The announced early closure of the stroke ward at Tunbridge Wells Hospital due to a lack of qualified staff has raised fears that Margate’s QEQM unit could suffer the same fate.
The ward was due to be closed, along with the one at QEQM and at Medway Hospital, when new specialist units are implemented in 2020 and 2021 at Maidstone, Ashford and Darent Valley.
But ward 22 at Tunbridge Wells is now earmarked to shut in September this year, with patients being diverted to Maidstone, because of staff shortages and problems recruiting.
‘Increasing challenge’
In a report to health overview scrutiny members at Kent County Council Sean Briggs, Chief Operating Officer, Maidstone and Tunbridge Wells NHS Trust, says: “There is an increasing challenge managing the stroke service on Ward 22 at Tunbridge Wells Hospital (TWH) where thrombolysis nurses and registered ward staff numbers are unsatisfactory and pose a high level of risk to staff and patients, despite robust and frequent recruitment activity
“The viability of Ward 22 until the opening of the new Hyper Acute and Acute Stroke Unit (HASU) and Acute Stroke Unit (ASU)on the Maidstone Hospital site planned for March 2020, as part of the Kent and Medway Stroke Network Development, is becoming increasingly unlikely due to the high level of vacancies and difficulty in recruiting.”
The report says the situation has been exacerbated by the plans for three hyper-acute stroke units (HASUs) across Kent & Medway which was agreed in February.
Mr Briggs says: “As a result of the future development of the HASU/ASU there has been uncertainty for staff regarding their future place of work and many do not want to move to the Maidstone Hospital site. This has added to our recruitment challenges.”
Vacancies at Tunbridge Wells have risen to a huge 53% resulting in the thrombolysis service only being covered 9am-5pm Monday to Friday and some weekends from next month.
Fate for service at QEQM?
The issue of staff leaving rather than moving their place of work and of recruitment difficulties could also pose a problem at QEQM in Margate.
In March The Isle of Thanet News exclusively reported that acute stroke services at Margate’s QEQM Hospital could be forced to shut down before a replacement specialist unit in Ashford is fully opened in Spring 2021.
In a business case report for the stroke review it said that QEQM services may have to be shut down “earlier than planned” during the change-over because of difficulty in recruiting and staff turnover.
Rachel Jones, Director of the Kent and Medway Stroke Review, said the desire is to keep QEQM open until the HASU is ready and work would continue to retain and recruit QEQM staff.
‘Failure to recruit’
The business case report added: “The Trust has suffered from a failure to recruit staff to key positions and high turnover rates for a number of years. The three new HASU/ASU (acute stroke) units operating as part of K&M stroke network will work together to maximise staffing across the network.
“The stroke services at QEQM may be forced to close earlier than planned if the current staffing levels cannot be sustained, because of the challenge to retain staff during the transition and to recruit stroke trained staff as there is a national shortage.”
The report revealed the number of stroke consultants across Kent and Medway are 70% below the recommended level and the minimum staffing levels for other clinical staff, such as stroke nurses, are not being met.
The Trust will offer new roles, training and a “benefit programme” to encourage people to stay.
Campaign group Save Our NHS in Kent has already lodged a Judicial Review against the Kent & Medway NHS decision to close three services in order to implement three hyper-acute units for the region.
Spokesperson Carly Jeffrey said the lack of staff means legal blocks to the plan being implemented are now being circumvented.
She said: “There are three major obstacles in the way of the controversial plans to close half of Kent’s stroke units: there are two judicial reviews from Thanet campaigners that challenge the decision and Medway Council has also referred the stroke plans back to the Health Secretary, Matt Hancock.
“Legally, the plans cannot go ahead as yet, until these processes run their course. As a result of these acts of resistance, it is possible that a new consultation could be called for, or the plans might need to be rethought entirely.
“This has been circumvented by the staffing situation in Tunbridge Wells being so bad that the units can be closed ahead of time due to patient safety. The plans themselves are the reason for the drop in staff. The madness of these expensive NHS reconfigurations is that simply by announcing the planned closure of a unit, you are putting it automatically at risk. As a result, staff begin to jump ship.
“The plans themselves create a problem which can only be solved by closures. Isn’t it time to stop mooting these disastrous schemes to reduce our essential services?
“We were told during the consultation that the stroke units would not close until the new services were up and running. Now one of the three earmarked for closure is to be shut with no ‘hyper acute’ unit in sight, and barely any warning. The only barrier to this happening at QEQM is if staff stay put.”
County councillor Karen Constantine has also raised concerns, writing to Kent and Medway Stroke Review bosses to question whether Thanet will face the same circumstances.
She said: “It appears that some of our staffing fears are being legitimatised. TWH staffing levels have dropped, as staff have ‘voted with their feet’ and found other jobs rather than face the prospect of being relocated to Maidstone.
“It’s a 36 minute drive from Tunbridge to Maidstone. It’s 102 minutes from QEQM to Ashford. I doubt staff at QEQM will want to transfer to Ashford. Will we face the same issues here in Thanet?
“This situation has a significant bearing on Thanet. “
Cllr Constantine has requested detailed information over where staff moved to and what offers were made to retain them.
‘Staff support’
Rachel Jones, Director of the Kent and Medway Stroke Review, previously told The Isle of Thanet News: “We know from staff feedback that specialist stroke staff support the development of hyper acute stroke units to improve the quality of care for patients. It is our intention and desire to continue the service at Queen Elizabeth the Queen Mother Hospital in Margate until the east Kent hyper acute stroke unit (HASU) at William Harvey Hospital in Ashford is ready.
“We are working towards this and continue to focus on how we can make this happen, including working hard to recruit and retain specialist stroke staff at QEQM.”
