Hyper acute stroke services in Barnsley and across our region are being reviewed as part of the work of Commissioners Working Together.
Background to the review of hyper acute stroke services
Commissioners Working Together have to plan and deliver a wide range of services in our region.
Fewer doctors than necessary are currently receiving training for hyper acute stroke services. The commissioners have been talking with Barnsley Hospital about possible outcomes for hyper acute stroke services in our region.
Barnsley Hospital and senior clinicians and managers from other regional hospitals have assessed our performance against national core standards for providing hyper acute stroke services. Each hospital also gathered data about how many people use our services and their staffing levels.
We then met with the commissioners to review services in the region as a whole.
What did the review find?
- Three out of five of the region’s critical care units (Hyper Acute Stroke Units) admit fewer than 600 patients each year. This is below the best practice minimum of 900 per year.
- Some existing services need more stroke doctors, nurses and other staff. There aren’t enough locally and nationally and this is leading to problems with medical cover in our local hospitals. We have already seen temporary closures of some of our units.
- Speed of diagnosis and treatment for patients varies from hospital to hospital. This is strongly influenced by time taken to scan, test and report.
- Some stroke patients may experience delayed treatment because of time taken to receive test results.
- Two units are less than 15 miles away from each other and currently treat fewer than 600 patients a year.
As a result we know that across our region, some people have better experiences, better outcomes and better access to these services than others. The commissioners agreed that everyone in our region should experience the highest quality and safest service possible and have been looking at options to make improvements.
Working with the clinicians and managers from each of the hospitals, supported by independent strategic clinical advice and an independent review, the commissioners have developed a proposal to reduce the number of hyper acute stroke units from five to three.
This proposal recommends the hyper acute stroke units in Barnsley and Rotherham close, with the three remaining units in Chesterfield, Doncaster and Sheffield.
What does this mean for Barnsley Hospital?
At the moment, it means no change. This proposal is still subject to public consultation.
However, we agree that current services across the region are unsustainable and we have a role in ensuring that everyone has access to high quality care and treatment in the first 72 hours of a stroke. We must be ready to put changes in place so are making plans to do this. Doing nothing is not an option.
What is the proposed change?
Our two hyper acute stroke unit beds could close. However, there are no changes to our stroke unit, and we would still care for and treat stroke patients stable enough to return to us.
The changes would only be to our hyper acute unit, which sees and treats patients for the first 72 hours of stroke care.
Barnsley patients in need of critical care would be taken to Doncaster, Sheffield or Wakefield.
Following the hyper acute period patients would be discharged either to their own home to continue their rehabilitation in the community. If patients need a hospital stay greater than 48 hours they will be transferred back to Barnsley Hospital..
How many patients would this affect?
Our Hospital treats around 550 patients a year who need hyper acute stroke treatment.
The majority of patients will remain unaffected by the proposed change.
What happens next?
Subject to approval by the Joint Overview and Scrutiny Committee and NHS England, this proposal will be open to consultation with people across the region from 3 October 2016 to 20 January 2017.
We will share consultation documents when they are available.