Proposal to centralise stroke services in Lewisham

The trust hopes to make 28 beds available for emergency admissions by piloting a move of Queen Elizabeth Hospital’s acute stroke unit, in Greenwich, to neighbouring University Hospital Lewisham.

There has been increased demand on Queen Elizabeth’s emergency department since the closure of acute services at nearby Queen Mary’s Hospital in 2010, according to a report in the trust’s September board papers.

A Care Quality Commission inspection in January found the Queen Elizabeth emergency department was not fit for purpose due to capacity problems that were delaying patient transfers out of the department.

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There was also concern about the time taken to transfer patients into the Queen Elizabeth stroke unit from hyper acute stroke units at King’s College and Princess Royal University hospitals.

A report to Lewisham and Greenwich’s September board meeting said there was a “serious issue with the trust’s ability to repatriate patients from the [hyper acute stroke units] in a timely way”. Transfer should take place within 24 hours but the trust “rarely achieves this”.

A trust spokesman said: “We are currently working to improve our resilience at both Queen Elizabeth Hospital and University Hospital Lewisham as we move into the winter period. [Queen Elizabeth] has additional capacity issues, identified by the [CQC], that need urgent resolution to improve patient safety and the patient experience.”

Bed occupancy in the acute medical unit at Queen Elizabeth is currently at 90 per cent, higher than the recommended 85 per cent. The report said: “It is mutually recognised by the trust and local commissioners that this target occupancy level is an unrealistic aspiration at this time.”

It added that Queen Elizabeth would be unable to meet the four hour target to see, treat, admit or discharge 95 per cent of patients “under existing conditions”.

The proposed move has the support of local clinical commissioning groups. It will now be scrutinised by councillors, and if approved will go ahead in November.