• Six stroke units to be reduced to three
  • Travel times of an hour have caused concern
  • First HASUs could be set up by spring 2020

Controversial plans to create three hyperacute stroke units in Kent and Medway have been approved, but could still face a judicial review. 

A joint committee of the area’s clinical commissioning groups has approved plans for HASUs at Maidstone Hospital, the William Harvey Hospital in Ashford and Darent Valley Hospital in Dartford.

Three other sites – Tunbridge Wells Hospital, Medway Hospital and the Queen Elizabeth, the Queen Mother, Hospital in Thanet – would lose stroke services. The CCGs argue the overall service will improve and ultimately save lives, with a better 24/7 service. 

Medway Council has already indicated it will launch a judicial review if the joint committee – which had representatives from High Weald Lewes Havens CCG and Bexley CCG – backed the removal of services from its local hospital. The council has argued that HASUs should be put in the deprived areas of the county and has attacked the evaluation process behind the selection of HASU sites, including changes to the methodology.

Medway Council’s health overview and scrutiny committee will also have the chance to consider the plans and could refer them to the secretary of state.

Stroke clinician David Hargroves said there was evidence from around the world to support centralisation and this extended beyond urban areas.

“Northumbria has demonstrated a statistically significant reduction in the time taken to give clot busting drugs,” Dr Hargroves said.  But Thanet GP Jihad Malasi asked whether lives in Thanet would be saved, given the travel times.

“It’s getting to the stroke unit that makes the difference,” said Dr Hargroves, suggesting 20 to 25 people were less likely to die or be disabled in the Kent and Medway area just from getting to a HASU.

The meeting on Thursday night was interrupted by protestors, many of whom argued for a HASU in Thanet, with the chair Mike Gill repeatedly insisting that the audience could not ask questions of the committee. It was adjourned and resumed in private.

The review of stroke services in the region began in 2014.  The preferred option of services in Dartford, Ashford and Maidstone was announced last September. However, it was criticised for the long travel times some residents would face to reach a unit – close to an hour for those living in parts of Thanet – and for leaving some of the most deprived areas without a unit.

The position is complicated, however, by the possibility of a new emergency hospital in Canterbury. East Kent Hospitals University Foundation Trust is also planning to develop a thrombectomy service with a trial starting within a year.

Services in north and west Kent could be reconfigured in March next year but changes in Ashford could take another year.

A Kent and Medway joint health overview and scrutiny committee will look again at the proposal later this month but is unlikely to refer them to the secretary of state.

Currently, Medway Hospital has an E rating in the national stroke audit – the lowest rating in the country. Darent Valley and the QEQM have D ratings, the William Harvey C, and Maidstone and Tunbridge Wells B.  The meeting was told that the ambition was for the HASUs would get an A rating within six months of going live.