Every minute in which a large vessel ischemic stroke is untreated, the average patient loses 1.9 million neurons, 13.8 billion synapses, and 12 km (7 miles) of axonal fibers. Each hour in which treatment fails to occur, the brain loses as many neurons as it does in almost 3.6 years of normal ageing. Thanet’s 141,000 residents will be one hour away from crucial stroke care once these plans are implemented, with possible ambulance response times of 40 minutes for some patients. We are confident that our concerns are justified.
They say that their ‘guiding principle’ is ‘first do no harm’, and stress that the project is clinically led, but the fact is that the project in Kent is led by high-salaried managers with a business mindset, plus a few clinicians. The STP’s main duty is to drive through national reforms to scale back services so that far fewer hospitals in the country provide acute care (the treatment of sudden, urgent or emergency injury and illness that can lead to death or disability without rapid intervention). It is the Kent & Medway STP’s role to ensure that these plans are rolled out in Kent. This is no secret, it is revealed in the STP’s own reports. Sadly, the duty to ‘do no harm’ is contradicted by the legal duty of the commissioning groups to eradicate their large financial deficits. Were NHS funding more in line with 1948-2010 levels, these deficits would not be as crippling as they are.
We stand by our assertion that it is an experiment on the people of Kent, as no other area in the country has such a high percentage of the population outside 45 mins journey time. We challenge the executives at the STP to disprove this. If they are unable to do so, it would be appropriate for them to retract the accusation that SONIK are behaving irresponsibly, halt the plans as they stand, and opt for a 4 HASU solution instead.
All of the studies being used to back up the stroke review plans are flawed in some way or not applicable to this area. We are working currently on a document that summarises the numerous ways in which the NHS managers are using data inappropriately, and in particular the misleading claim that death and disability outcomes will improve – there is no such evidence. They are also aware that studies exist that prove there are disbenefits to moving acute care further away, but they have consistently chosen not to mention that. They have also ignored their own impact assessment that was carried out independently in December 2017; it shows that negative consequences are likely.
Signed Dr Coral Jones, Dr Tim Winch, Dr Paul Hobday, Carly Jeffrey, Helen Whitehead