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Darent Valley, Maidstone and William Harvey Hospitals chosen to house hyper-acute stroke services

By Anna MacSwan

The 'preferred options' for a £40 million shake up of stroke services in Kent and Medway have been revealed.

Dartford's Darent Valley Hospital, Maidstone Hospital and Ashford's William Harvey have been chosen to house three specialist stroke units following a consultation which began in February.

The three 24/7 hyper acute units will replace the care currently provided at six hospitals.

Darent Valley Hospital, Dartford.
Darent Valley Hospital, Dartford.

It is hoped that the shake-up will raise the standard of care patients receive in the crucial first few hours after a stroke.

The three hospitals were chosen from a shortlist of five options, which also included Tunbridge Wells Hospital and Medway Maritime Hospital.

A final decision is expected in December 2018 or January 2019.

Patricia Davies, senior responsible officer for the Kent and Medway Stroke Review, said: "Today's announcement is an important step in the stroke review process. However, it is important to stress there are still several hurdles to clear before a final decision is made about the future of urgent stroke care in Kent and Medway.

"I would like to thank the hard-working staff at all our stroke units in Kent and Medway for their ongoing loyalty and dedication.

"I appreciate this is a time of uncertainty, but I believe there is an exciting future for everyone working in stroke services across Kent and Medway.

"The identification of a preferred option brings us closer to being able to deliver the first class care our stroke teams strive for."

Maidstone Hospital.
Maidstone Hospital.

Glenn Douglas, accountable officer for the eight Kent and Medway Clinical Commissioning Groups said: "Going from five possible options to one preferred option was always going to be a challenging step. All the five options had the very real potential to improve stroke care, and there was little to differentiate between them.

"The purpose of the post-consultation evaluation was to dig down into the fine differences between the options and identify which option was the ‘best of the best’.

"I know there will be disappointment at the hospital sites not identified in the preferred option, but I also know those organisations have always been clear they supported the stroke review as a way to improve care for stroke patients across the whole of Kent and Medway, whatever the outcome.

"We look forward to making a final decision early in the new year so that we can give certainty to our excellent staff and start to make improvements for those people who have a stroke in Kent and Medway in the future."

Helen Grant, MP for Maidstone and the Weald said: "I am delighted that Maidstone Hospital has been selected as a preferred option for one of Kent’s new Hyper Acute Stroke Units.

"As the best provider of stroke care in Kent; the excellent leadership and clinical teams at Maidstone and Tunbridge Wells NHS Trust are superbly placed to make a success of this multimillion pound new service and I am confident they will deliver improved outcomes for stroke patients across our County.

"I am delighted that such an outstanding new service will be on the doorstep of many of my constituents, should they require it, and I look forward to continuing to work closely with the Trust as they develop the new unit in the months ahead."

But not everyone was pleased with the announcement.

The Save Our NHS In Kent campaign group said the decision would have "deadly consequences for people in Thanet and east Kent.

A spokesman said: “Stroke sufferers will have to travel 40 miles on difficult roads and people will have less chance of surviving and will have worse outcomes because of this.”

The spokesperson added: “The STP has argued that having just three hyper acute stroke units in Kent will be safer than the present arrangements — but there is absolutely no evidence for this. This is a dangerous experiment on the people of Kent.

“The STP have ignored the will of large numbers of the public who responded in protest during the consultation. Their own consultation results show the many concerns of medical staff and the total lack of support for the plan in Thanet, the most adversely affected region.”

Helen Grant MP and Maidstone and Tunbridge Wells NHS Trust Chief Executive Miles Scott. (4220943)
Helen Grant MP and Maidstone and Tunbridge Wells NHS Trust Chief Executive Miles Scott. (4220943)

Cllr Alan Jarrett, leader of Medway Council, reacted strongly to the announcement.

He said: "We are extremely disappointed by this decision. We believe it is a bitter blow for the half a million people of Medway and wider Kent served by the Medway Maritime Hospital and potentially puts many hundreds of lives at risk.

"Cardiovascular disease and stroke disproportionately impacts on people living in the most deprived areas of the country.

"Investment decisions should take into account the need to address these health inequalities.

"In Medway 20.3% of local residents live in areas identified as the most disadvantaged in England, for Swale it is 22.2%.

"The North Kent areas of Medway and Swale experience some of the worst health inequalities in the country and as a consequence we experience higher rates of deaths from coronary heart disease which is why we need excellent medical facilities here.

"This decision has ramifications for patients across all of Kent. Medway Maritime Hospital currently cares for the largest number of stroke patients in Kent and Medway. It is therefore very concerning that over 500,000 people in Medway and Swale, who also receive their stroke care at Medway Maritime Hospital will soon no longer be able to do so. These patients, should this proposal be implemented, will now need to be treated at other hospitals."

"We believe it is a bitter blow for the half a million people of Medway and wider Kent served by the Medway Maritime Hospital and potentially puts many hundreds of lives at risk" Cllr Alan Jarrett

He said the authority would be challenging the decision.

Lesley Dwyer, chief executive of Medway NHS Foundation Trust said: "Naturally we are very disappointed that Medway is not identified as one of the locations for a HASU, having presented a strong case.

"We know this decision will be disappointing to staff, and to patients. However, what’s important now is that we will work with commissioners and other providers to do the best for our patients, ensuring that the services we provide assist the recovery of stroke patients.

"At Medway we support the creation of HASUs as all the evidence tells us that patients have better outcomes in a specialist unit – more lives are saved and the impact of a stroke on quality of life is improved. We also agree that three HASUs, supported by acute stroke units (ASUs) is the right number for Kent and Medway.

William Harvey Hospital, Ashford.
William Harvey Hospital, Ashford.

"We are pleased to have had the opportunity to engage with so many patients and public about the importance of getting the best possible care following a stroke, and we thank those who supported us during the consultation.

"We will now continue to build on improvements already made to the care of stroke patients at Medway, such as receiving clot-busting thrombolysis drugs more quickly, and with access to consultants on a rota 24 hours a day, seven days a week.

"We need stroke services in Medway to be the best we can provide now for our patients, in the knowledge that they can be safely transferred to a HASU in future"

Dartford MP Gareth Johnson said: “I am really pleased that Darent Valley Hospital has been identified in the preferred option for the configuration of future urgent stroke services in Kent and Medway.

“All the evidence shows that having access to a hyper-acute stroke unit is the best way to treat stroke patients, save lives and reduce disabilities in patients.

“Having this service in Dartford would be hugely beneficial to our residents and I hope this option is confirmed when the final decision is made at the end of the year.”

The next stage in the review process is to develop a decision-making business case which will describe how the preferred option was selected and set out an implementation plan covering areas such as workforce, estates and capital requirement.

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