Trust takes action after slump in stroke performance

The hyperacute stroke unit at St Peter’s Hospital in Surrey has been given a D rating in the latest round of stroke audits – a decline from its A rating two years ago, before it was designated as the HASU for much of north and west Surrey. The target for admitting patients to a speciality unit within four hours is 90 per cent. 

The latest data, covering July to September last year, showed the trust had one of the worst performances in the south east for patients being admitted to a specialist unit. In September, the rates of admission slumped to 22 per cent, prompting commissioners to demand what action has been taken to mitigate risks to patients.

Ashford and St Peter’s Hospitals Foundation Trust said it had increased bed numbers on the unit from 23 to 32. It is also discharging more patients earlier with rehabilitation care at home and has increased training and development for staff, and invested in a lead nurse and therapist. This month, a new pathway for stroke patients arriving by ambulance should see them bypass accident and emergency and go straight to the stroke unit.

However, the trust said it was changing its model last year so that patients receive both immediate and rehabilitation care on the same unit – rather than some moving to Ashford Hospital for ongoing care – which had some “implementation challenges”.

These led to drops in performance in both the time to admit to a specialist bed and the target of inpatients spending 90 per cent of their time in a specialist stroke unit. It said its performance against some of the other metrics for stroke – such as scanning within an hour of arrival at hospital – remain excellent. Changes in capturing and recording stroke performance also affected its results, it said.

“Our priority remains to provide the very best care and treatment in a timely way to the patients we serve and we, of course, continue to closely monitor our stroke performance and provide assurance to our commissioners on the quality of these services,” the trust added.

The HASU is one of three in Surrey – the others are at Frimley Park Hospitals and East Surrey Hospital. Neighbouring Royal Surrey County Hospital stopped taking immediate stroke cases in January 2017, leading to patients going to St Peter’s and Frimley Park instead. This temporary change was then backed by the area’s clinical commissioning groups later in 2017 as part of a countrywide stroke review. Later that year, St Peter’s lost its A rating.

A statement for the Surrey Heartlands clinical commissioning groups said: “A recovery plan is in place and is being monitored via a contract and quality review meeting.”