THE IMPORTANCE OF SPECIALISTS v
MOBILE STROKE TREATMENT IN AMBULANCES
By Carly (SONiK research team)
The core argument for the implementation of HASUs* in Kent, and for a very specific number of HASUs (just three) is that it will give patients access to treatment by specialists 24/7.
The case for change put forward by the STP claims that this is not currently available, and it is only by having three HASUs in Kent that this can be achieved. The problem though, is that the STP's plan also involves certain areas of Kent facing much longer journey times in emergencies for a condition whose treatment is extremely time sensitive. The STP argues that in-ambulance treatment could mitigate this, but it is precisely this 'mitigation' that goes against their own case regarding treatment by specialists only.
The 'Stroke Review' plan will upgrade many patients in Kent to specialist-only treatment in a new specialist unit, whilst Thanet, Herne Bay and Dover will be receiving treatment by non-specialists in an ambulance whilst taking a long, bumpy journey on A roads to Ashford. The staff administering drugs in ambulances will be trained and experienced I'm sure, but so are those in the existing Acute Unit at QEQM, and there you will at least have a good chance of seeing a specialist for initial treatment.
The 'improvement' to services that the STP insists is for all of Kent is in reality only an improvement for West and Mid Kent. We want the same improvements to apply to everyone in Kent, and that will mean upgrading Acute Units to HASUs in any area where long journey times could affect the quality of care and leave patients in the wrong postcode with unequal access to the best quality treatment.
When this plan is implemented, the Stroke unit at QEQM hospital should be upgraded to provide the same level of care as the rest of Kent will receive in the new HASUs. Anything else amounts to 'inequality of care', which all CCGs have a statutory duty to prevent.
We know that incidences of stroke are highest in Thanet compared with the rest of Kent (Public Health England, 2016). The QEQM has an existing Acute Stroke unit. So why is it that Thanet is not even being considered as a location for a HASU?
As yet we do not even know if all ambulances serving East Kent will be guaranteed to have scanning, thrombolysis and telemedicine capabilities before the unit at QEQM is closed. We do not know who will pay to upgrade the ambulances and train the staff. We do not know if private finance or management of the ambulances will be part of the plan. Save Our NHS in Kent is asking these questions, and waiting for a response.
* Hyper Acute Stroke Units - a best practice stroke unit staffed with specialists and the best equipment.