- Kent and Medway residents currently have no access to thrombectomy
- St George’s stopped taking patients from outside its core area amid staff shortage concerns
- New service would not be co-located with a neuroscience centre
East Kent Hospitals University Foundation Trust could become one of the first hospitals to offer thrombectomies for stroke patients outside a neuroscience centre as part of a six-month pilot.
The service is being developed after St George’s Hospital in south London stopped taking patients from outside its core area amid concerns over staffing shortages among its interventional radiologists.
Until February last year, Kent and Medway patients normally received thrombectomies at the London trust. Since then, these patients have had no access to the treatment, which can significantly improve outcomes.
Last week, HSJ reported that thrombectomy – the mechanical removal of blood clots which cut off blood flow to the brain – could be provided outside existing neuroscience centres, as part of a shake-up of stroke services.
The new pilot service will initially be limited to East Kent residents who present with a stroke between 8am and 2pm Monday to Friday and only when an intensive care bed is available for them.
The planned service would be a six-month pilot treating a maximum of 10 patients at the William Harvey Hospital in Ashford. Four consultants, from cardiology and interventional radiology, will be trained to deliver the service with additional training for stroke consultants and anaesthetists who will be involved in the procedures or looking after patients post-operatively.
According to a review of the Kent and Medway stroke service, the pilot could lead to a 24/7 service treating 210 patients a year – although the intensive care unit at the William Harvey may need to expand to deliver this. The service would be extended to cover 8am to 6pm seven days a week in 2020-21 and then become 24/7 in 2021-22.
The Royal Sussex County Hospital in Brighton provides an ad hoc service, currently only available to local residents, and hopes to provide a 24/7 service by 2021-22. Unlike the William Harvey site, it is a neuroscience centre.
Services in Kent and Medway are already likely to change – with plans to set up three hyperacute stroke units, including at the William Harvey, likely to be approved by a joint committee of clinical commissioning groups next month. However, EKHUFT said the thrombectomy plan is not dependent on the CCGs’ decision.
A St George’s spokeswoman said: “We continue to provide a high quality, 24/7 thrombectomy service for patients in south London and Surrey, and in 2016 were the first to offer the service 24/7, 365 days a year.
“In February 2018, we took the decision to only accept patient referrals from these areas – this was due to high demand for the service from other parts of the country, plus challenges in recruiting to consultant interventional neuroradiology posts.
“NHS England’s decision to commission thrombectomy services nationwide is improving access to this service, and will build on the success of the service established here at St George’s in recent years.”
Trust comment and appendix to papers for the stroke review