SERVICE DESIGN: The number of hospitals in Kent and Medway admitting patients for treatment after a stroke is likely to be reduced to three or four.

An “urgent” review of stroke services across the area was launched last year amid concerns that the seven existing units did not meet guidelines for the minimum number of patients seen, did not provide adequate specialist staffing and only one unit had seven day consultant cover.

A long list of options – including offering services at three, four and five sites – has been drawn up by the review. However, a joint overview and scrutiny committee set up by Kent and Medway councils heard that some of these might not deliver all the required standards of care – which include seven day consultant and therapist access, and critical co-dependencies. All options meet the criteria of 95 per cent of patients having access within 45 minutes but they also all require more stroke consultants than the area currently has.

Oena Windibank, programme director for the review, told the committee: “A five site model appears to be the most challenging… the workforce gap is considerable.” However, having three sites did raise capacity and sustainability issues, she said.

David Hargroves, a stroke consultant involved with the review, said: “This is purely about clinical outcomes for patients. It is not about cost. There are many patients who are suffering in Kent and Medway because we don’t have a unified policy.”

A four site model could potentially leave each acute trust in the county with one unit – but it could meet East Kent Hospitals University Foundation Trust would have to concentrate services at just one of its three sites. If two sites were retained in east Kent, two would have to be lost in the west and north.

The programme board will continue discussions with trusts before producing a final proposal to be presented to the scrutiny committee. However, the review is likely to lead to a formal public consultation later this year.