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22 January 2018

Improvement proposed for stroke services in Kent and Medway

Further details about a proposal to establish three new ‘hyper acute’ stroke units in Kent and Medway have been announced today (Thursday, 18 January 2018).  The proposed shortlist of potential options for the location of these units, which is still subject to final assurances and approval, is1:

  1. Darent Valley Hospital, Medway Maritime Hospital, William Harvey Hospital
  2. Darent Valley Hospital, Maidstone Hospital, William Harvey Hospital
  3. Maidstone Hospital, Medway Maritime Hospital, William Harvey Hospital
  4. Tunbridge Wells Hospital, Medway Maritime Hospital, William Harvey Hospital
  5. Darent Valley Hospital, Tunbridge Wells Hospital and William Harvey Hospital

Unlike current services, these hyper acute stroke units would operate with a multi-disciplinary team of stroke specialists, providing expert care round the clock with consultants on the wards seven days a week. The new units will allow people to get the best possible care in the vital first few hours and days immediately after their stroke – saving lives and reducing disability. The units would care for all stroke patients across Kent and Medway and from some neighbouring communities, in the critical first 72 hours after a stroke. We don’t currently have any hyper acute stroke units working in this way in Kent and Medway, patients are currently cared for in general stroke units.  Each site would also have an acute stroke unit where people may go after the initial 72 hours for further care until they are ready to be discharged, and a transient ischaemic attack (TIA or ‘mini stroke’) clinic.

These proposal would mean significant changes to the urgent stroke care currently provided in six hospitals across Kent and Medway. The proposed changes would affect every hospital in our area, residents in every part of Kent and Medway, e and some beyond our boundaries. The proposed three new hyper acute stroke units would ensure all residents get consistently high-quality hospital-based stroke care regardless of where they live or what time of day or night a stroke occurs. However, under these proposals urgent stroke services would not be available at the other three hospitals in Kent and Medway.

The proposed changes are focused on ensuring the best care and outcomes for people who have a stroke, meaning faster diagnosis and treatment, fewer deaths, and less disability. To make these proposed changes we would need to invest up to £40million in hospitals and recruiting more staff across the county, but we expect a reduction in costs over time, mainly due to better recovery for patients who wouldn’t then need as much long-term care, and shorter hospital stays.

A Joint Committee of the ten clinical commissioning groups in Kent, Medway, Bexley and High Weald Lewes Havens is meeting to discuss the shortlist on 31 January 2018.  The joint committee meeting is held in public and will take place from 13.00-16.00, in the Council Chamber at County Hall, Sessions House, Maidstone ME14 1XQ.  It is a meeting in public, but places are limited by the venue so if you would like to attend this meeting, please book your place and register in advance at https://strokejcccg.eventbrite.co.uk.  For those without access to the internet, places can be booked by calling the Joint Committee admin office on 01892 638331.

If the shortlist above is approved, we will begin a wide public consultation in February on the future shape of urgent stroke services in Kent and Medway. The consultation will provide further opportunity to help us design the best stroke services and to continue to engage staff, stakeholders, patients and local communities in the issues important to them about stroke services.

When the consultation begins we will publish our consultation document. The consultation document will set out the reasons why we believe Kent and Medway needs three hyper acute stroke units and a range of potential options for where they could be located. It will also summarise the issues we have considered to select the shortlist – from travel times through to staffing issues and how long it would take to establish hyper acute stroke units at different hospitals across the area.

We recognise that people have concerns when hospital services change, but we strongly believe change is needed to improve care. These proposals represent a major investment in stroke services and a commitment to making consistently high-quality care available for all stroke patients, regardless of where you live or when a stroke happens.

We will update this information with further details of our formal public consultation once it starts, and how to get involved and share your views, if the required assurance processes are met, in early February.

Background to the stroke review

We started reviewing our stroke services in 2015. We did this because whilst staff in our stroke services are working extremely hard to provide the best care that they can, we know that things would be better, for both patients and staff, if we developed our stroke services further. We want our stroke services to meet the latest national best practice standards so that patients get have the best chance of the best outcome after a stroke. These new ways of working have been introduced in other parts of the country and are bringing significant benefits to patients. In London, hyper acute stroke units have reduced deaths from stroke by nearly 100 a year.

There has been a detailed process to consider potential options for the future shape of hospital-based urgent stroke services. Over the course of the review we looked at:

  • a long list that considered different numbers of hyper acute stroke units
  • a medium list of possible three-site options
  • the shortlist of deliverable three-site potential options which is being announced today.

Our proposed shortlist has been through a rigorous process and takes account of other work, particularly in east Kent, around changes to acute hospital services.

Find out more about the stroke review here

1 The order is not a ranking and we are not identifying a preferred option until we have fully and carefully considered all the evidence and data available.

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