Emergency stroke services could disappear at four Yorkshire hospitals

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Emergency stroke services could soon disappear from four Yorkshire hospitals as part of massive NHS reorganisation plans.

On the second day of a Yorkshire Post investigation into the future of the NHS, the paper can reveal services in Calderdale and Harrogate are understood to be at particular risk as the number of sites across West Yorkshire that currently provide a critical service in the first 72 hours after a stroke is potentially reduced from five to three.

A separate consultation is already under way in South Yorkshire on stopping Barnsley and Rotherham hospitals providing critical care for stroke victims.

Health bosses say no decisions have been made about the future of hyper-acute stroke services in West Yorkshire and have launched a public survey to allow people to share their views.

But the West Yorkshire and Harrogate Sustainability and Transformation Plan (STP) on how to fill a £1bn funding shortfall by 2020/2021 has said officials “need to reduce the number of hyper-acute stroke units across West Yorkshire and Harrogate”.

That plan published in November follows a specialist county-wide stroke services ‘blueprint’ in June 2016 which stated that the five stroke units in West Yorkshire - at Bradford Royal Infirmary, Calderdale Royal Hospital, Harrogate and District NHS Foundation Trust, Leeds General Infirmary and Pinderfields Hospital - should be reduced to ‘three or four’.

That paper stated the two units “not currently achieving the required minimum activity levels are Harrogate and District NHS FT and Calderdale & Huddersfield NHSFT”.

But health chiefs said today decisions on what, if any, units shut “will not be based purely on activity levels”.

In South Yorkshire, a separate plan pre-dating the STP process is proposing that Barnsley and Rotherham hospitals no longer provide hyper-acute care in the first 72 hours after a patient has had a stroke.

The June 2016 blueprint highlighted concerns about closures putting extra pressure on stroke services in Leeds.

It said: “Reconfiguration in South Yorkshire could potentially have a significant impact on Mid Yorkshire and Calderdale & Huddersfield hospitals with a subsequent knock-on effect on Leeds.”

The STP states centralising critical care for stroke victims to fewer sites “will save more lives, reduce ongoing disability and ensure better care and quality of service for patients”.

In 2015/16 there were 3,633 stroke admissions to West Yorkshire and Harrogate hospitals, with the majority of people over 65 and half being 75 or older.

Speaking for the West Yorkshire STP, Dr Andy Withers, chairman of the West Yorkshire and Harrogate Clinical Forum, said: “Progress in improving stroke care over the past 10 to 15 years has also increased the demand for the provision of specialist services. This has led to some of our hyper acute stroke services experiencing difficulty in recruiting and retaining the skilled workforce needed to meet these demands. We need to change if we want to meet this growing demand whilst maximising people’s opportunities of a good recovery.”

Dr Withers added: “Further work is required to inform out next steps. It will not be based purely on activity levels. This, alongside our engagement, will help healthcare professionals across the region better understand how our stroke services can ensure everyone can access sustainable, high-quality, consistent care. It is important to note that no decision has been made to change the number of units.”

Doctors in quiet units ‘could lose their skills’

Stroke doctors and nurses based in units that admit less than 600 patients per year risk losing their skills, NHS England has said.

Discussing proposals to stop emergency care in the first 72 hours after a stroke at Barnsley and Rotherham hospitals, NHS England said there are potential benefits to running such a service from three sites rather than the current five in South Yorkshire and North Derbyshire.

A spokesman said that units which deal with less than the national best practice minimum of 600 patients each year mean ‘stroke doctors and nurses in some of our units risk become de-skilled – which in turn would mean patients may not receive the best possible or safest care in the future’.

Potential closures of hyper-acute stroke services are also being considered in West Yorkshire. A report has said both Harrogate and Calderdale will have fewer than 600 admissions per year in 2020.