Agenda item - Regional Review of Stroke Services: Update

Report of the Executive Lead, Strategy, Governance & Law, on NHS plans to reconfigure Sussex stroke services.

32.1    This item was introduced by Caroline Huff (CF), Clinical Programme Director, Central Sussex & East Surrey Alliance; and by Dr Nicky Gainsborough (NG), Consultant in Stroke, Brighton & Sussex University Hospitals Trust.

32.2    In response to a question from Cllr O’Quinn about the risk of longer blue-light journey times for Mid Sussex residents should stroke services be single-sited at the Royal Sussex County Hospital (RSCH), NG told members that the advantages of single-siting outweigh any disadvantages of increased journey times. In response to a query from Cllr Deane, NG confirmed that this is likely to be true even if road works or congestion lead to longer than anticipated journeys to RSCH.

32.3    In reply to a question from Fran McCabe (Healthwatch representative) on whether current quality could be maintained with a single-site service, NG told the committee that there has been a divert to RSCH in place since February this year, so effectively stroke treatment has been single-sited for a number of months, and has been offering a superb service, despite all the estates challenges at RSCH. As a consequence of the divert, 10-14 beds have been freed at the Princess Royal Hospital (PRH). Patient satisfaction with the service remains very high (consistently at 98% for the NHS Friends & Family survey), even amongst those who have to travel further, because patients recognise that quality of service is more important than travel times. Although travel is an issue, there are good transport links to RSCH from Mid-Sussex, including the 40x bus service linking PRH and RSCH.

32.4    In response to a question from Cllr Taylor on performance as measured in terms of patient outcomes, NG told members that outcomes have improved recently. It should also be noted that outcomes are identical across the catchment: patients who have to travel longer to access services at RSCH are not disadvantaged by this. Further improvements in outcomes are expected when the team is fully staffed and able to offer a full seven day service.

32.5    In answer to a question from Colin Vincent (Older People’s Council representative) on whether Mid Sussex patients could initially be seen and assessed at PRH, with those needing more specialist treatment then being referred on to RSCH, NG told the committee that this had been considered, but that it was quicker to process all patients at RSCH.

32.6    In response to a question from Cllr Mac Cafferty on the impact on stroke services of initiatives like 3Ts and of system pressures, NG told members that her team are ferocious in protecting their patients’ interests and generally manage to do so successfully. However, delays in getting timely social care assessments and placements do represent a challenge.

32.7    RESOLVED - That the evidence provided detailing the benefits and risks of the Central Sussex Stroke Programme Board’s recommendation to centralise Hyper Acute Stroke services and Acute Stroke services at the Royal Sussex County Hospital (RSCH), Brighton (Appendix 1) be noted; and

That members agree that the HOSC should continue to receive updates on the progress of the stroke review, but that no further formal consultation with the HOSC is required.