Agenda item

Dr Kate Langford (Chief Medical Officer, NHS Kent and Medway) presented the following item:

1)    The committee received a report providing an update on the proposed reconfiguration of stroke services in East Kent, which would result in the creation of a Hyper-Acute Stroke Unit (HASU) at William Harvey Hospital in Ashford.

2)    Dr Langford highlighted that the temporary stroke unit at Kent & Canterbury Hospital (KCH) had delivered strong patient outcomes which would inform and aid the transition to the William Harvey site. She explained that ambulance journey times from Thanet to the William Harvey for the angioplasty service had ranged between 33 to 56 minutes over the past year. She later confirmed this was in the same band as the expected times during the original stroke review which demonstrated travel times did not appear to have changed significantly since then. The comparable blue light times for the stroke service at KCH were not available.

3)    Subject to planning permission (expected imminently), construction at William Harvey was expected to commence on 1 June 2026, with an anticipated opening in late 2027/ early 2028.

4)    Members discussed the report and the following points were noted:

a)    Dr Langford said she expected equivalent patient outcomes at the William Harvey HASU to the KCH service.

b)    Recognising the increased travel time for Thanet residents, a Member asked how their outcomes would be monitored. Dr Langford confirmed SNNAP data would continue to be collected which would allow comparison between particular geographical areas. Whilst this data was not published, the Committee could request such information in a future paper.

c)    The call to needle times were available but had not been provided for this report.

d)    Future stroke patients requiring the thrombectomy service would be transferred to KCH (once the service was open). Such transfers were common practice, and current transfers from Kent were to London. 

e)    Dr Langford explained that a target of 1 hour and 20 minutes had been set to get victims of a stroke into the unit for treatment. The current triage processes had worked well and contributed to meeting this target.

5)    The Committee were concerned about the proposals, and wanted to see the stroke unit at KCH retained, for the following reasons:

a)    potential health inequalities, noting that more deprived areas may be disproportionately affected by increased travel distances to a service that was further away from them.

b)    The stroke unit at KCH was already performing very well and achieving positive patients outcomes.

c)    There were limited public funds available, and the capital money could be invested in other areas that were not performing so well.

d)    The relocation was expected to achieve equivalent, not improved, outcomes.

e)    The data and evidence was from 2018 and a lot had changed since then (such as a pandemic, the introduction of a Marmot coastal region and the Sturry Link Road) so it may no longer be reliable.

6)    Dr Langford acknowledged those concerns but explained that the changes were part of a whole county service reconfiguration, and reminded the Committee that the KCH unit had always been a temporary arrangement, as it was not suitable for a long-term stroke service, which would typically be located on an acute site with co?located services. She reported that the hospital Trust’s preference was to co?locate acute services on a single site to support a more efficient delivery of care.

7)    Some Members suggested that the Chair write to the NHS and the Secretary of State for Health to express the Committee’s lack of confidence in the changes and that the proposed move would not improve patient outcomes for East Kent.

8)    Dr Sturley proposed, and Cllr Tanner seconded, the following motion:

(a)That Canterbury should be retained as the permanent East Kent hyper-acute stroke unit.

(b) That NHS Kent and Medway and NHS England provide further clear evidence supporting the proposed model to William Harvey.

(c) That a full, updated Equality Impact Assessment be completed, with specific focus on Thanet and coastal East Kent as well as deprivation and transport access.

(d) That side-by-side modelling between the current (Canterbury) and proposed alternative arrangements, including the impact on Ashford and Thanet.

(e) That independent assessment be undertaken covering travel times, ambulance resilience, access to family support rehabilitation and discharge planning.

(f) Justification be provided from the ICB as to why the existing high-performing service cannot be retained as a permanent East Kent HASU.

9)    A vote was carried out and the motion passed. Mr Jeffrey wished to be recorded as abstaining from the motion, which he felt was in breach of Section 2 of the Local Government Act 1986.

10)  The Clerk advised the committee that, whilst HOSC could express comments or concerns to the NHS, they remained the ultimate decision maker in regard to proposals, and whilst the committee could request information they had limited ability to require changes. Concern was expressed that the proposed motion may not be enforceable.

RESOLVED that the Committee ask NHS Kent and Medway to address the following concerns:

(a)That Canterbury should be retained as the permanent East Kent hyper-acute stroke unit.

(b) That NHS Kent and Medway and NHS England provide further clear evidence supporting the proposed model to William Harvey.

(c) That a full, updated Equality Impact Assessment be completed, with specific focus on Thanet and coastal East Kent as well as deprivation and transport access.

(d) That side-by-side modelling between the current (Canterbury) and proposed alternative arrangements, including the impact on Ashford and Thanet.

(e) That independent assessment be undertaken covering travel times, ambulance resilience, access to family support rehabilitation and discharge planning.

(f) Justification be provided from the ICB as to why the existing high-performing service cannot be retained as a permanent East Kent HASU.