Agenda item

Dr Peter Maskell, Stroke Network Clinical Lead,Rachel Hewett, Acting Chief Strategy and Partnerships Officers, NHS Kent and Medway and Tracey Fletcher, Chief Executive, EKHUFT were in attendance for this item.

1.    The Chair welcomed the guests and explained to the Committee that several questions had been submitted in advance for response. Ms Hewett confirmed a written response would be provided after the meeting but a verbal response was also provided at the meeting. This included:

a.    The clinical pathway for a suspected stroke patient would start with a video triage call with telemedicine colleagues to assess whether the patient needed conveyance to a HASU or Emergency Department (ED). The patient will be taken to the nearest site that can meet their needs.

b.    Dr Maskell was aware of other Trusts where Mechanical Thrombectomy (MT) and Thrombolysis were not co-located and the separation was not unique to East Kent. MT was commissioned by NHS England Specialised Commissioning and not something the officers could talk about at the meeting.

c.    Call to Needle statistics were not included in SSNAP audits. Dr Maskell explained that across Kent and Medway the “door to needle” and “door to scan” times were excellent. SECAmb held data about “call to hospital” times.

d.    Acknowledging the figures used when commissioning the HASU were 10 years old, Dr Maskell explained they were still the figures being used and were not expected to have significantly changed.

e.    Assistance with travel costs was available to patients with low incomes, but not their relatives and carers. Further information would be set out in the written response.

2.    The Chair welcomed further questions from the Committee. Discussion included the following:

a.    The benefits of MT were evident, and eligible patients were currently being transferred to London. A nearer service had been championed by the Stroke Network and the service at Kent and Canterbury Hospital was expected to open at the end of April 2025.

b.    A Member noted that a recent update from SECAmb had shown an increase in ambulance category 2 response times, and they wondered what impact this would have on stroke patients. Dr Maskell explained that the SSNAP audit collected many process measures and when best practice was met patients had less long term disability. He noted that East Kent were high performers in many of the measures. Outcome mortality figures were reviewed by the East Kent “mortality surveillance group” and not monitored by the Stroke Network.

c.    Until the HASU opened at William Harvey Hospital (WHH), nearby stroke patients were taken to the stroke unit at the Kent and Canterbury Hospital (K&CH). This unit was performing well. The WHH HASU was expected to open in April 2027. Ms Fletcher explained the national recommendation remained for HASUs to be co-located alongside an Emergency Department (ED) (which K&CH did not have).

d.    The location of the HASU at WHH had changed from under the Critical Care Unit to a two storey modular new build located in front of the ED. Planning permission had been requested but not yet granted. It had not been confirmed what the original space would be used for.

RESOLVED that the Committee:

i)             noted the report but had the following concerns:

a.    further delays to getting the HASU built in Ashford;

b.    the Mechanical Thrombectomy unit not being delivered alongside the HASU at William Harvey Hospital;

ii)            invited an update at the appropriate time. If the full business case for the HASU at the William Harvey Hospital was not approved in May 2025 and the construction timeline to complete by April 2027 slipped, the Committee must receive an update as soon as possible. The update should include mortality and long term disability statistics for sufferers of stroke in East Kent