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Transforming services in Medway

Find out more about what’s happening to improve health and social care services in Medway.

Review of pathology services in Kent and Medway underway

A review of pathology services delivered across Kent and Medway is underway.

The review, undertaken by provider NHS trusts across the county, is driven by a desire to deliver an improved, sustainable service, as well as national requirements to develop a pathology network.

The review will lead to the development of a modern and innovative service for Kent and Medway which provides a high quality pathology service. By developing a more efficient and streamlined service, there is also the opportunity to reduce the overall costs, ensuring best value for taxpayers.

Lesley Dwyer, Chief Executive of Medway NHS Foundation Trust and Chair of the Pathology Review Steering Group said: “Trust chief executives in Kent and Medway have recognised that change is needed to create a more vibrant, self-sufficient pathology service which meets the needs now and in the future, and is affordable for trusts. The national requirement for regional networks is also a driver to implement change at pace.

“We are actively engaging pathology leaders and trust representatives. We will now be engaging staff and unions as we build on the success of closer partnership working over the past few years in Kent and Medway pathology services.

“It will take time to reach a new model of service, but we have a clear goal and look forward to creating a clinically-led and sustainable service that is more suited to future ways of working. This will include improved technologies, and enable us to create a service where people wish to come to learn, work and carry out research. ”

Work has already started to scope potential options which will then form part of a strategic outline case. The new service is likely to be fully implemented in 2021.

Background information

The provider trusts involved in the review are:

  • Medway NHS Foundation Trust
  • Dartford and Gravesham NHS Trust
  • East Kent Hospitals University NHS Foundation Trust
  • Maidstone and Tunbridge Wells NHS Trust.

 

Joint Health Oversight and Scrutiny Committee praise quality of stroke consultation

The Joint Health Overview and Scrutiny Committee (JHOSC), established to scrutinise the Kent and Medway review of urgent stroke services, met on Thursday 5 July 2018 to receive and consider the recently published reports on the stroke consultation and to receive an update on the next steps in the stroke services review process. The JHOSC is a committee spanning four local authorities and is formed of local councillors from Kent, Medway, Bexley in south east London and East Sussex.

The JHOSC councillors put questions to two members of the Kent and Medway stroke review leadership team, about the approach to consultation presented in the activity report and the outcomes presented in the consultation response report.  Overall the members were pleased with and supported the extent of the activity undertaken and they commented on the quality of the formal public consultation and engagement. The chair took the unusual step of formally recording that all the JHOSC members noted the high quality of the consultation activity and agreed it had been comprehensive and well managed.

With regard to the responses to the consultation, the JHOSC discussed the themes that had emerged from the independent analysis of well over 5,000 responses. They acknowledged the concerns raised about travel times and asked that the Kent and Medway stroke review team ensure they have carefully reviewed the data and evidence available before reaching a preferred option. The committee also discussed the importance of rehabilitation services, and requested that the NHS ensures sufficient, high quality rehabilitation services are in place at the same time as any hyper acute stroke units are implemented.

See the recording of the JHOSC meeting on the Kent County Council website

Other areas of discussion included:

  • what consideration had been given to prevalence and incidence of stroke in, and the health needs of, different communities
  • the impact on families and carers of potentially longer and more complicated journeys to visit loved ones for some people
  • how the consultation reached areas outside Kent and Medway and what the implications are for those communities – particularly whether the proposals would negatively impact the Princess Royal University Hospital in south east London and the border populations in East Sussex
  • staffing challenges and how these can be addressed
  • acknowledgement of the concerns raised about the future of hospital services in both Canterbury and Thanet

Patricia Davies, Director of Acute Strategy for the Kent and Medway Sustainability and Transformation Partnership said, “We are naturally very pleased that councillors endorsed and commented on what they felt to be a high quality public consultation – we worked hard to ensure as many people as possible heard about the stroke proposals and could share their views through in a range of ways if they wanted to. We listened carefully to the comments made by the Joint HOSC members on Thursday and noted the areas where they had questions or clarifications. We also noted they would like to be reassured on rehabilitation services and travel times. Our next steps over the summer and into the autumn are to consider the responses to the consultation alongside the agreed evaluation criteria, and all the other available information, evidence and data that the review has gathered in order to reach a preferred option. I would encourage those who want to keep up to date with the review to ensure they have subscribed to the Kent and Medway NHS bulletin via our website at www.kentandmedway.nhs.uk/subscribe.”

Background information

Find out more about the Joint Health Oversight and Scrutiny Committee formed to scrutinise the review of Kent and Medway urgent stroke services at https://democracy.kent.gov.uk/mgCommitteeDetails.aspx?ID=909

The next steps of the process will include:

  • Summer to early autumn:detailed consideration of the consultation responses and establishing whether any viable additional options have been put forward to evaluate in detail, agreeing the approach to the evaluation of the shortlisted options, meeting with the Joint Health Overview and Scrutiny Committee, evaluation workshops
  • Autumn:identifying a preferred option, development of the ‘decision making business case’, including discussion with the South East Clinical Senate, NHS England and NHS Improvement and the Joint Health Overview and Scrutiny Committee
  • Winter:final assurance process with NHS England and NHS Improvement, and the Joint Committee of CCGs meeting to agree the preferred option for implementation

Formal public consultation began in February 2018 on proposals to implement ‘hyper acute stroke units’ (HASUs) in Kent and Medway.

The consultation was run by the eight clinical commissioning groups in Kent and Medway – Ashford CCG, Canterbury and Costal 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.

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

The public consultation ran for 11 weeks from 2 February to 20 April 2018 and comprised the following key questions:

  • Do you think there is a clear case for changing the way we deliver stroke services?
  • Do you think there should be hyper acute stroke units in Kent and Medway?
  • Should acute stroke units and transient ischemic attack (TIA or mini-stroke) clinics be located alongside these units?
  • Do you think that three hyper acute stroke units would be the right number for Kent and Medway?
  • Do you have a preference for any of the five options?
  • Are there any other options or any other factors that we should consider?

To encourage and enable as many residents as possible to take part in the consultation, within the available budget, and to get a broad and representative range of views, a variety of different methods of collecting views were used:

  • Telephone surveys
  • Postal and online surveys
  • Listening events, public meetings and attending meetings and events held by others
  • Outreach engagement (amongst ‘seldom heard’ groups)
  • Focus groups (amongst those not engaging in other consultation activities)
  • Social media activity – Twitter and Facebook
  • Letters/emails via dedicated Freepost address and email address.

Further details can be seen in the full report via the link above.

Reports on the stroke consultation response and activity published

The NHS in Kent and Medway have today published two reports arising from the recent consultation on changes to urgent stroke services, describing the consultation activity that was delivered and summarising the key themes from the responses received.

Urgent stroke services across Kent and Medway don’t consistently meet national quality standards and outcomes for people who have had a stroke aren’t always as good as they should be, despite the hard work of dedicated staff.

Earlier in 2018 the NHS in Kent and Medway, along with some parts of East Sussex and south east London held a public consultation on the future organisation of urgent stroke services in Kent and Medway.

Following the consultation, the NHS is publishing two reports today, one describing the consultation activity that was delivered and one detailing the responses to the consultation:

  • Consultation activity report: This report sets out how the formal consultation on urgent stroke services was delivered across Kent and Medway and with neighbouring areas in Bexley and High Weald Lewes and Havens. It describes the range of activity undertaken but does not describe the responses received.
  • Consultation response report: DJS Research, an independent research consultancy, analysed all consultation responses to develop a report on the themes emerging from the public consultation

The consultation activity report shows that the public consultation activity was comprehensive, reaching in excess of 2 million people, and generating over 5000 responses. The responses to the consultation have been independently analysed to identify a number of key themes. These themes include:

  • The majority of people who took part in the consultation activity – regardless of whether they ‘self selected’ to get involved or were approached to take part in a telephone survey/focus group or other formal research – agree that hyper acute stoke units should be established in Kent and Medway.
  • People generally think that the two most important questions to ask about the proposals are whether they will improve access to care and whether they will improve the quality of care.
  • Whilst many people understand the reasoning behind having three proposed units in the area, and specifically the argument that it would be difficult to staff more than three units in the area, some feel that staffing should not drive such decisions, and that more should be done instead to improve recruitment and retention of staff.
  • The location of hyper acute stroke units, and travel times to the proposed units, are the key area of concern, with particular concern for people living in Thanet.
  • Many feel that the geography of the area means that four units would be better in order to provide fair and equal access to all residents.
  • Whilst the consultation was not positioned nor intended as, a vote or referendum but rather as a chance to gather views and feedback on the proposals, the most preferred option amongst those who responded to the questionnaire was Option A (Darent Valley, Medway Maritime and William Harvey Hospitals), closely followed by Option B (Darent Valley, Maidstone and William Harvey Hospitals).
  • Key reasons given for preferring these options were that they have potentially the greatest reach and accessibility. Many acknowledged that they chose the option with their preferred hospital, usually the one closest to where they live.
  • Many people within the CT postcode area (which covers the largest part of East Kent, less Faversham and Ashford) did not feel any option is suitable and expressed a desire for Kent and Canterbury Hospital or Queen Elizabeth the Queen Mother Hospital to be re-considered as part of the short-listed options.
  • There was also a particular concern over whether after care, including rehabilitation services and care in the community is being considered as part of the review, and the impact that hyper acute stroke units will have on these services.
  • Respondents also wanted to make sure that there was a good focus on preventing stroke as well as treating it.

The extent of consultation and engagement activity undertaken during the consultation period, the number of responses received, and the consistency of the themes coming through from the feedback gathered means the themes arising from the consultation can reasonably be relied upon to be a fair representation of the views of the impacted population across Kent and Medway, Bexley and High Weald Lewes Havens.

Speaking about the response, Patricia Davies, Director of Acute Care for the Kent and Medway Sustainability and Transformation Partnership, and Senior Responsible Officer for the Stroke Review, said, “We would like to thank the thousands of people who took the time to contribute to the consultation. We welcome the many and varied responses and feedback received and the richness of conversation and debate about what we know is a complex and often emotive subject.  We certainly all want the best for ourselves and our loved ones.  We acknowledge and understand the range of views, and in some parts concerns, expressed from many different parts of Kent, Medway, south east London and East Sussex.  The views we have gathered will play an important part of the next stage of decision making. Our next steps are to consider the consultation responses alongside the agreed evaluation criteria, and all the other available information, evidence and data that the review has gathered in order to reach a preferred option. I would encourage those who want to keep up to date with the review to ensure they have subscribed to the Kent and Medway NHS bulletin via our website at www.kentandmedway.nhs.uk/subscribe

The next steps of the process will include:

  • Summer to early autumn: detailed consideration of the consultation responses and establishing whether any viable additional options have been put forward to evaluate in detail, agreeing the approach to the evaluation of the shortlisted options, meeting with the Joint Health Overview and Scrutiny Committee, evaluation workshops
  • Autumn: identifying a preferred option, development of the ‘decision making business case’, including discussion with the South East Clinical Senate, NHS England and NHS Improvement and the Joint Health Overview and Scrutiny Committee
  • Winter: final assurance process with NHS England and NHS Improvement, and the Joint Committee of CCGs meeting to agree the preferred option for implementation

Although there is a desire to make changes as soon as possible in order to improve care and outcomes for people who have had a stroke, implementation will take some time after a decision has been made. We will continue to update staff, stakeholders and local people on our progress around this.

To keep up to date on the progress of the stroke review please subscribe to our bulletin at www.kentandmedway.nhs.uk/subscribe

Background information

  • A formal public consultation began in February 2018 on proposals to implement ‘hyper acute stroke units’ (HASUs) in Kent and Medway.
  • The consultation was run by the eight clinical commissioning groups in Kent and Medway – Ashford CCG, Canterbury and Costal 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.
  • 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
  • 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?
      • 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?
  • The public consultation ran for 11 weeks from 2 February to 20 April 2018.
  • In order to encourage and enable as many residents as possible to take part in the consultation, within the available budget, and to get a broad and representative range of views, a variety of different methods of collecting views were used:
    • Telephone surveys
    • Postal and online surveys
    • Listening Events and public meetings
    • Outreach engagement (amongst ‘seldom heard’ groups)
    • Focus groups (amongst those not engaging in other consultation activities)
    • Social media activity – Twitter and Facebook
    • Letters/emails via dedicated Freepost address and email address

Medway’s Clinical Commissioning Group’s small grant scheme

Medway CCG has been running a small grants scheme – to encourage local people to lead action in their communities to improve health and wellbeing – a key ambition for the STP’s prevention and mental health workstreams.

 

Grants of up to £1,500 are awarded to local communities for a wide range of activities from woodwork classes to singing groups to local outings.  £44,484 has been awarded, 36 projects have been involved benefiting an estimated 2,199 local residents. The project is part of Involving Medway – a pilot, funded by Medway CCG and run through a partnership of seven community organisations to explore effective ways of engaging local community-based groups and residents, in order to promote better health and wellbeing and to help transform local services.

Watch a short film about the small grants programme here.

Helping pregnant women quit smoking – success of support in women’s homes

Helping pregnant women quit smoking – success of support in women’s homes

The early results of a pilot project to offer stop smoking support from specialist advisors to pregnant women in their own homes is proving a runaway success.

 

 

One of the big targets for the STP is to reduce the number of smokers in the population as a whole and, particularly, in expectant mothers.

The council public health departments and the NHS have jointly been trying out a new way of targeting pregnant women in Medway, South Kent Coast, Swale and Thanet, with a very personalised service.

Since December 2017, over 45 women in South Kent Coast and Thanet have stopped smoking as a result. Although early days, these are very encouraging results.

Andrew Scott-Clark , Director of Public Health for Kent and co-chair of the STP prevention workstream, said:

“These are amazing outcomes, way above the levels achieved in the past.
“These are likely to be vulnerable women who may not seek out services and are deeply addicted to nicotine. By offering a service that goes to them, we are able to help them manage their tobacco addiction – the single most important thing they can do to improve their health and that of their babies.

 

What’s more, the advisors are also picking up other issues for these women and their families, giving us the opportunity to help them give their babies a much healthier start in life.

 

BabyClear support from midwives

Meanwhile, midwives with a special interest in smoking in pregnancy working in hospitals in Kent are helping to improve the monitoring and referral to specialist stop smoking services of mothers-to-be, as part of the BabyClear project.

They are working with the other midwives in their teams to maximise the number of women whose carbon monoxide levels are checked. Women who smoke are identified and offered a referral for specialist stop smoking advice. The scheme meets good clinical practice guidance.

Smoking is a key risk factor for stillbirths and deaths of very young children.

“It is fantastic to see the impact midwives can have by talking to pregnant women about how giving up smoking will protect their babies’ health,” said Andrew.

 

I would like to thank every midwife who supports the health of mothers and babies in their care by checking carbon monoxide levels and ensuring support is offered.”

Coming soon: campaign in Medway
In Medway, where one-fifth of pregnant women smoke, public health is preparing to launch a targeted campaign to encourage mums-to-be to quit. Please look out for more information about the campaign here.

Sugar Smart Medway

Sugar Smart Medway

Medway is gearing up for the launch in June of a 12-month drive to make Medway sugar smart as part of the national campaign, launched by Jamie Oliver.

 

 

The national campaign encourages local authorities, organisations, workplaces, and individuals to reduce the amount of sugar we all eat and drink.

Currently, the Medway public health team is working with local people to find out their views on sugar and how much they consume. This kicked off at a public health event at Medway Park on Sunday 15 April which saw 546 residents attend a fun day, run by the ‘Tri for You’ programme.

There was a stand with information on how to look for products with high sugar, and ideas for recipes which are low in sugar.

In coming weeks, a survey will ask Medway people questions to provide a baseline so the success of the campaign can be measured.

Find out more here.

Consultation launches on proposed improvements to stroke services in Kent and Medway

The NHS in Kent and Medway, Bexley in south east London and the High Weald area of East Sussex, is today launching a public consultation on the future of urgent stroke services in Kent and Medway. The NHS is asking for people’s views on proposals to establish new 24/7 hyper acute stroke units in Kent and Medway. The consultation runs from today, Friday 2 February 2018 for 10 weeks until midnight on Friday 13 April 2018.

To take part, people can read the consultation document, participate in public meetings and events, and complete an online or postal questionnaire. There will also be specific engagement through focus groups and other work with people whose views are less likely to be heard, and people whose age, ethnicity or other factors puts them at higher risk of a stroke.

Dr Mike Gill, Independent Chair of the Joint Committee of Clinical Commissioning Groups for Kent and Medway Hyper Acute and Acute Stroke Services said, “This consultation is an opportunity to make your voice heard and help us design the best stroke services in Kent and Medway. We encourage everyone to respond, whether you have been involved in the earlier work or not; whether you work in the local NHS or are a resident; whether you have first-hand experience of stroke or not. All views are important to us.”

At the moment there are no hyper acute stroke units in Kent and Medway, and urgent stroke care is provided at six hospitals. The changes to stroke services are being proposed because currently hospitals are not able to consistently deliver the standard and quality of stroke care that people should be able to expect.

The proposals have been developed by stroke doctors and other stroke specialists. They are in line with evidence-based best practice on how urgent stroke services can be run to give patients the best possible outcomes and reduce death and disability from stroke.

The proposals recommend creating three hyper acute stroke units in Kent and Medway and give five different options for where these three new units could be located. If the proposals go ahead, urgent stroke services would not be provided in other hospitals in Kent and Medway.

Each of the proposed hyper acute sites would also have an acute stroke unit to give patients expert care after the first 72 hours until they are ready to leave hospital, and a clinic for assessing and treating transient ischaemic attacks (TIAs or mini strokes).

The shortlist of possible locations is:

  • Darent Valley Hospital, Medway Maritime Hospital, William Harvey Hospital
  • Darent Valley Hospital, Maidstone Hospital, William Harvey Hospital
  • Maidstone Hospital, Medway Maritime Hospital, William Harvey Hospital
  • Tunbridge Wells Hospital, Medway Maritime Hospital, William Harvey Hospital
  • Darent Valley Hospital, Tunbridge Wells Hospital and William Harvey Hospital

The order of the shortlist is not a ranking and no preferred option will be identified until doctors and others taking the decision about the future organisation of stroke services have fully and carefully considered all the evidence and data available, including feedback from the public consultation.

“I am delighted that we’re launching this consultation today. There is clear evidence that patients benefit most from being treated at a hyper acute stroke unit in the first 72 hours after their stroke, even if that means ambulances driving past the nearest A&E department to get to one,” said Dr David Hargroves, clinical lead for the stroke review and senior stroke consultant at East Kent Hospitals University NHS Foundation Trust.

“We know that patients might currently be able to get to an A&E fairly quickly and the thought of travelling further seems to go against the ‘Act F.A.S.T.’ advice. With stroke, what counts is the total time it takes from calling 999 to having a scan and starting the right treatment. Spending 15 minutes in an ambulance but waiting three hours in A&E is worse than an hour in an ambulance going to a specialist unit that can scan you and start treatment within 30 minutes of arrival. It is also vital for patients’ recovery that over those first three days they are seen by a stroke consultant every day, and regularly assessed by specialist therapists – something we can’t always offer at the moment.”

“Stroke is a medical emergency and the third most common cause of death for people under the age of 75 in the UK,” said Dr Diana Hamilton-Fairley, Medical Director of Medway NHS Foundation Trust. “Almost two-thirds of stroke survivors leave hospital with a disability, such as sight problems, limb weakness or communication problems. We are convinced these proposals for hyper acute stroke units in Kent and Medway will improve the quality of services and help us achieve better outcomes for the 3,000 stroke patients treated in our area each year.”

“Across Kent and Medway, stroke services are not consistently organised in a way that delivers the most efficient or effective care. Experience elsewhere has shown that consolidating stroke teams should provide better care in the future: that must be the aim of us all,” said Dr Steve Fenlon, Medical Director of Dartford and Gravesham NHS Trust. “The involvement of the public will help us shape the model of care and provide support to our committed healthcare professionals delivering this vitally important service.”

Dr Peter Maskell, Medical Director at Maidstone and Tunbridge Wells NHS Trust, said: “We welcome the opportunity to take part in this important consultation to improve stroke care for patients across Kent and Medway, and encourage as many people as possible to take part so their views are heard.”

A meeting on 31 January 2018 of the Joint Committee of Clinical Commissioning Groups for Kent and Medway Hyper Acute and Acute Stroke Services, which has delegated authority from each of the eight Kent and Medway clinical commissioning groups (CCGs), NHS Bexley CCG and NHS High Weald Lewes Havens CCG, gave the go-ahead to the public consultation which is launching today, 2 February 2018. It will run for ten weeks, until midnight 13 April 2018.

To find out more about how to respond to the consultation, please visit www.kentandmedway.nhs.uk/stroke

To find out more about the signs of stroke and what to do if you suspect a stroke please visit www.nhs.uk/actfast

Papers for the Kent and Medway Acute Stroke Services Joint Committee – 31 January 2018

Below are the papers that will be discussed at the Kent and Medway Acute Stroke Services Joint Committee on 31st January 2018.

The  Joint Committee is made up of the eight clinical commissioning groups in Kent and Medway along with Bexley Clinical Commissioning Group and High Weald Lewes Havens Clinical Commissioning Group. The meeting will discuss the proposed changes to urgent stroke services in Kent and Medway and the proposed shortlist for the location of hyper acute stroke units.

The joint committee meeting is held in public and will take place from 13:00-16:00, in the Council Chamber at County Hall, Sessions House, Maidstone ME14 1XQ.  It is a meeting in public, but places are limited by the venue so if you would like to attend this meeting, please book your place and register in advance at https://strokejcccg.eventbrite.co.uk.  For those without access to the internet, places can be booked by calling the Joint Committee admin office on 01892 638331.

Improvement proposed for stroke services in Kent and Medway

Further details about a proposal to establish three new ‘hyper acute’ stroke units in Kent and Medway have been announced today (Thursday 18 January 2018).  The proposed shortlist of potential options for the location of these units, which is still subject to final assurances and approval, is*:

  1. Darent Valley Hospital, Medway Maritime Hospital, William Harvey Hospital
  2. Darent Valley Hospital, Maidstone Hospital, William Harvey Hospital
  3. Maidstone Hospital, Medway Maritime Hospital, William Harvey Hospital
  4. Tunbridge Wells Hospital, Medway Maritime Hospital, William Harvey Hospital
  5. Darent Valley Hospital, Tunbridge Wells Hospital and William Harvey Hospital

Unlike current services, these hyper acute stroke units would operate with a multi-disciplinary team of stroke specialists, providing expert care round the clock with consultants on the wards seven days a week. The new units will allow people to get the best possible care in the vital first few hours and days immediately after their stroke – saving lives and reducing disability. The units would care for all stroke patients across Kent and Medway and from some neighbouring communities, in the critical first 72 hours after a stroke. We don’t currently have any hyper acute stroke units working in this way in Kent and Medway, patients are currently cared for in general stroke units.  Each site would also have an acute stroke unit where people may go after the initial 72 hours for further care until they are ready to be discharged, and a transient ischaemic attack (TIA or ‘mini stroke’) clinic.

These proposal would mean significant changes to the urgent stroke care currently provided in six hospitals across Kent and Medway. The proposed changes would affect every hospital in our area, residents in every part of Kent and Medway, e and some beyond our boundaries. The proposed three new hyper acute stroke units would ensure all residents get consistently high-quality hospital-based stroke care regardless of where they live or what time of day or night a stroke occurs. However, under these proposals urgent stroke services would not be available at the other three hospitals in Kent and Medway.

The proposed changes are focused on ensuring the best care and outcomes for people who have a stroke, meaning faster diagnosis and treatment, fewer deaths, and less disability. To make these proposed changes we would need to invest up to £40million in hospitals and recruiting more staff across the county, but we expect a reduction in costs over time, mainly due to better recovery for patients who wouldn’t then need as much long-term care, and shorter hospital stays.

A Joint Committee of the ten clinical commissioning groups in Kent, Medway, Bexley and High Weald Lewes Havens is meeting to discuss the shortlist on 31 January 2018.  The joint committee meeting is held in public and will take place from 13.00-16.00, in the Council Chamber at County Hall, Sessions House, Maidstone ME14 1XQ.  It is a meeting in public, but places are limited by the venue so if you would like to attend this meeting, please book your place and register in advance at https://strokejcccg.eventbrite.co.uk.  For those without access to the internet, places can be booked by calling the Joint Committee admin office on 01892 638331.

If the shortlist above is approved, we will begin a wide public consultation in February on the future shape of urgent stroke services in Kent and Medway. The consultation will provide further opportunity to help us design the best stroke services and to continue to engage staff, stakeholders, patients and local communities in the issues important to them about stroke services.

When the consultation begins we will publish our consultation document. The consultation document will set out the reasons why we believe Kent and Medway needs three hyper acute stroke units and a range of potential options for where they could be located. It will also summarise the issues we have considered to select the shortlist – from travel times through to staffing issues and how long it would take to establish hyper acute stroke units at different hospitals across the area.

We recognise that people have concerns when hospital services change, but we strongly believe change is needed to improve care. These proposals represent a major investment in stroke services and a commitment to making consistently high-quality care available for all stroke patients, regardless of where you live or when a stroke happens.

We will update this information with further details of our formal public consultation once it starts, and how to get involved and share your views, if the required assurance processes are met, in early February.

* The order is not a ranking and we are not identifying a preferred option until we have fully and carefully considered all the evidence and data available

Read our frequently asked questions about the stroke review and the media release issued on 18 January 2018.

Background to the stroke review

We started reviewing our stroke services in 2015. We did this because whilst staff in our stroke services are working extremely hard to provide the best care that they can, we know that things would be better, for both patients and staff, if we developed our stroke services further. We want our stroke services to meet the latest national best practice standards so that patients get have the best chance of the best outcome after a stroke. These new ways of working have been introduced in other parts of the country and are bringing significant benefits to patients. In London, hyper acute stroke units have reduced deaths from stroke by nearly 100 a year.

There has been a detailed process to consider potential options for the future shape of hospital-based urgent stroke services. Over the course of the review we looked at:

  • a long list that considered different numbers of hyper acute stroke units
  • a medium list of possible three-site options
  • the shortlist of deliverable three-site potential options which is being announced today.

Our proposed shortlist has been through a rigorous process and takes account of other work, particularly in east Kent, around changes to acute hospital services.

Find out more about the stroke review here

 

Making Medway Better: Medway CCG announces new public event dates

Have your say on a new Medway Model for joined up NHS health and social care services.

The Medway Clinical Commissioning Group is looking for your views on the future of health and care in Medway and they now have new listening event dates across Medway.

The Medway Model is a new way of joining up local health and care services so that, where appropriate and possible, they can be delivered closer to people’s homes. We know that most people, when given a choice, want to stay out of hospital and receive care either in their own home or in their neighbourhood.

When someone is ill, there are so many more people involved in their care than just the patient and their GP, so we are bringing services together in six locations across Medway. This will enable health and care staff to work more closely together and develop services that focus on patients.

The approach also recognises that patients have better outcomes if they are involved in decisions around the care they receive and are supported to make healthy choices about their lifestyle. The Medway Model is designed to ensure patients and their families have a strong voice in decisions about their health, care and wellbeing.

You can view a presentation that explains more about the Medway Model here.

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