Five acute care stroke units could close under centralisation proposals

By David Young, Press Association

Five of Northern Ireland's eight acute care stroke units could close under plans to centralise treatment services.

Emergency care provision for stroke patients could be lost at Causeway Hospital in Coleraine, South West Acute Hospital in Enniskillen, Daisy Hill Hospital in Newry, Ulster Hospital in Dundonald and Antrim Area Hospital.

Health chiefs have proposed six potential models for consolidating services in larger hyperacute units, with the suggested number of these better resourced facilities ranging from three to five.

In all scenarios, hyperacute units will be sited at the Royal Victoria Hospital in Belfast, Altnagelvin in Londonderry and Craigavon Area Hospital.

In the five-unit model, acute services would also be offered in Enniskillen and Antrim.

The centralisation of acute stroke services is a major plank of plans to restructure health service delivery in the region.

Health chiefs insist the proposals, which have gone out for a 12-week public consultation, will lead to better outcomes for patients.

They will enable increased use of the clot-busting thrombolysis and support greater access to thrombectomy, a groundbreaking procedure that removes clots from the brain.

Thrombectomy is only currently available at the Royal Victoria from Monday to Friday, over limited hours.

The proposals would see the procedure offered seven days a week, 24 hours a day at the Royal.

The new network would be supported by a planned extension of Northern Ireland's air ambulance service, with the provision of a second helicopter helping to transport stroke patients to hospital from rural areas.

Department of Health Permanent Secretary Richard Pengelly insisted that a preferred model had not yet been identified.

He encouraged people to give their views on the six options outlined.

"We have an exciting opportunity to change services for the better, protecting many more people from the devastating consequences of stroke," he said.

"We can't secure these improvements without reshaping current provision.

"Our hospital stroke services are currently too thinly spread. Too many units are struggling to maintain sustainable quality care and staffing levels.

"Establishing hyperacute stroke units is vital to ensure we keep pace with advances in treatment and provide the best possible treatment.

"The principle of consolidating care is backed by stroke charities, expert research and the proven success of reforms introduced in London and Manchester."

Stormont ministers had committed to review stroke services prior to the collapse of powersharing in early 2017.

The commitment was made on the back of the findings of a major Stormont-commissioned examination of healthcare delivery in the region by health reform expert Professor Rafael Bengoa in 2016.

The Stroke Association welcomed the launch of the consultation.

Brenda Maguire, from the charity, said: "Stroke is a devastating condition which can change lives in an instant. Stroke can happen to anyone, at any age and at any time.

"It's the third biggest killer in Northern Ireland and the leading cause of adult disability.

"We are delighted that the Department of Health is moving forward and exploring options to modernise and improve stroke services.

"Reform is urgently needed and will save lives, reduce disabilities and help everyone affected by stroke to access the ongoing support they need to rebuild their lives.

"There is clear evidence that reshaping stroke services works - creating larger hyperacute stroke units with the equipment and experts to treat stroke patients, all day, every day as well as creating more sustainable services.

"We believe everyone affected by stroke should get the best treatment and care possible. Reorganising stroke services will help achieve that."