One hospital should lose stroke care, doctor says (From Bucks Free Press)

One hospital should lose stroke care, doctor says

11:55am Tuesday 27th July 2010 in

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A TOP doctor today said stroke care should be axed from Wycombe or Aylesbury hospitals to save lives.

Piers Clifford, a consultant cardiologist, said Wycombe Hospital and Stoke Mandeville Hospital, Aylesbury were not seeing enough patients to keep up doctors’ and staff skills.

Government guidance said about 500 people should be seen a year – but each site was seeing 200 to 300 cases.

One hospital is therefore likely to lose the service – but bosses have not said which. They have pledged a full public consultation.

The hospital has already lost major A&E cases and doctor-led births. Yet Dr Clifford said it had kept a key heart attack service that was saving lives.

He told the annual meeting of Buckinghamshire’s hospital authority today there are four options for stroke care.

Having all care on one site ‘is probably the way that we in Buckinghamshire are going to go’ he said.

This would have ‘hyper-acute care’, treatment within 12 hours of a stroke, and acute care, treatment within six days, at one hospital, he said.

Keeping the service at both sites ‘probably isn’t the way forward’ he said. The size of the community, its level of deprivation and ethnicity would help decide the hospital, he said.

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Other options are to have hyper-acute care at one site and acute care at both or hyper-acute at one and clot busting thrombolysis on one. The latter treatment is infrequently used.

Dr Clifford told The Bucks Free Press that the Royal College of Physicians – the professional body for consultants – said the hospitals were not seeing enough patients.

Buckinghamshire Hospitals NHS Trust chief executive Anne Eden said: “There will need to be a degree of centralisation.”

It comes after a life saving heart attack procedure was saved for Wycombe after South East NHS chiefs suggested it move to Oxford.

Dr Clifford said time was a vital factor for Primary Percutaneous Coronary Intervention, where a balloon is inserted into the body to clear blocked arteries. It is open in the day.

He said ‘there would be several people in those circumstances who would not get the appropriate treatment’ if it left Wycombe, he said.

Patients would have had to go to the John Radcliffe 2 Hospital in Oxford, he said. Survival was 2.7 per cent from one to two hours – but this rose to 11.4 per cent over three, he said.

The treatment cut deaths by 30 per cent compared to the previous treatment, thrombolysis, where a drug is injected into the patient to break apart blood clots.

Ron Newell, vice chairman of the Buckinghamshire Local Involvement Network, the official NHS watchdog, said: “We will be talking with the trust to see if patients do get the best care.

“They are committed to it – whether they achieve it, we will find out.”

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