Concerns raised over stroke reconfiguration transfer plans

Under the proposed shakeup, which is set to be discussed by the regional clinical senate in the coming weeks, a specialist hyper acute stroke unit would be established at Basildon and Thurrock University Hospitals Foundation Trust for the patch, which has two other acute providers.

The model depends on transporting the most serious cases from other local accident and emergency departments to the new HASU. The trusts estimated two to three patients would be transferred to Basildon from Mid Essex Trust and Southend University Hospital FT every day.

Campaigners told HSJ they were concerned it would not be possible to safely provide the transport service because of the shortage of paramedics and because of the capacity issues already facing the local NHS provider East of England Ambulance Service Trust.

HSJ has confirmed with a senior source that these concerns are shared by some high ranking clinicians on the patch, who are supportive of campaign group Save Southend NHS’s stance.

A previous attempt to set up a HASU at Basildon in 2014 was also blocked because of concerns around transfers. On that occasion Basildon and Brentwood Clinical Commissioning Group raised concerns about the local ambulance trust’s capacity to deliver the service.

The latest stroke reconfiguration plans were developed as part of the mid and south Essex sustainability and transformation partnership sets closed on 23 March and will be discussed by the East of England clinical senate in the coming weeks.

Tom Abell, deputy chief executive and chief transformation officer across the three acute providers insisted the transfers could be delivered safely. He told HSJ: “The model now is quite different [to the 2014 proposals].

Mr Abell led Basildon and Brentwood Clinical Commissioning Group in 2014 when it opposed the previous reconfiguration plans. He said: “We did not have clinical consensus across the hospitals [in 2014], but we do now.

“The model is also supported by the Stroke Association and has passed through the first phase of an assessment by the clinical senate. That gives me the confidence to say that this is the right thing to do for patients in mid and south Essex.”

He added that a key part of the procurement process would be to assess if providers bidding to run the patient transfer element had “the capability and capacity” to deliver the service.

Mr Abell said the STP would need to commission the new transfer service separately, so the service would not necessarily be run by the ambulance trust, which suffered a torrid winter and was forced to investigate potential patient harm and deaths caused by significant delays.

Save Southend NHS told HSJ: “We are guided by the views of the senior stroke clinicians in our region.

“Transport is the elephant in the room. They have not made public a robust plan of how the transfers can be done safely. We know that there is national and local shortage of paramedics, and that East of England ambulance trust is already struggling to deliver its existing service.

“If a private firm is brought in, it is not clear where they would get their staff and what impact that could have on other services.

Save Southend said it was calling for a model which had telemedicine, 24/7 imaging, and designated stroke doctor and nurse at all hospitals to reduce transfer risk to patients to a minimum.