The following NHS colleagues presented this
item:
·
Alan Goldsman – Chief Financial Officer, Kings College
Hospital NHS Foundation Trust
·
Andrew Bland – STP Lead, Chief Officer for Southwark CCG
& AO for Southwark, Greenwich and Bexley CCG
·
Angela Bhan – Chief Officer, Bromley CCG & STP SRO for
Urgent & Emergency
Background was provided to the consultation.
Stroke services in London had been reorganised nearly 10 years ago
in order to create a network of 8 Hyper Acute Stroke Units (HASUs)
where patients suspected of having a stroke are now taken. The
units have the ability to provide patients with specialist care 24
hours a day. This model has proved successful.
Kent is now looking to reorganise into HASUs
also, in order to improve outcomes. The models compiled by Kent and
Medway would leave 3 HASUs across the county with various different
combinations. Depending on the options
chosen there may be potential impacts on stroke services in SE
London.
- It was noted that should Darent
Valley Hospital (DVH) not be designated a HASU then more patients
may access services in SE London, with the potential for additional
pressures at the PRUH. However, the CCG
emergency lead stated that it would be a manageable number.
- It was likewise reported that if DVH
is designated a HASU then there may be a slight reduction in the
number of patients at the PRUH. It was acknowledged however, that
South East London STP would support the improvement of stroke
services in Kent. It was noted that Bexley CCG is a consultor and
the other 5 boroughs of the SEL STP are consultees.
- A member commented that her
principle concern is the volume and numbers of patients and if
there has been sufficient modelling to accurately assess the impact
on services. The CCG Emergency lead responded that they are doing
the modelling and consultation in tandem. King’s commented
that they are looking at the impact; including follow on
therapies.
- The committee asked if there will be
consultants 24/7 at all three units.
The CCG leads confirmed there will
be; in order to do this there will need to be a concentration of
resources at those sites.
- A member commented while it may make
sense to spend 20 minutes longer travelling if there are better
clinical services at the end, as has proved the case in recent
changes to London HASU provision, however this present proposal for
Kent covers a larger geographical spread and is looking like a much
longer time traveling time; perhaps as long as 120 minutes. This
needs to be accurately quantified in the modelling.
(From previous item)
- King’s reported that they will
be making a response to the Kent and Medway Stroke Services
consultation as some options may have implications for the PRUH
including additional patients. It was
reported that the data provided is from NHS England and relates to
episodes of care not numbers of patients; it was confirmed that the
data in the consultation papers are accurate as they can be.
- Members expressed concern regarding
the lack of a figure for the potential number of additional
patients that could access services in SEL (depending on the option
selected).
Members stated that patients were being
transferred to Lewisham hospital due to the pressures currently at
the PRUH. The CCG Emergency lead
reported that they (OHSEL STP) were in close consultation with Kent
and Medway STP and they are working with NHS England and Public
Health England.
- The Committee agreed that they
would be in support of options for DVH
to be designated a Hyper Acute Stroke Unit (HASU) in light of the potential impact on the
number of residents accessing services in SE London, should it not
be designated a HASU.
- Concern was also expressed by the
Committee regarding the achievability of the travel times cited in
the consultation document.
RESOLVED the chair will
provide a consultation response on behalf of the committee
supporting options where Darent Valley Hospital (DVH) is a
HASU.