A summary of the Listening Event at Margate Football Club, Kent and Medway stroke Review, 26th Feb 2018.
People arrived and seated themselves at round tables facing the panel at the front of the room. Each table had one facilitator from the Kent and Medway STP (Sustainability and Transformation Partnership, the group of NHS executives who created the stroke review plan) seated amongst the audience members. There was a brief presentation, followed by an open Q&A session, which went as follows:
It was argued by various audience members at length that three HASUs (Hyper Acute Stroke Units) are not enough, that it must be possible to find enough consultants to staff at least one extra unit, and that the distance to Ashford is not safe for emergency treatment. The panel’s responses to this relied heavily on the argument that workforce shortages are the reason why there can only be three stroke units for all of Kent in their plan, despite the geographical size of the area.
Members of the public referred to the FAST initiative, the golden hour, the need to be seen as quickly as possible, and the journey time being over an hour from Thanet to Ashford.
People commented that this was not a true consultation for the people of Thanet and East Kent, as there is in fact no choice; this area has been presented with one option only, the questionnaire does not allow people here to reflect their need for the best quality stroke care at QEQM, as that option was taken off the table before the consultation began.
Another person asserted that the option for East Kent (Ashford) is not really even in East Kent, it is in mid Kent.
These were the questions that were not properly answered, causing the audience to become agitated and call for clear answers:
– This plan means a reduction in the number of acute beds, how is this an ‘improvement’?
– Is it possible to train nurses to administer thrombolysis and then we could have more HASUs (Hyper Acute Stroke Units) rather than just 3 for the whole of Kent?
– Will you confirm that the STP (the NHS executive body who designed the stroke review) is committed to saving £457m from Kent’s NHS budget by 2020?
One questioner talked about difficulties getting to Ashford without a car on a weekend, and described her two options when she had to take her sick daughter from Cliftonville to William Harvey Hospital in Ashford; her choices were either a £70 taxi both ways, or a journey over 2 hours each way with two train journeys, lots of walking and a bus journey. She didn’t feel her daughter could cope with the public transport option, so she had to pay a large sum for 2 cabs; as a low income earner, she felt this was not acceptable.
Also raised was this question regarding potential privatisation: “Will the new stroke units be put out to tender?” This was one area where panel were willing to give clear answers, and the answer was ‘no’ to this. They were also asked “Will you be following the London model which includes ambulance transfers in the payments made to the stroke providers?”, and the panel answered that SECamb will continue to provide the service, and that SECamb will continue to use private providers to cover some of their service, as they do currently.
There was much frustration from the public due to what appeared to be evasion from the panel. The chair was also attempting to avoid certain questioners because they had already asked a question; this and the chair’s decision to call and end to open Q&A while there were still many questions to be asked spilled over into disruption of the meeting, in the form of people standing up to show that they wanted the Q&A to continue. This action was led by a member of SONIK. A good portion of the room were standing, maybe two thirds of the audience, if you exclude the facilitators sitting at each table. After that, the meeting broke down as many people left to get home in the snowy weather, and a few stayed to take part in the facilitated round table groups. The chairperson was quoted after the meeting as saying he’d been given a set structure and timings to follow, and that everyone should be limited to one question unless the timings allowed a second “go” round.
It’s safe to say that the panel from Kent and Medway STP did not manage to reassure or persuade the audience on this occasion; Save Our NHS in Kent will be attending or getting reports from future meetings where possible.
Dr Tony Martin (Head of Thanet Clinical Commissioning Group and Manager of Bethesda GP Surgery)
Dr David Hargroves (Clinical Lead for Stroke in East Kent)
Caroline Selkirk (Accountable Officer for Medway CCG)
James Pavey (Regional Operations Delivery, South East Coast Ambulances East)
Susan Acott (Chief Executive, Dartford and Gravesham NHS Trust, interim CEO, EKHUFT)