Agenda item

To answer the following question received in accordance with Procedure Rule 11.2 from Cllr Robert Knowles, Haslemere East and Grayswood Ward:-

“What written response has Waverley Borough Council made to the consultation on Stroke services in West Surrey which proposes two units in north west Surrey and no service in south Surrey, what discussions has the portfolio holder had with the CCG, NHS England, the Secretary of State and SE Coast Ambulance service?”

The following question was submitted by Cllr Robert Knowles, Haslemere East and Grayswood Ward, in accordance with Procedure Rule 11.2:-

            “What written response has Waverley Borough Council made to the consultation on Stroke services in West Surrey which proposes two units in north west Surrey and no service in south Surrey, what discussions has the portfolio holder had with the CCG, NHS England, the Secretary of State and SE Coast Ambulance service?”

The response given was as follows:-

“As part of the Public Consultation for Improving Stroke Care West Surrey the Portfolio Holder for Health and Wellbeing, Cllr Jenny Else, has been gathering the views of Waverley’s residents.  The main areas of concern are:

Ambulance Response Times

1. Waverley’s residents’ lack confidence in ambulance response times; especially in the south and east of the Borough to get them to the nearest HASUs and ASUs which are proposed to be located at Frimley Park Hospital and St Peter’s Hospital.

2. There is confusion about the speed of stroke diagnosis and treatment to ensure best outcome for patients.  The public understanding is the ‘golden hour’ and door to needle time promoted for cardiology patients but there are a wider range of factors that contribute to securing the best outcomes for stroke patients.

3. Is it realistic that a model trialled in London will work in rural area (In London longest ambulance transfer of 17mins is indicated)?

4. South East Coast Ambulance Service (SECAmb) are in special measures - Residents have been assured that the problems with SECAmb were mainly with Kent/Sussex and have now been resolved - Does SECAmb still have an ‘area wide’ target time which disadvantages those living in the furthest reaches of the Borough?  There is concern that a ‘whole population’ approach will certainly disadvantage the rural community.

Rehabilitation

1. Through conversations with Waverley residents it is also apparent that there is a lack of confidence about the ability of the Clinical Commissioning Group to provide necessary rehabilitation recommended for 6 weeks by a specially trained team (due to funding or staffing).
2. Concerns were raised about how a planned discharge from hospital to home will be funded? Where will these teams be based/managed and who will be part of these teams?
3. What does rehabilitation specialist care involve?
4. Which Community hospitals are in the proposed plan – eg Farnham, Milford, Cranleigh, Haslemere?   Concerns were raised on how family and friends will visit if an ASU is not located in each area.

As part of the consultation process, Cllr Jenny Else, Portfolio Holder for Health and Wellbeing, asked Jeremy Hunt in his capacity as Constituency MP for South West Surrey to broker a meeting with all the key players to address these concerns on Friday 21 April 2017. 

Attendees included: Prof. Tom Rudd Head of NHS Stroke Services, Dr. James Thallon, Medical Director NHS England - South (South East), Daren Mochrie, Chief Executive Officer SECAmb, Dr. David Eyre-Brook, Guildford & Waverley Clinical Commissioning Group, Paula Head, Richard Nelson, Press & Campaigns for Jeremy Hunt MP, Chief Executive Officer Royal Surrey County Hospital, Cllr Julia Potts, Leader Waverley Borough Council and Cllr Robert Knowles for Haslemere East and Grayswood.

There was an overall consensus that with a shortage of specialists in this field of medicine that the proposed HASU’s at Frimley Park Hospital and St Peter’s Hospital should be able to deliver the required stroke outcomes and improved life expectancy as recommended in National Clinical Stroke Guidelines – 2016.  However, it was agreed that to meet the required outcomes ambulance response and door to needle times need to ensure that the potential time lost in getting to a HASU would still provide you with the best outcome from the specialist care provided in an acute unit.

The following next steps were proposed:

1.  Daren Mochrie, the new CEO of SECamb, is to produce a study of current ambulance response and door to needle times with the south and east of our Borough being of predominant interest. This will be completed by the end of June.

2.    It was agreed that Prof. Tom Rudd, the country’s leading expert in the management and treatment of stroke is to have an input into the study to ensure that the current ambulance response and door to needle times  are able to meet the stroke outcomes and improved life expectancy when being transported to a HASU.

3.    Prof. Tom Rudd will share a HASU model operated in Northumbria or a similar area which has many rural areas and has seen an improvement in stroke recovery outcomes.

4.  There will be a further meeting in July where we will consider SECamb’s current position in their ability to provide a fit for purpose service and discuss the practicalities of the rehabilitation provision proposed throughout the Borough and decide how best to get this important information out into the public domain.

A response to the consultation on behalf of Waverley Borough Council and its residents covering the points highlighted will be sent this week now that we are in possession of factual information on which to make an informed response.