Go ahead for stroke improvements

NHS in Kent and Medway welcomes stroke services go-ahead from Secretary of State

The NHS in Kent and Medway was pleased to learn today of the Secretary of State for Health and Social Care, Sajid Javid’s decision to agree to change the way stroke services are delivered across Kent and Medway. The decision, which will see three new ‘hyper acute stroke units’ established to give very specialist care to stroke patients in the immediate days after a stroke, is expected to save a life a fortnight compared to the previous configuration.

The Secretary of State has supported in full the advice received from the Independent Reconfiguration Panel (IRP). The IRP reviewed and supported the decision by doctors from the as-was eight Kent and Medway clinical commissioning groups (CCGs), along with Bexley CCG and East Sussex CCG, to move from six general stroke units in Kent and Medway to three hyper acute stroke units (HASUs).

This means the NHS is now able to proceed with the implementation of the HASUs. The implementation is supported by a commitment from the NHS to deliver a business case for investment in comprehensive stroke rehabilitation and prevention services across Kent and Medway.

Speaking about the decision, Dr David Hargroves, Senior Stroke Consultant for East Kent Hospitals University NHS Foundation Trust, and lead clinician for the Kent and Medway acute stroke review said, “The review of urgent stroke services in Kent and Medway has always been about improving the quality of care and outcomes for patients leading to fewer deaths and less long-term disability from stroke. All patients, no matter where they live in Kent and Medway, will benefit from being admitted to units that are able to provide excellent stroke care 24 hours a day, seven days a week.

“This welcome announcement from the Secretary of State for Health and Social Care means that we are able to proceed in earnest to deliver much needed improvements to acute stroke services, and certainty for our hard-working staff.”

Rachel Jones, Executive Director for Strategy and Population Health at Kent and Medway CCG, said: “We now have the go-ahead to focus on implementing our plans to deliver three hyper acute stroke units in Kent and Medway - a widely recognised way of delivering high quality hospital-based care for people in the immediate days after a stroke.

“We will continue to work closely with the doctors, nurses, therapists, other front-line staff and stroke survivors who have been so central to the design of these plans, as we seek to implement the HASUs as quickly as we can.

“I am also delighted to announce a wider package of investment, including £100,000 investment into Medway to support neuropsychological rehabilitation for the local Medway population. In addition we are working on a detailed business case for stroke rehabilitation and prevention services that will deliver further investment across Kent and Medway. We will have a clearer picture of this investment once the business case has been fully developed.”

Health Minister Edward Argar said: “I am pleased to give the green light to plans to transform stroke services in Kent and Medway, with three new stroke units and a network of local services to significantly improve care for stroke victims, helping to save lives and reduce disability.  

“Alongside this we are backing Kent and Medway with £100,000 to support neuropsychological rehabilitation for people in Medway, in addition to previous investment to improve emergency care and diagnostic services, and modernise services as the NHS continues to recover from the pandemic.”

Background

1. In February 2019 the NHS in Kent and Medway (8 CCGs as was) along with Bexley CCG and East Sussex CCG agreed to establish three new ‘hyper acute stroke units’ to replace the existing six general acute stroke units, effectively signalling the closure of three general units. The decision followed a 14-week public consultation on five potential options which drew thousands of responses from local communities.
2. The six existing stroke services were at Darent Valley Hospital (Dartford), Maidstone Hospital, Medway Hospital, Tunbridge Wells Hospital, Queen Elizabeth the Queen Mother Hospital (Thanet) and William Harvey Hospital (Ashford).
3. The location of the three new HASUs agreed by the CCGs will be:
   • Darent Valley Hospital (Dartford)
   • Maidstone Hospital 
   • William Harvey Hospital (Ashford).
4. Medway Council Health and Adult Social Care Overview and Scrutiny Committee referred this decision to the Secretary of State for review by the Independent Reconfiguration Panel.
5. Two individuals, supported by campaign groups, sought a judicial review of the NHS decision. The judge emphatically found in favour of the NHS in February 2020, ruling against the claimants on all grounds.
6. Since the NHS decision in February 2019, there have been three emergency temporary changes to stroke services in Kent and Medway:
   • Tunbridge Wells Hospital stroke service (provided by Maidstone and Tunbridge Wells NHS Trust – MTW) transferred to Maidstone Hospital (also provided by MTW) in September 2019 due to staffing challenges.
   • In April 2020, in response to Covid and the need to separate non-covid inpatients from covid inpatients, East Kent Hospitals University Foundation Trust (East Kent Hospitals) transferred its stroke services at William Harvey Hospital in Ashford and Queen Elizabeth the Queen Mother Hospital in Thanet to the Kent and Canterbury Hospital. The stroke service remains at Kent and Canterbury at this time.
   • Medway Hospital stroke service closed in July 2020 due to staffing challenges and the majority of stroke patients that would previously have gone to Medway Hospital are now going to Maidstone Hospital with a small number going to Darent Valley Hospital.
7. It is important to note that while acute stroke services are currently being delivered from three sites in Kent and Medway as a result of the emergency, temporary moves, the better, hyper acute stroke unit model agreed by the Joint Committee of CCGs in 2019 has not yet been implemented because of the referral process to the Secretary of State for Health and Social Care to make a final decision on the proposals.