Daily Insight: The patients facing seven-hour bed delays

Stroke patients in England are waiting almost seven hours for a specialist bed on average, HSJ analysis suggests – double pre-covid levels.

National performance against key measures collected by the Sentinel Stroke National Audit Programme has fallen significantly over the past two years, with only four in 10 patients being admitted to a stroke unit providing routine care within the official NICE standard of four hours in 2022-23.

That compares to 60.6 per cent in 2018-19. NHS England’s own guidance states that every patient with acute stroke should gain rapid access to a stroke unit within four hours, with this time frame considered critical. Patients can only access clot-busting drugs, and treatments such as thrombectomy which surgically removes a clot, within the first few hours of onset.

Trusts whose performance deteriorated the most cited bed pressures, where stroke patients were having to wait in emergency departments while beds on specialist wards were found.

HSJ’s analysis of performance for 103 units directly admitting stroke patients in England also suggests average waits between clock start and arrival on a stroke unit have almost doubled, going from three hours and 29 minutes in 2018-19 to six hours 49 minutes in 2022-23.

Critical decision

Niall Dickson, the chair of East Kent Hospitals University Foundation Trust, is stepping down in the wake of a warning notice from the Care Quality Commission after an inspection.

Mr Dickson, who had returned to the position after a voluntary period of absence, cites personal and health reasons for his departure.

The CQC’s inspection report criticised the trust’s leadership and various departments, revealing a lack of staff confidence in executive leadership. More than half of the surveyed staff rated leadership as “requires improvement”.

Board changes made it challenging for the trust to implement improvement plans, and governance arrangements were deemed unclear and ineffective by the CQC.

Mr Dickson, who led the trust since April 2021, acknowledges progress during his tenure, including improvements in staffing and maternity care. However, he cautions that the necessary improvements outlined in the Kirkup report for maternity services will require several more years.