On Wednesday 17 July 2019 Maidstone and Tunbridge Wells NHS Trust (MTW) confirmed that they are planning a temporary emergency change to their stroke service. MTW currently operate two stroke services at both the Maidstone and Tunbridge Wells hospital sites. While the Trust has improved its overall vacancy rate following a robust recruitment drive, they still have a high number of nursing vacancies on the stroke ward at Tunbridge Wells Hospital and are also facing a particular pressure in staffing their thrombolysis (emergency clot-busting treatment for stroke patients) service.

As a result, from late September MTW will be temporarily moving their stroke service on to one site at Maidstone Hospital in order to ensure they can continue to offer patients safe stroke care. It is the view of the MTW Board that there is a risk to the safety and welfare of both patients and staff, if the stroke service continues on the Tunbridge Wells Hospital site in light of the staffing challenges.

It is important to be absolutely clear that this is not early implementation of the stroke review and Maidstone Hospital will not be a Hyper Acute Stroke Unit (HASU) as a result of the change. We are very mindful of the outstanding review by the Independent Reconfiguration Panel following a referral to the Secretary of State, and the two applications for Judicial Review that are currently being considered by the Court. We have made an application to expedite the Court’s consideration of these applications and to expedite the hearing of the case, should permission for a Judicial Review be granted.

MTW have confirmed they will comply with the final outcome of the Judicial Review and referral to the Secretary of State, whatever that may be, and the temporary change to the stroke service is reversible.

Difficulty recruiting and retaining enough specialist stroke staff was one of the drivers for making changes to our stroke services in Kent and Medway, and we were aware that maintaining staffing levels during a period of change can be a challenge. Since the new HASU sites were agreed by the Joint Committee of Clinical Commissioning Groups in February 2019, this risk has unsurprisingly increased and has been further compounded by the legal challenges and referral to the Secretary of State.

It is anticipated the change will mean patients in Tunbridge Wells and the surrounding areas will be transferred directly to Maidstone Hospital if a stroke is suspected (likely to be around three patients per day). Currently ambulances transporting suspected stroke patients are already being diverted during the night and increasingly during the day to Maidstone Hospital.

It is not anticipated that this temporary change to stroke services in the west of Kent will impact on other hospital stroke services across Kent and Medway.

All the hospital providers of stroke services across Kent and Medway are working, and will continue to work, incredibly hard to ensure stability of current stroke services in the interim until they are able to move to a confirmed option when the outcome of the challenges are known.