• Unit will close by September 2019 rather than in March 2020
  • Service due to close as part of planned reconfiguration of stroke services in Kent
  • Nursing vacancies have risen, with three-quarters of registered nurse posts on ward now empty

A Kent stroke unit is to close seven months earlier than planned, as the loss of staff is putting patient safety at risk.

The unit at the Tunbridge Wells Hospital is now expected to close by September. Patients sent in via an ambulance overnight are already diverted to Maidstone Hospital.

The service is one of three in Kent and Medway which are scheduled for closure, while combined hyperacute and acute stroke units are created at other sites.

The first stages of the reconfiguration were expected to be the closure of the Tunbridge Wells service and another service at Medway Foundation Trust, and the establishment of HASUs at Darent Valley Hospital, in Dartford, and Maidstone Hospital in March 2020.

But vacancies in the Tunbridge Wells unit have increased over the last few months, with more than half the thrombolysis nurse posts vacant along with three-quarters of registered nurse posts on its stroke ward.

In a report to Kent County Council’s health overview and scrutiny committee, Sean Briggs, chief operating officer of the trust, warned the thrombolysis service at Tunbridge Wells can only be staffed 9-5 Monday to Friday and on some weekends from August.

The report noted the vacancies existed “despite robust and frequent recruitment activity”, adding: “Uncertainty around the implementation of the HASUs and ASUs has added to our recruitment challenges at Tunbridge Wells, and some staff have, understandably, sought more certainty in other roles both within and outside of the trust.”

Maidstone and Tunbridge Wells Trust is also increasingly having to ask for ambulances carrying stroke patients to be diverted to its other hospital in Maidstone and has now asked for all overnight stroke patients to be diverted. In May this year, there were 20 diverts compared with none a year ago.

The report to the HOSC added: “Local resolutions have been exhausted and are now not able to deliver what is required to sustain [the stroke ward]… whilst maintaining quality and managing risks.

“The indications are that the service will progressively deteriorate to a point where urgent and potentially knee jerk intervention is required.”

The trust now plans to move all stroke care to the Maidstone site by September.

Plans to reconfigure stroke services in Kent and Medway were backed by a joint committee of clinical commissioning groups in February this year. However, Medway Council has referred the plans to the health and social care secretary and a number of judicial reviews are underway or planned.

Under the reconfiguration, HASUs would be set up at Maidstone Hospital, Darent Valley Hospital and the William Harvey Hospital in Ashford – all of which already have stroke units.

Existing stroke services at Tunbridge Wells Hospital, Medway Hospital and Queen Elizabeth, the Queen Mother Hospital in Margate, would close – the latter in 2021. According to initial documents on the reconfiguration, there would also be some impact on services run by East Sussex Healthcare Trust, as some patients who currently go to Tunbridge Wells might in future go to the stroke unit at Eastbourne District General Hospital.

Maidstone and Tunbridge Wells Trust said the planned “temporary and urgent” move could be reversed if a different configuration of services eventually goes ahead.

Medway FT said its stroke unit was fully recruited for specialist stroke nurses and therapists and had two full-time stroke consultants.

A spokesperson for East Kent Hospitals, which runs the stroke services at both William Harvey and the QEQM, said: “The safety of our patients is our first priority and we continue to regularly review the sustainability of stroke services in east Kent.” 

The HSJ National Cardio Forum takes place for the first time on 21 November 2019 in London at etc.venues Monument. The forum is free to attend for clinical leaders and senior managers who need to know how national policy intersects with clinical practice. By attending you’ll be joining more than 100 of your peers in hearing from NHS England and NHS Improvement leaders setting out how the commitments for cardiovascular disease made in the NHS Long Term Plan will be implemented in STPs, ICSs and PCNs. The programmes covers a range of relevant topics from prevention to intervention.

Build your networks and join a group dedicated to the sharing of best practice in local health economies. NHS England’s Dr Matt Kearney, Professor Jamie Waterall from Public Health England and Jane Tomkinson, the chief executive of Liverpool Heart and Chest NHS FT are just three of the confirmed keynote attendees. Register for this free to attend forum here: https://cardioforum.hsj.co.uk/register-2019