London’s controversial centralisation programme is delivering lifesaving benefits to patients, according to one of England’s largest foundation trusts.
University College London Hospitals Foundation Trust claims to have reduced the death rate for stroke patients to 6 per cent, compared with a national average of 27 per cent.
Sir Robert admitted the centralisation had caused concern as other hospitals “don’t want to lose patients” to the eight specialist units
Some changes already under way have been allowed to continue. These include moves to redirect emergency stroke care from London’s 28 accident and emergency departments to just eight hyper-acute stroke units. The reconfiguration is controversial because there are concerns that longer travel times will negate the benefit of higher quality treatment.
UCLH chief executive Sir Robert Naylor said the trust’s first review into the unit’s survival rates - which covers the period from its opening in February until June - would help put an end to those concerns.
The trust hosts the only specialist stroke unit in north central London. It is able to offer rapid CT scans for suspected ischaemic stroke patients and then deliver clot busting thrombolysis treatment where appropriate.
Sir Robert admitted the centralisation had caused concern as other hospitals “don’t want to lose patients” to the eight specialist units.
But he said the preliminary findings gave “a clear indication this type of centralisation works in favour of patients”.
The health secretary has said that if other hospitals in London can match the standards of the eight hyper-acute stroke units, they should be able to continue treating patients. Sir Robert said that would be difficult, as it was generally only larger hospitals that were able to afford onsite access to CT scans and had sufficient neurological expertise available 24 hours a day.
Since February, 240 suspected stroke patients have been referred to the UCLH unit. Of those, 51 diagnosed with ischaemic stroke were thrombolysed - representing a 204 per cent increase for the north central sector of London as a whole.
The mortality rate for the 240 patients was 6 per cent and more than 40 per cent of the patients were able to return home within three days of admission.
Sir Robert admitted the figures were preliminary and the sample size was small but he said they indicated, for stroke care at least, “the more you specialise and the more experts you can bring, the better”.
Immediate thrombolysis treatment is recommended for stroke patients. But unless a stroke can be confirmed through a CT scan there is a risk brain haemorrhage patients might also be given the clot busting treatment, putting them at risk of death or severe disablement.