Friday 24 June 2016

The Royal Surrey to lose stroke services


For some time the Surrey Clinical Commissioning Groups (CCGs) have been reviewing the provision of stroke services and, for W Surrey, have concluded there should only be two 'Hyper Acute Stroke Units (HASUs). They propose they be at Frimley Park Hospital and at St Peters Hospital. The Royal Surrey in consort with St Peters has indicated its agreement. 

The purpose of limiting the number of HASUs is to make sure each has a sufficient number of patients to build experience and  expertise and to ensure they are big enough to justify top level equipment and supporting services. St Peters is expert in cardiology and vascular surgery which tips everything in its favour. It has been shown that patients have a much better chance of survival and of avoiding post -stroke complications in large and well equipped HASUs. The centralisation proposed is therefore aimed at better clinical outcomes.

On the other hand speed is of the essence in strokes. It is essential to get patients to a HASU as soon as possible and certainly within a clinically reasonable time. The CCGs has studied ambulance travel times from all the points in West Surrey and is claiming that clinically reasonable ambulance travel times can be achieved with HASUs in only Frimley Park and St Peters. Ambulances with stoke patients would no longer go to the Royal Surrey and it will lose its existing stroke facilities which have always been highly rated in external audits.

Clearly for residents of Guildford and environs (and other places) ambulance travel times will be very substantially increased and will be a  matter of obvious concern.

The CCGs have an obligation to consult the public and this it will do  from July to September. Nevertheless the chance of anyone changing their mind is, in my view, minuscule (an advert for a Clinical Director for St Peters is already underway).