West Sussex stroke services proposal: NHS experts back plans to develop new centre in Chichester and remove Worthing's site

Plans to ‘improve hospital-based stroke services’ were set out by health and care leaders in Sussex and could see Worthing Hospital lose its site for acute stroke events.

The recommended option is for an acute stroke centre to be developed at St Richard’s Hospital in Chichester, led by University Hospitals Sussex NHS Foundation Trust.

The proposals were approved to go out for public consultation by the NHS Sussex Board at its meeting in public this morning (Wednesday, January 4), with no members raising any objections.

To make the changes, and ‘realise these benefits’, it would mean Worthing Hospital would no longer be a receiving hospital for people who are experiencing a stroke.

This would lead to an increase in number of people with a stroke going to St Richard’s Hospital in Chichester and the Comprehensive Stroke Centre at Royal Sussex County Hospital in Brighton.

‘We should follow national best practice’

The NHS in Sussex, for the past two years, has been carrying out a ‘comprehensive review of stroke services’ in the coastal area of West Sussex – which covers the population of Adur, Arun, Chichester, Worthing and south of Horsham. Investigations found that ‘improvements are needed’ to ensure ‘we are meeting national guidelines for the treatment of stroke’.

Dr Ryan Watkins, chief of service for the specialist division at University Hospitals Sussex, said: “If you have a stroke, you have a better chance of survival and making a fuller recovery if you are treated quickly at a larger dedicated stroke centre, with access to specialist clinicians and support services 24 hours a day, seven days a week. Evidence shows this is true, even if you initially have to travel a bit further to reach the hospital.

“To provide the best treatment and outcomes for our patients, we know we should follow national best practice and develop an Acute Stroke Centre (ASC) in West Sussex."

Dr Watkins said the NHS has ‘spent a long time considering options’, as well as listening to health professionals and those who have experienced a stroke. He said a proposal has been developed that ‘we are confident would improve access to specialist stroke care for the population we serve’.

The NHS said the option will bring ‘many benefits’ to people living across the coastal area of West Sussex, including; access to specialist stroke services 24 hours a day, seven days a week; a reduction in deaths from stroke; less people living with long-term disability following stroke; fewer people losing their independence and being admitted to nursing/care homes; shorter stays in hospital.

A spokesperson added: “It would also support a more resilient workforce and give them a better opportunity to develop their skills to improve standards and continuity of care.”

Concerns over travel times

Dr Raju Rajan, a GP from Mid Downs Medical Practice in Lewes, spoke during the meeting on Wednesday morning:

He said he has ‘consulted with colleagues in Worthing’, who raised ‘concerns about travel times’ for patients in ambulances if they have to travel to Chichester or Brighton.

In response, Pennie Ford, executive management director for NHS Sussex in West Sussex, said: “We have done some extensive mapping of the travel times. We recognise that for the majority of stroke patients will travel by ambulance following a 999 call.

"They will still be well within the 60 minute proposed travel time. Most are within 45 minutes.

“We are confident that those travel times are acceptable for the relevant population.

"We do recognise there is also an impact on friends and family visiting. We are looking to include further discussions about that, as part of the consultation.

"We have included beds in our Worthing site so people can transfer back and be closer to their family.”

Implementation challenges

Susan Marshall, a former chief nursing officer and chairman of the patient experience committee, spoke during the meeting.

She said: “I absolutely agree with and support the proposal from a patient safety and clinical effective perspective. I understand the need for centres of excellence to improve survival rates.”

However, she said there are ‘very clear challenges’ regarding implementation that need to be looked at.

Oliver Phillips, director of strategy, said the workforce is ‘clearly a challenge’, adding: “We think the proposal will make the service much more attractive to staff. We won’t move towards implementation until we are fully confident that we will be able to staff those revised services.”

Claudia Griffith, chief delivery officer, said strokes are ‘preventable and treatable’ but remain ‘one of the leading causes of death in the UK’ and the ‘single largest cause of severe disability’.

She added that there is ‘really strong evidence’ that stroke services are ‘best delivered as part of a 24/7 network service’.

“Worthing and St Richard’s are both stroke receiving units but don’t have specialist stroke staff available on site 24 hours a day, seven days a week,” she said. “Both units receive less than the recommended 600 cases per year.

"Consequently, the programme has produced a case for change. Six options were developed and fully evaluated over three month period between November 2021 and February 2022. Option 4b was determined to be the viable option recommended for implementation.”

The NHS said the proposed two stroke centres would work together – 24 hours a day, seven days a week – to ensure everyone in the coastal area of West Sussex is within a 60-minute ambulance journey to a stroke centre – ‘staffed by the right specialists’.

A spokesperson added: “The NHS in Sussex wants everyone to benefit from safe, effective, and high-quality stroke services when they need them, and whilst we are proud of the safety and quality of the stroke services on offer currently, further improvements are planned outcomes and experiences for patients.”

The consultation will run from February through to March, with feedback and the final decision following in May/June and July. If agreed, transition to implementation would happen by next year.

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