The schedule for opening new Hyper-acute Stroke Units (HASUs) at Darent Valley, Maidstone and Ashford has been set back by more than a year due to legal challenges and the wait for capital funding.
A final decision on the location for the three HASUs across Kent & Medway was confirmed by doctors on the Joint Committee of Clinical Commissioning Groups (JCCCG) in February.
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as at Medway Hospital, Tunbridge Wells Hospital, and Kent & Canterbury Hospital – which has already had its service withdrawn due to the removal of training doctors by Health Education England in March 2017.
But this has now been set back to Darent Valley Hospital and Maidstone Hospital to open in April 2021 and the William Harvey Hospital to open in autumn of 2022.
The bringing of legal action, in the form of a Judicial Review and referral to the Secretary of State, by Save Our NHS in Kent, Thanet Stroke Campaign and Medway Council, has meant the Kent and Medway Stroke Services Review are unable to implement anything that is irreversible – such as building works – until the outcome of legal action is revealed.
A decision on the Judicial Review cases is expected in January.
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.
But to house the new unit at William Harvey Hospital it will require a new build 32 bed ward, linked to the existing stroke ward to create a single unit, at a cost of some £20.9million.
A stakeholder update, first published back in July, says the set back is due to: “The legal challenges and the referral to the Secretary of State for Health – the legal advice we have is that we can and should continue with implementation planning, but we should not take any irreversible decisions.
“This means that the vast majority of our implementation work continues for example workforce and IT planning, and the development of detailed policies and operating procedures to support new ways of working in the HASUs. The only irreversible decisions are linked to the new build at William Harvey Hospital which requires significant financial investment and it would not be right to spend public money on these building works until we know the outcome of the legal proceedings.”
The Judicial Review outcome must also be known before NHS England and Improvement will agree the release of capital funding needed to implement the new HASUs.
A spokesperson for the Kent and Medway review of urgent stroke services: said: “We plan to continue running stroke services as they are now, until we know the outcome of the Judicial Reviews and Secretary of State referral and have clarity about the next steps in our work to improve stroke care.
“However, the uncertainty caused by the ongoing delay to the reconfiguration of services is naturally unsettling for staff and we continue to monitor workforce risks very carefully both at an organisational and county wide level.
“We have not been able to commence the building works required at any of the sites as these require financial investment and it would not be right to spend public money on this work at this stage.
“Depending on the outcome of the judicial review and the Secretary of State referral, and the timing of the release of capital funding, the earliest we could go live with the HASUs at Darent Valley Hospital and Maidstone Hospital is currently April 2021, and the autumn of 2022 at William Harvey Hospital (this is solely due to the extent of the capital works required at William Harvey).
“We have secured approval in principle from the NHS England Investment Committee for the required capital and are finalising our full business case for the funding. We are waiting only for the judicial reviews and referral to the Secretary of State to be resolved.”
The Kent and Medway stroke review requires a capital investment of circa £28.5 million to implement the approved option of HASUs at Darent Valley Hospital, Dartford, Maidstone Hospital and William Harvey Hospital, Ashford. The additional time for William Harvey Hospital to implement delivery of a HASU is related to the scale of the building works required on that site.
A spokesperson for SONIK said: “During the court case, the defendants argued that their plans would save lives (something we dispute) and that therefore the stroke plans must be implemented as soon as possible.
“They appealed to the judge to not delay any further on this basis. Now we learn that a major delay is happening anyway, and it seems remiss that this was not expressed to the judge in the Royal Courts of Justice.
“Save Our NHS in Kent (SONiK) has already asked repeatedly that the East Kent Hospitals Trust (EKHUFT) urgently pay retention premia to QEQM staff to stop them from leaving whilst their jobs hang in the balance. EKHUFT refused. Surely now they must agree to do this, otherwise QEQM’s stroke unit might become understaffed.
“It is their duty to prevent this. We do not want another stroke unit to be closed because of understaffing (like Tunbridge Wells) caused by this proposal hanging over the heads of NHS workers. We hope that EKHUFT will respond and do the right thing.”
A spokesperson for East Kent Hospitals said: “We are working closely with our stroke staff to develop our services. For this reason we introduced a recruitment and retention incentive for newly recruited stroke nurses earlier this year at all hospitals in east Kent, including QEQM.”
County councillor Karen Constantine, who is supporting the Thanet Stroke Campaign case, added: “I attended the Judicial Review each day to advise our legal teams and to listen carefully to submissions.
“Like everyone else I’m anxiously awaiting the outcome in the New Year and I’m sincerely hoping the ‘equality’ issues raised are fully taken into account and persuade the Judge that the decision is unfair, as it puts Thanet residents at a disadvantage. So unfair that the decision should be overturned. If this happens it will have consequences far beyond Thanet. It will strengthen all communities fighting for equality of access.
“I have contacted Cllr Sue Chandler chair of the HOSC and Cllr Roger Gough Leader of Kent County Council to raise the on-going health inequalities faced by Thanet residents at next week;s HOSC on December 16 and full council meeting on December 17.”