Agenda item

A cover report and summary of the consultation are enclosed.

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 are 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, Angela Bhan 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 ED 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 covers a larger geographical spread in Kent 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)

·  Kings 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. Angela Bhan reported that they (OHSEL STP) were in close consultation with Kent and Medway STP and is 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 to this on behalf of the committee supporting options that where Darent Valley Hospital (DVH) is a HASU.