• Norwich and Addenbrooke’s to be linchpins of eastern stroke network
  • Norwich to become only second thrombectomy service in East of England
  • Fate of services at local DGHs King’s Lynn and James Paget not yet decided
  • STP said it was ”wrong to portray  the “discussions” as ‘plans for a major stroke reconfiguration’”

Norfolk and Waveney sustainability and transformation partnership is drawing up plans for a major stroke reconfiguration which involves partnering with a neighbouring trauma centre, HSJ has learned.

Local leaders want two major hubs at Norwich and Addenbrooke’s hospitals, run by Norfolk and Norwich University Hospitals and Cambridge University Hospitals Foundation Trusts respectively, to underpin the plans.

The plans for the health economy, which is struggling to contain rising demand for stroke care, are still at a relatively early phase. But the two hub model has been given informal backing by NHS England, local leaders told HSJ.

The networking arrangements will also involve Norfolk’s two district general hospitals: Queen Elizabeth Hospital King’s Lynn Trust and James Paget University Hospitals FT.

A significant first step will be Norwich hospital, which was placed in special measures in June, significantly upgrading its existing facilities and capacity to secure its hub status.

It will become only the second East of England trust, behind Addenbrooke’s, to have the facilities to carry out thrombectomies, where blood clots are directly removed from the brain following a stroke.

The trust told HSJ it had secured £7m of capital for four new interventional radiology labs, one of which would house its thrombectomy service, which are scheduled to open in the middle of next year.

A spokesman added: “NHS England has indicated that NNUH is likely to be asked to provide thrombectomy services in the future as one of two centres in the East of England.

“This fits well with the trust’s ambition to develop its neuroscience service and discussions are taking place about working in partnership with Addenbrooke’s hospital.”

Planning permission for four new labs to be built on the roof of hospital’s east wing was granted in May.

The roles to be played in a network by QEHKL and James Paget have not been decided, but the large rural geography presents a different challenge to other areas which have successfully remodelled stroke services into hub and spoke models, like London.

Journey times between hospitals in urban areas tend to be shorter but with QEHKL an hour away by road from Norwich hospital, there remains a strong clinical argument to retain services at the King’s Lynn site.

Staffing QEHKL, which was itself placed in special measures in September however remains a major problem, particularly nurses.

The depth of this problem was illustrated when it was forced, shortly after being placed in special measures, to consider suspending cancer and urgent operations over winter. 

The board opted against rolling out the emergency proposals and instead hopes it can plug the gaps by drafting in agency staff, and possibly cancelling a significant number of routine operations. Cancer and urgent operations will, however, continue as planned.

The line from Norfolk and Waveney STP : “It would be wrong to portray our discussions as ‘plans for a major stroke reconfiguration’. This is not the case.

“We are certainly discussing the best way to provide stroke services as partners in Norfolk and Waveney and NHS England. However there are many different, possible options to discuss and we are not at the stage of reconfiguring stroke services.”

UPDATED: This story was updated to include the STP’s statement on 1 October at 12:35