Update on the future of stroke and vascular services in Kent and Medway

Date: 17 September 2018

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Please find below an important update on the future of stroke and vascular services at the Trust.


An announcement has now been made about the preferred option for the location of hyper acute stroke units in Kent.

Medway Maritime Hospital is not included in the preferred option. The preferred option is to have a hyper acute stroke unit, alongside an acute stroke unit, at Darent Valley Hospital in Dartford, Maidstone Hospital and William Harvey Hospital in Ashford. It is important to stress however, that no final decision has been made and there are still several more steps in the decision-making process, with a final decision expected in December 2018 or January 2019.

Option B was chosen because it was considered to offer the best mix when all of the detailed evaluation criteria were applied.

Naturally we are very disappointed that Medway is not identified as one of the locations for a HASU, having presented a strong case.

We know this will be disappointing to staff, and to patients. However, what’s important now is that we will work with commissioners and other providers to do the best for patients, ensuring that the services we provide assist the recovery of stroke patients.

The preferred option will now need to be considered by a number of bodies including the clinical senate, NHS Improvement and NHS England, and the joint health overview and scrutiny committee, with a final decision in December or January. Implementation would take place in the months following the decision.

At Medway we support the creation of HASUs as all the evidence tell us that patients have better outcomes in a specialist unit – more lives are saved and the impact of a stroke on quality of life is improved. We also agree that three HASUs, supported by acute stroke units (ASUs) is the right number for Kent and Medway.

The next stage in the review process is to develop a ‘decision-making business case’ – a detailed document that will describe how the preferred option was selected and set out an implementation plan that will cover areas such as workforce, estates and capital requirement.

The decision-making business case will be reviewed by the South East Clinical Senate and the Joint Health Overview and Scrutiny Committee and assured by NHS England and NHS Improvement.

Once the assurance process is completed, the DMBC will be presented to the Joint Committee of Clinical Commissioning Groups for the Kent and Medway Stroke Review (JC CCG) for a final decision. We anticipate this meeting of the JC CCG will take place in December 2018 or January 2019.

We are pleased to have had the opportunity to engage with so many patients and public about the importance of getting the best possible care following a stroke, and we thank those who supported us during the consultation.

We will now continue to build on improvements already made to the care of stroke patients at Medway, such as receiving clot-busting thrombolysis drugs more quickly, and with access to consultants on a rota 24 hours a day, seven days a week. We need stroke services in Medway to be the best we can provide now for our patients, in the knowledge that they can be safely transferred to a HASU in future.


In a second announcement today, Medway is being recommended as a non-arterial site for vascular services in the future, with a recommendation that the arterial site is at the Kent and Canterbury Hospital. This follows a long period for review and engagement with patients and public, to find the best configuration of vascular services for the county.

This is a recommendation from the Kent and Medway Vascular Review Programme Advisory Board to NHS England specialised commissioning, and is for an interim solution for vascular services.

Although we felt that Medway could have been the arterial centre, with the non-arterial centre in east Kent, we accept this recommendation and will work with other providers and commissioners to ensure that the vascular services that will be provided in Medway in future, including appointments before surgery and follow-up in outpatients, are the best they can be.

A preferred option had already been identified to locate a single arterial inpatient centre in east Kent. The final decision on the hospital in which this would be located is linked to the East Kent Transformation Programme, which is looking at options for the future delivery of urgent and emergency care. The timescale to identify and implement this reconfiguration is likely to not see a future solution in place for five to seven years, hence NHS England felt it was important to consider interim solutions.

Four key objectives have been identified for the Kent and Medway Vascular Network:

  • Multi-disciplinary team meetings undertaken across the network rather than just organisationally focused
  • A single on call rota across the network
  • Improved outcomes across Kent and Medway, including a clear improvement on the variable outcomes currently present
  • Shared utilisation and improved use of resources.  

In order to improve the quality of vascular services in the county, it is clear that an interim solution is needed.

It is important to note that this is a recommendation and a final decision has not been made at this point. This will be undertaken by NHS England specialised commissioning.

  • Summary:

    An announcement has been made on the future of stroke and vascular services in Kent and Medway.