To receive an update on the relocation of Stroke Services within Surrey.
Minutes:
Yasmine Makin, the Policy Officer, advised the Committee that the Portfolio Holder, Cllr Else had been heavily involved at the public consultation stage with the stroke service relocation and sent her apologies for not being able to attend to speak with Members.
The Committee was advised that this item was designed to introduce the topic to Members who were not aware of the recent changes to the location of stroke services and to provide background on the reasons, changes made and implications.
The Committee was advised that the Hyper Acute Stroke Unit (HASU) provided expert specialist clinical assessment, rapid imaging and the ability to deliver intravenous clot busting drugs 24/7, up to 72 hours after admission. Acute Stroke Unit immediately follows the hyper-acute phase, usually after the first 72 hours following admission and up to 10 day following a stroke. Acute service provide continuing specialist day and night care.
The West Surrey stroke services were subject to review as part of the wider Surrey stroke review process initiated in 2014. The review that was undertaken by a national panel of experts and clinicians found that 3 hospital sites in Surrey offering a HASU would allow volumes of patients needed to keep skills up to date. This model was the co-located model, with 3 co-located HASUs and ASUs. It was decided that the locations of these hospitals would be Frimley Park Hospital, East Surrey Hospital and Ashford St Peters Hospital. There was a report form Committees in Common in September 2017 which outlined what this would mean for different area of Surrey.
For Farnham there was no change to location of the hospital or follow on care.
For the rest of Waverley the people who usually go to the Royal Surrey will now go to Frimley Park Hospital for HASU and ASU. This would clearly result to a change in ambulance times.
In terms of the follow on care for the rest of Waverley, early supported discharge would now be linked to Frimley rather than via the adult community services with hospital rehabilitation at Farnham, Ashford, Woking or Milford hospital. Since then Frimley Health and Royal Surrey had submitted a case for a networked HASU and ASU with the ASU and RSCH (this meant FPH and RSCH will work closely together to provide the acute stroke care) this proposal had been subject to NHS England assurance process with consent to proceed to committees in common for CCG’s decision.
Guildford and Waverley CCG considered that bedded specialist rehabilitation in RSCH linked with provision of the ASU with access to non specialist rehabilitation within the community was the best fit for the local population. The result was that the Guildford and Waverley population will be served by co-located HASU ASU at Ashford St Peter’s and a HASU at Frimley with a networked ASU at RSCH.
To ensure that these pathways were delivered as modelled the CCGs had established a surrey wide stroke oversight group including commissioners and providers across Surrey. The change in service became operational in April 2018. The ambulance response times continued to be monitored by SEACamb.
The Committee raised concern about the changes and the affect these would have on the more rural communities in the Borough. It was agreed that I the committee monitored the ambulance response times and minutes of the Surrey-wide Stroke Oversight Group Meeting to stay updated with the impact of these changes and agreed that it was something that could come back to the committee in the future.