meeting in Maidstone today (February 14).
The units will be at Darent Valley Hospital, Maidstone Hospital and William Harvey Hospital – meaning the closure of acute services at Margate’s QEQM Hospital as well as at Medway Hospital, Tunbridge Wells Hospital, and Kent & Canterbury Hospital – which has already had its service withdrawn due to the removal of training doctors by Health Education England in March 2017
The plan is for Darent Valley to have a 34 bed unit, Maidstone General Hospital 38 beds and William Harvey Hospital 52 beds. There will also be a two bed outflow at Eastbourne General Hospital.
The decision comes despite a sustained campaign for more than a year by Save Our NHS in Kent, isle county councillors and many members of the public.
SONiK has been fighting for a fourth HASU at QEQM and is now urging members of the Kent County Council’s health scrutiny committee to vote to refer the plan back to government when they discuss it again on March 1.
Plans for going live -and the costs
The JCCCG expects the hyper-acute units at Darent Valley and Maidstone to go live in March 2020 followed by the William Harvey Hospital in spring 2021.
The final decision was taken in private following disruption from angry health campaigners earlier in the session.
To house the new unit at William Harvey Hospital will require a new build 32 bed ward, linked to the existing stroke ward to create a single unit The total cost for the build is estimated at £20.9million.
Currently for east Kent there are 24 stroke beds at WHH, 22 at QEQM and 24 at K&CH, only the 46 beds at WHH and QEQM admit hyper acute patients.
The new units are expected to reduce financial deficits in the Kent and Medway service, although a review of those finances will take place.
An estimated £13.6m was spent by CCGs on acute stroke activity in the Kent and Medway catchment area in 2016/17. Hospital stroke services are currently running at an estimated £7.5 million deficit. The new service would decrease that deficit by £0.5m
The cost to CCGs of implementing the new hospital stroke service model has been estimated at £3m per year :
- An estimated £1.7m, comprising the costs of re-training the work force, double running, excess travel and agency premium to continue services on those sites set to cease services.
- An estimated £1.6m costs for agency premium to continue services on those sites set to cease services.
- A proposed annual £0.5m (full year effect) increase in ambulance costs reflecting the impact of the increase in ambulance mileage.
- Plus a £3.3m for programme management costs to implement the changes and three years for the renting of a modular building in Dartford
These costs are in addition to a total capital investment of £27.7million.
Health professionals in Kent and Medway are now designing new stroke rehabilitation services, including hubs.
Care will include rehabilitation therapy at home and in clinics as needed for up to six months; intensive rehabilitation at home three times a day, seven days a week; care in an inpatient rehabilitation unit for up to six months or care in a nursing or residential care home.
Kent and Medway NHS says the new approach to rehabilitation must happen at the same time as the implementation of hyper-acute stroke units. A rehabilitation business case will be presented to CCGs this Spring and today’s meeting agreed implementation of the services should be done alongside the opening of the hyper-acute units.
A new build at Canterbury
The JCCCG agreed the William Harvey unit option despite proposals that could see the service having to be shifted again if a new general hospital is built in Canterbury. As part of looking at two options for urgent, emergency and acute medical services in east Kent, commissioners are also discussing whether to move maternity and children’s inpatient services to a new hospital in Canterbury and options for moving specialist services to either Canterbury or Ashford.
There has been an offer by Quinn Estates to build the shell of a new hospital in Canterbury as part of a development of 2,000 new homes. It would involve changes at all three sites, including moving some services currently provided at the William Harvey and QEQM hospitals.
Under this option there would be an A&E department for east Kent at the major emergency centre at Canterbury. This would mean that A&E, acute medical care and complex inpatient surgery, which currently take place at William Harvey and QEQM, would relocate to Canterbury. This would likely include moving the HASU despite the investment at Ashford.
Rachel Jones, Director for the Kent and Medway Stroke Review, said: “We would like to thank everyone who has been involved in the stroke review. This has been a detailed and robust process, led by stroke specialists dedicated to improving care for patients.
“We undertook an extensive public consultation, involving thousands of people who told us they understand why stroke services need to change, but we recognise they have concerns about the impact of those changes.
“We have listened carefully to those concerns and considered them in detail. While our proposals have not changed, we are working to address issues such as travel and transport and putting plans in place to make sure that rehabilitation and support services are closer to home and better planned.”
‘Little basis in fact’
In a statement, stroke consultants from each of the four hospital trusts in Kent and Medway said:”People who live further away from the proposed specialist centres are understandably worried about how long it will take them or a loved one to be transported there by ambulance. We have heard concern that stroke patients could come to harm as a result of longer travel times. There is talk of a ‘golden hour’, and fear that more deprived communities will suffer unless there is a specialist stroke centre near them.
“We understand why these arguments sound concerning, but they have little basis in fact.
“The reality is, sadly, that any stroke patient who dies within a few hours of having a stroke would almost certainly have died whether they were at home, in an ambulance or being cared for in the best stroke unit in the world. For the very small percentage of patients whose strokes are the cause of almost instant death, or who fall into a coma and never wake up, currently little can be done.
“However most people will survive their stroke, and the critical factor for them is how we can reduce their risk of dying in the following days, minimise their risk of long-term disability and therefore improve independence.
We can do that best by getting them to a specialist stroke centre where they can get clot-busting care within 30 minutes of arrival if they need it, and round-the-clock care for the vital first few days after their stroke.”
Save Our NHS in Kent (SONiK) has fought the proposals, insisting a fourth HASU is needed at QEQM. Campaigners were at today’s meeting until the decision to remove the public.
SONiK spokesman Carly Jeffrey said: “We are very disappointed that not one of the 14 doctors present voted against, but we are also not surprised. We asked why six of the doctors were missing, but the chair was very petty and refused to say, telling us we must wait for the minutes.
“The audience were very unhappy about the way their questions were handled, and about the claims that the consultation was a big success, which resulted in the public shouting out ‘Sham! Sham!” in unison.
“Our aim now is to appeal to the members of the KCC HOSC to vote to refer this plan back to government. The HOSC is a committee made up of councillors who can get the plan referred back if they think it’s unfit.”
County councillor Karen Constantine, who was at today’s meeting, branded the decision “predictable and disappointing.”
She added: “Leaving East Kent without a HASU is a disgraceful decision and leaves more questions that now need urgent answers from our NHS managers. What reassurances will be given to staff at QEQM? Morale must be protected and we need to retain our existing skilled and dedicated stroke unit staff. What action is being taken?
“Once either the Darrent Valley or Maidstone HASU’s go live, will Thanet residents be expected to be sent to either of those locations? What prospect is there for the potential for a HASU in Canterbury?
“What investment into ambulances services is now being made, including the recruitment of any necessary staff, that will ensure Thanet residents will have the emergency transport they require and the same degree of safety and outcome as residents else where in Kent.?”
Thanet is an hour from Ashford on a good day, on a bad day we will die before we get to hospital. Maidstone is half an hour from Ashford on a bad day. All hospitals are concentrated in the heart of Kent. Where is the consideration for the residents of Thanet? A disgraceful decision.
I agree. I have just posted a comment regarding Thanet. and the closure of the QEQM unit
There has NOT BEEN a stroke review there has been a lot of deceit by pretending that there has been a stroke review. The decision was made in 2013/14 the faceless wonders know it and we knew all along what the outcome would be. The chairperson of the so-called review body should now demonstrate how patients can be effectively treated if they suffer a stroke in THANET and they are taken by ambulance to William Harvey. What do our useless MPs from the Useless party think about it. ???
All I can say is… I hope I never have stroke then or I will be dead… Absolutely disgusting what is happening to Thanet. And there are supposed to be another three and a half thousand houses being built around the Margate area? Really… Get a grip.
This is disgraceful. Very disappointed in the outcome but it isn’t the end of the fight.
There are no words.
Craig Mackinlay and Roger Gale have let down their constituents very badly.
If only they had put the same amount of vigour and passion into saving these services rather than promoting a speculative endeavour for a third party.
The kicker is of course that one of the most common adverse health effects associated with aviation noise is cardiovascular disease (which includes all the diseases of the heart and circulation including coronary heart disease, angina, heart attack, congenital heart disease and stroke) so they have literally campaigned for something that will increase strokes whilst we are losing our stroke services.
Thank you to all at SONIK and in particular to Carly Jeffrey as well as all the many campaigners.
Of course my comment extends to all elected Thanet District Councillors who have merrily done the same as Craig Mackinlay and Roger Gale and literally campaigned for something that will increase strokes whilst we are losing our stroke services.
It is a disgrace.
Healthcare is and must be a fundamental right for every constituent in North and South Thanet.
The Cabinet Advisory Group at Thanet Distrcit Council of which I am a member unanimously opposed the proposals because Thanet was not in the plans. A number of councillors from all parties sat on that group and I know also a number attended the various protests so your observation regarding TDC is incorrect.
It’s corporate man slaughter,they are criminals who have stolen part of our hospital and getting paid mega bucks to do it and guess whose paying them
The decision has already been made, this meeting is just wasting time and making it look like they are listening. All I can say is if my husband dies on his way to Ashford after another stroke the decision makers will be sorry. Work it out, time to get ambulance to you all supposing they are not all at Ashford queuing to discharge patients 30 mins to check details vitals etc when they get to you then depending on time of day at least 90mins to get to Ashford!!!!!! then of course what happens when there is no bed!!!!!!
Like everybody else, I am frustrated by the phoney pretence of “consulting the public” when we all know that they had already made the fateful decision well in advance. But we shouldn’t forget that those ultimately responsible aren’t nameless or faceless or hidden away in back offices. They are our elected government who are extremely well-known and whose faces are on display on TV every day. They are the ones who invented “austerity” as a way of getting us used to lower wages, poorer public services, longer times at work and long-delayed pension ages.Apparently we have to “pay off the public debt”. But we only took on the debt to keep the Banks in business after they blew the lot on useless investments.The Banks OWE US, not the other way round! Our lives are being put at risk to keep the City investors happy and rolling in cash. We COULD vote for change. But dare we?
It was a foregone conclusion and we all suspected what would happen with this. These callous people all getting highly paid to waste £££ millions more of public money on fake consultations knowing they had already made that decision. But to rub their contempt in even more they book an expensive hotel to pass this decision officially. They are a disgrace to our society. It is not even going to save money. They are playing a lottery with our lives, some will benefit at the cost of others living in Thanet no longer being able to survive.
Our MP’s for Thanet whilst vigourously fighting for their business pals to come pollute us all in Thanet with aviation fumes and noise, which would increase incidents of stroke, they are silently struck dumb when it comes to their constituents best interests in keeping services at the QEQM hospital. They must hold themselves partly responsible for the outcome. This will never be forgotten by the residents and voters who care one iota for Thanet.
“We can do that best by getting them to a specialist stroke centre where they can get clot-busting care within 30 minutes of arrival if they need it.. ”
Completely meaningless statement.
A person living up the road from WH will get the drugs (if they need them) within 30 minutes of the need being recognised. A person living here in Thanet won’t get them for at least an hour.
The ad on the Tele is called F.A.S.T act fast how is going save lives…….rip in thanet
Digraceful decision that will result in unnecessary deaths. I know that if anyone in my family dies as a result of this criminal decision I will sue the NHS. Rachel Jones and her team should be made accountable for every death their decisions will contribute towards.
I would like to thank you all for allowing me to talk down to you and treat you as if you were all total ignoramuses.Why I have to go through these dreary consultations,with the great unwashed, when we the lovely ones, living our lovely lives, near all the best medical facilities, can do your thinking for you;I don’t know?
After all aren’t we the ones who are making such a smashing job of running the hospital trusts and ambulance services? Why those busy bodies at the CQC had to turn up and find half of the William Harvey unmanned and various drugs not properly stored, I don’t know.It was just a bad hair day and anyway we have sorted it out for now!
Superb! The irony, nicely summed up George Nokes, couldn’t have put it better myself…
It seems to me they are encouraging private contractors to cash in on health care
Thanet Clinical Commissioning Group are just a load of career bureaucrats, and bean pushers, who don’t give a damn about patients needs, just being awarded a gong, for years of government Boot licking!
Here’s another money saving ploy: My Consultant ophthalmologist prescribed two lots of eye drops for me many years ago, as I have Blepharitis (very painful dry gritty eyes) Dry Macular Eye Disease (very photosensitive), and am being monitored for Glaucoma, which means I am often partially visually impaired! Recently during a routine check up, my Ophthalmologist agreed these were most probably due to when I worked as an engineer at Dungerness, when Radiation levels were 10 times higher than permitted now!
Guess what, Thanet CCG has said I am no longer entitled to my eye drops, because I can buy them myself over the counter! My Chemist said these will cost me £25.00 to £30.00 a month! I have written to my GP surgery and said what happens if I can’t afford them, is there a “Means” test, and if so who carries it out, my GP? So far no answer!
Whats going to happen in Thanet when the 17000 houses are built. Will the new stroke units cope? No of course not. Its not just the hour to get to WH it can take 20 min for an ambulance to arrive. Then at least an hours journey on a good day. Disgusting descions supported by Sir Rog andd McKinley.