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22.1.      The Committee considered a report providing an overview of the review of stroke services underway in Kent and Medway and to consider the potential implications for East Sussex residents.

22.2.      Ashley Scarff, Director of Commissioning and Deputy Chief Officer; and Michael Ridgwell, Programme Director, Kent and Medway Sussex and East Surrey Sustainability and Transformation Plan, responded to questions from HOSC members.

22.3.      Michael Ridgwell said that the consultation is likely to include four reconfiguration options, although the details of the options have not yet been finalised. Meeting certain travel times is a requirement for all of the shortlisted options, specifically that a patient – including those outside Kent and Medway – is able to reach the stroke unit within one hour. This travel time analysis is being developed in close collaboration with South East Coast Ambulance NHS Foundation Trust (SECAmb). Access considerations are also being considered by an independent company, particularly for disenfranchised or isolated populations.

Capital investment

22.4.      Michael Ridgwell confirmed that all hospitals in the Kent and Medway area will require capital investment in order to make the necessary changes to create 24/7 Hyper Acute Stroke Unit (HASU) with a co-located Acute Stroke Unit (ASU).

Attracting consultants

22.5.      Michael Ridgwell said that there are significant issues with attracting stroke consultants to all of the hospital in Kent and Medway, so it is difficult to say which would be the most difficult to attract consultants to. He explained, however, that being able to say that a HASU reconfiguration is underway has resulted in some increase in the ability to recruit staff, including the recruitment of one consultant; this appears to be the case in other areas that have gone through this process.  Ashley Scarff added that there is tangible evidence that following the consolidation of stroke services the Royal Sussex County Hospital (RSCH) is now more attractive to medical staff, and it would be reasonable to expect the same across Kent.

Thrombectomy

22.6.      Michael Ridgwell said that thrombectomy – the surgical removal of a clot – is a new service commissioned by NHS England that is not yet widely provided by hospitals outside of London. NHS England is, however, recommending that CCGs and trusts begin developing their own thrombectomy centres. He confirmed that each of the four reconfiguration options will include the opportunity for one of the sites to develop as a thrombectomy centre in the future. He added that developing a thrombectomy centre will require a complex process of developing other services that sit alongside a HASU, but it is being given consideration.

RECOMMENDATIONS

The Committee RESOLVED to:

1) note the report;

2) agree that the proposed reconfiguration of stroke services in Kent and Medway is likely to constitute a ‘substantial development or variation’ to services for East Sussex residents requiring formal consultation with HOSC;

3) authorise the Chair, in consultation with the committee, to make arrangements with the other affected HOSCs for the formation of a joint HOSC to respond to the NHS consultation, should this be required before the committee’s next meeting.