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Ida Linfield on the Kent & Medway Stroke Review

February 6, 2019 4:45 PM

I'm aware that this article is full of statistics and figures- but no apologies for that, as I believe this is a really important subject for us all.

Last Friday the final version of the Kent & Medway Stroke Review was presented to a scrutiny committee at KCC before it goes to a meeting of the JCCG on February 14th for them to make a final decision. The plan is to set up Hyper Acute Stroke Units (HASUs) where all stroke patients will be treated. But these units don't just cover people in Kent and Medway but will also treat all stroke patients from the London Borough of Bexley and from East Sussex as well.

KCCs view is that just three HASUs, sited in Kent, will cope with all the patients from all over East Sussex, Bexley, Kent and Medway, for the next 20 years.

Although on the committee I want to distance myself from KCC's position and would like to explain some of my reasons.

Firstly the population figures in the NHS report:

In 2017 there was just short of 3 million people living in the whole catchment area. The NHS assured the committee that all new housing stock planned for the future is included in their calculations for "the next ten years". But the figures they used are only for Kent and Medway and do not include any from East Sussex and Bexley. Also the report does not include any of the'windfall' developments like the one in Thannington and which are now cropping up all over the country. Finally the population figures that are quoted are supposed to be "refreshed regularly" but that hasn't happened for the last year!

So NHS report uses reduced figures which exclude East Sussex and Bexley, and which are valid only for the next 10 years, to justify their decision for a 20 year plan!

Then I am concerned that the number of stroke patients will exceed the capacity of the 3 HASUs:

The report to the Committee said that a recent local NHS report predicts that there will be a 43.1% increase in the number of strokes between 2016 -2042 - in Kent and Medway alone; that each HASU needs to be designed to cater for 500-600 patients each year and that "in 2016/17 there were 3,146 confirmed strokes in the Kent and Medway catchment area". So from these NHS stats, we already need some five HASUs now - never mind over the next 20 years - just to cope with the current situation in Kent alone!

The NHS is not following its own guidance about patient numbers for a HASU and is again using reduced figuresin a 20 year plan.

The sites for the new HASUs as proposed in the NHS report are not spread equally throughout the catchmentarea:

It is planned that they will be at Ashford, Maidstone and Darenth Valley and so will all to be based in the middle of Kent. It would be interesting to know what an equalityassessment report would make of this decision as residents in Cliftonville and Crowborough, to name but two towns, are clearly discriminated against. And yet this "equality" is to last for 20 years…

Last but by no means least to turn to Canterbury. I havebeen reassured by the leader of KCC and by the NHS that once the work for the new K& C is complete theHASU can be relocated to Canterbury. The HASU at Ashford is the last to be set up as work will only start on it some 2 years after the other. I completely support CHEK's approach, which is to simply start the HASU in Canterbury now - after all this is a 20 year plan.

Indeed local residents have told me that its time the East Kent Hospital Trust pulled their socks up (other metaphors are available!) and started work on our new hospital to accompany our new medical school. Again I completely agree with this view - there is more the Trust could be doing.

At last Friday's committee I managed to get a resolution passed asking that the NHS should look at their figures again and come back to the Scrutiny committee, hopefully with a view to how many HASUs are reallyneeded. We certainly more than 3 sites right now and, is this really is a plan for the next 20 years, then the totalcould be up to 6. I don't think anything less is acceptable.