The NHS in Kent and Medway has today published the preferred option for three new specialist ‘hyper acute stroke units’ to be introduced across the county. This is part of an ongoing review of urgent stroke services led by local doctors and other clinicians. The aim is to reorganise services so that specialist stroke staff can more consistently deliver high quality care around the clock, and in so doing reduce deaths and long-term disability from stroke for local people

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The preferred option is to have hyper acute stroke units, alongside acute stroke units, at Darent Valley Hospital in Dartford, Maidstone Hospital and William Harvey Hospital in Ashford.

Currently stroke services do not consistently meet best-practice standards across the whole of Kent and Medway. The identification of a preferred option brings the NHS a step closer to improving stroke outcomes and reducing deaths and disability because of stroke. The preferred option was identified following careful consideration of the responses to a public consultation, all the evidence and data gathered during the four-year review, and further detailed evaluation of five shortlisted options, including trust proposals for implementation.

The next stage in the review process is to develop a decision-making business case – a detailed document that will describe how the preferred option was selected and set out an implementation plan that will cover areas such as workforce, estates and capital requirement. A Joint Committee of the ten local NHS clinical commissioning groups that ran the consultation will examine this and then make a final decision on the future shape of urgent stroke services in January 2019.

Patricia Davies, the Senior Responsible Officer for the Kent and Medway Stroke Review, said: “Today’s announcement is an important step in the stroke review process. However, it is important to stress there are still several hurdles to clear before a final decision is made about the future of urgent stroke care in Kent and Medway. I would like to thank the hard-working staff at all our stroke units in Kent and Medway for their ongoing loyalty and dedication. I appreciate this is a time of uncertainty, but I believe there is an exciting future for everyone working in stroke services across Kent and Medway. The identification of a preferred option brings us closer to being able to deliver the first class care our stroke teams strive for.”

Glenn Douglas, Accountable Officer for the eight Kent and Medway Clinical Commissioning Groups (CCGs) said: “The clinical committee was satisfied that the consultation did not identify any new evidence or viable new options that required a change to the consultation proposals. However, the responses to consultation emphasised important issues for consideration during the implementation of the final option. For example, people were concerned about travel times, relatives and carers visiting loved ones, effective rehabilitation close to home and the ability to staff the new units. These and other issues will all be considered in the detailed implementation plans for the final option. Some work to address these issues is already underway. For example, we are looking at how we can make sure effective rehabilitation services can be delivered locally and close to home for people once the immediate period of their care in hospital in a specialist unit is complete.

“Going from five possible options to one preferred option was always going to be a challenging step. All the five options had the very real potential to improve stroke care, and there was little to differentiate between them. The purpose of the post-consultation evaluation was to dig down into the fine differences between the options and identify which option was the ‘best of the best’. I know there will be disappointment at the hospital sites not identified in the preferred option, but I also know those organisations have always been clear they supported the stroke review as a way to improve care for stroke patients across the whole of Kent and Medway, whatever the outcome. We look forward to making a final decision early in the new year so that we can give certainty to our excellent staff and start to make improvements for those people who have a stroke in Kent and Medway in the future.”

Further information is on the Kent and Medway STP website at www.kentandmedway.nhs.uk/stroke.

The NHS is also announcing details of a proposed new approach to rehabilitation for stroke patients. A key theme from the public consultation was that good quality, well-resourced rehabilitation services, in or close to home, were of vital importance to local people.

Over the next few months the NHS will be gathering views and feedback on the proposed new approach to rehabilitation from stroke survivors, their families and carers, front-line staff, local councillors and the public to help inform detailed implementation plans. Look out for further information on the Kent and Medway NHS website [www.kentandmedway.nhs.uk/stroke].

Contact information

Amanda Crawford
Communications officer
NEL CSU
03000 424499
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Notes to editors

  1. A formal public consultation ran for 11 weeks from 2 February to 20 April 2018 on proposals to implement ‘hyper acute stroke units’ (HASUs) in Kent and Medway.
  2. The consultation was run by a joint committee of clinical commissioning groups (JC CCG), comprising the eight CCGs in Kent and Medway – Ashford CCG, Canterbury and Coastal CCG, Dartford, Gravesham and Swanley CCG, Medway CCG, South Kent Coast CCG, Swale CCG, Thanet CCG and West Kent CCG - along with Bexley CCG in south east London and High Weald Lewes Havens CCG in East Sussex.
  3. The CCGs were consulting on proposals to establish three hyper acute stroke units and to locate acute stroke units and 7-day transient ischemic attack (TIA or mini-stroke) clinics alongside the hyper acute stroke units. Five possible three-site options for hyper acute and acute stroke units were included in the consultation, these were:
  • A: Darent Valley, Medway Maritime, William Harvey
  • B: Darent Valley, Maidstone, William Harvey
  • C: Maidstone, Medway Maritime, William Harvey
  • D: Tunbridge Wells, Medway Maritime, William Harvey
  • E: Darent Valley, Tunbridge Wells, William Harvey
  1. The consultation comprised the following key questions:
    1. Do you think there is a clear case for changing the way we deliver stroke services?
    2. Do you think there should be hyper acute stroke units in Kent and Medway?
      1. Should acute stroke units and transient ischemic attack (TIA or mini-stroke) clinics be located alongside these units?
    3. Do you think that three hyper acute stroke units would be the right number for Kent and Medway?
    4. Do you have a preference for any of the five options?
    5. Are there any other options or any other factors that we should consider?
  2. In June 2018 two reports were published detailing the consultation activity and consultation response.
  3. The preferred option was identified at an evaluation workshop that involved representatives from all 10 CCGs, including GPs, commissioners, and patient representatives. Councillors from Kent, Medway, East Sussex and Bexley were also in attendance at the meeting.