Health campaigners question stroke treatment figures used for hyper-acute units review

QEQM Photo Chris Constantine

Health campaigners have questioned figures used during a public consultation to show that QEQM Hospital does not treat enough stroke cases to warrant a hyper-acute unit at the site.

Save Our NHS in Kent (SONiK) members submitted a freedom of information request to establish the number of stroke cases treated at QEQM and the William Harvey Hospital in Ashford between 2017 and September of this year.

According to consultation documents from the Kent and Medway NHS: “(Stroke) units should see a minimum of 500 patients a year to make sure staff maintain and develop their specialist skills.”

SONIK says the figure for QEQM in 2016-2017 was 372 confirmed strokes but for 2017/18 this rose to 549 and then again for 2018/19 to 608 with 328 confirmed cases from April to September 2019.

Campaigners share their message Photo Carly Jeffrey

Campaigners say this figure was not discussed during consultation events looking at the plan to close acute stroke services at Kent and Medway hospitals, including QEQM, in favour of specialised hyper-acute stroke units at Darent Valley Hospital, Maidstone Hospital and William Harvey Hospital in Ashford.

During a listening event in 2018 the need for 500-plus cases was iterated by those leading the stroke review.

The plan, which was approved in February, would mean Thanet acute stroke patients travelling to Ashford. SONiK says the journey is too far and there should be a fourth HASU in Thanet. The group says the figures released in the FOI support this.

The increase in figures for QEQM and WHH is due to the closure of stroke services at Canterbury hospital in 2017. This resulted in Canterbury patients being treated in Thanet or Ashford rather than an overall rise in stroke cases across east Kent.

Figures ‘warrant’ 2 HASUs in east Kent

Jon Flaig, chair of Save Our NHS In Kent (SONIK), said: “Anyone who attended the stroke ‘listening events’ will have heard senior NHS figures insisting that four hyper acute stroke units in the county could not be supported due to a requirement for 500 strokes at least per unit.

“They said that because Margate hospital had less than 500 per year, it wasn’t reasonable to have a HASU in Thanet. We now know that during 2018 stroke numbers were much higher in Margate.

“At the point in time when NHS bosses were arguing that QEQM’s stroke admissions were too low, they were actually high enough to warrant a HASU at both the William Harvey hospital in Ashford and the QEQM in Margate.”

“Critically, the information provided by NHS bosses for the public consultation was based on figures compiled prior to the closure of the Canterbury stroke unit and so did not take into the account the inevitable rise in stroke victims being treated in Margate after Canterbury closed.”

SONIK say the figures could mean decisions by Kent County Council Health Overview and Scrutiny Committee (HOSC) and the Joint Health Overview and Scrutiny Committee (JHOSC)  backing the HASU plan were not fully informed.

QEQM not selected due to ‘combination of factors’

A spokesperson for the Kent and Medway stroke review said there were a combination of reasons for QEQM being discounted from hosting a HASU which included a lack of other specialised services on site and the practical issues of one trust running two HASU sites.

They said: “In June 2017 the Kent and Canterbury Hospital stopped receiving emergency patients with a suspected stroke. Since then, patients who would have gone to the Kent and Canterbury Hospital have been treated at either Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate or William Harvey Hospital, Ashford. This has led to an increase in the number of stroke patients admitted at both QEQM and William Harvey hospitals but it has not changed the overall number of stroke admissions in east Kent or across the county.

“The Kent and Medway stroke review undertook a rigorous evaluation of all the possible combinations of sites for new hyper acute stroke units (HASUs) in Kent and Medway. QEQM made it through to the medium list of 13 options but not the shortlist of five because of a combination of factors.

“These included the fact that QEQM has fewer of the specialised services it is desirable to have alongside a HASU than other hospitals and the challenge of recruiting enough specialist stroke staff to run two HASUs in east Kent. These factors have not changed.

“There is clinical evidence that patient care improves with the volume of patients treated in a HASU. It is increasingly accepted that the previous minimum number of 500 confirmed strokes a year is too low and a HASU should consistently treat a minimum of 600 confirmed strokes.”

Two separate Judicial Review cases brought by SONIK and by the Thanet Stroke Campaign are due to be heard in the high court from December 3-5.

Find about more about the HASU proposals here

Find out more about the SONIK campaign here

12 Comments

  1. Highly suspicious use of bogus statistics to justify closing our local stroke unit. BUT, even if the statistics are accurate, surely this indicates the gross lack of investment in the Health Service. This isn’t a High Street shop where Head Office in London closes it down when not enough profit is made in the store. This is our health and lives we are talking about. Saving peoples lives is essential. You can’t just write us off in Thanet because we cost too much to save!!

  2. Did they take in to consideration the new owners of the 17000 new homes to be built around the QEQM hospital, with a possible 50,000 new residents in Thanet? Of course not!
    A lot of them will be older and so, more susceptible to stroke incidents.
    This whole situation is farcical with barely any truths being told.
    Don’t give it up yet, let them proved their lies, (impossible) first.
    Keep the SONIK attack Fully in action.
    One day they will accept they’re wrong!

  3. Shameful that the health chiefs have lied to us putting Thanet’s vulnerable residents at risk. Disgraceful that both Thanet MPs have dismissed this issue and let them get away with it. I’ll remember your failure on December 12th Roger Gale when you agreed it was OK to close the stroke unit

    • That’s the trouble with these greedy Tory MP’s, it’s all about them and their big business partners, not about what’s best for their constituents. Shame on them all, they need to be voted out on 12th December. One here in Thanet at least is so long in the tooth he should really retire and give someone else a chance.

  4. Here’s the audio of the Broadstairs ‘listening event’ meeting:
    https://soundcloud.com/km_healthandcare/broadstairs-stroke-event
    1.37m: Dr Tony Martin (on the panel) says: “The overall number of strokes in Thanet isn’t enough to sustain an individual HASU”
    1.42m: Dr Tim Winch (in the audience) says “If there are 3000 strokes in Kent, then I invite you to do the simple maths, and dividing 3000 by 600….you come up with more than three”
    applause
    1:44m: Dr Hargroves (on the panel) responds “…is three the right number? 1.44m “…can’t divide the 3000 equally”

    Dr Tony Martin was on the Joint Committee of Clinical Commissioning groups until June 2018, and spoke in favour of the plans at a number of listening events. At the time he was the Chair of Thanet CCG, and he is lead partner at Bethesda Medical Practice in Cliftonville.

  5. To summarise:
    – The PCBC was made public in Jan 2018. Canterbury stroke unit was shut during 2017. The PCBC should have predicted the major catchment area changes for QEQM and WHH that would result from the closure of K&C hospital, and all presentations regarding the 500/600 figure should have taken into account this change. There should not have been any claims that QEQM did not have enough strokes to warrant a HASU.
    – The FOI figures show that confirmed stroke numbers shot up at QEQM once the K&C unit closed. At the broadstairs listening event (24/3/2018), Dr Tony Martin (JCCCG member until June 2018) said “The overall number of strokes in Thanet isn’t enough to sustain an individual HASU”. Dr Hargroves did not correct him.
    – The FOI data shows that East Kent (EKHUFT catchment area) had 1164 confirmed strokes in 17-18, and 1192 strokes in 18-19. Hargroves maintained the argument that strokes not being evenly spread across areas meant that altho 3000 confirmed strokes happen in K&M each year, it was still not possible to have 4 HASUs. He was still making this argument in the HOSC and JHOSC committees in early 2019.

  6. The FOI shows that
    Confirmed stroke cases for QEQM are:
    2016-2017 – 372
    2017/18 – 549
    2018/19 – 608
    first six months of 2019/20 – 328 (April to September 2019)

    I think we can all see why they took the 2016/17 figures and stuck with them….

  7. Dr Hargroves, I believe has a vested interest, as it is proposed that he is to head the Ashford Unit, no doubt with an increased salary – please correct me if I am mistaken.

  8. We have an ageing population hence the incidence of stroke will increase. My mum had a stroke in January this year – we waited 7 1/2 hours for an ambulance to take her to QEQMH – she did receive good care there but there is no way my father could have visited her on a daily basis at Ashford which would have impacted on her recovery. Sadly we lost mum in August of this year but there are many families in the same situation.

  9. You hit the nail on the head Sharon! I have tried to bring up the difficulty of getting to the Kent & Canterbury and the William Harvey by Public Transport, not just for treatment, but also for visitors with the Clinical Commissioning Group! I received a reply from a Hazel Carpenter, Accountable Officer, saying I could join the Thanet Volunteer Drivers Scheme, which meant I had to pay to become a member, and pay a volunteer driver to take me to these hospitals. Yes, but would they hang around for several hours whilst I underwent treatment, and bring me back home again? And what if all I wanted to do was to visit someone at these hospitals? The Loop bus service goes directly to the QEQM, and as a pensioner I don’t pay, and I have used this often for treatment without any hassle. These ‘bean counters’ at the Clinical Commissioning Group have no idea of the difficulties many people, especially the elderly, young mums, the disabled etc have when trying to get to these outlying hospitals, probably because they all own costly top model cars!

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