The Independent London Newspaper
23rd August 2014

Letters

HEALTH: Stroke treatment switch ‘a life-saver’ - Three years after controversial closure of hospital units, research finds changes have paid off

Dr Charlie Davie
Chris Philp (fourth from right) and Royal Free stroke unit protesters in 2010

PIC 1: Dr Charlie Davie
PIC 2: Chris Philp (fourth from right) and Royal Free stroke unit protesters in 2010

Published: 8 August, 2013
by TOM FOOT

THE closure of the Royal Free and Whittington stroke units in 2010 was a highly controversial political issue in the build-up to that year’s general election.

In a move inspired by Labour peer Lord Ari Darzi, NHS bosses wanted to replace the hospitals’ services with a specialist “Hyper Acute Stroke Unit” in University College London Hospital.

It was claimed that, while it would take ambulances longer to get there, stroke victims would get a better emergency service.

But many – including clinical specialists – feared valuable seconds lost in transit could do lasting damage to the brain.

This week, the first research-based report into the changes have been released by experts at UCLH, claiming that the change has led to “significant reductions” in both mortality and costs.

The researchers found that predicted survival rates at 90 days were 81.5 per cent before the new model was implemented, and 88.7 per cent after.

It was also calculated that an estimated 400 lives have been saved across the whole of London since 2010.

The new model required some upfront financial investments and increased costs per patient in the first 72 hours “due to the more intensive, specialist care provided to patients”.

There was also a marked increase in administration of vital clot-busting drugs, from 5 per cent to 12 per cent following the reconfiguration.

The findings, published in the medical journal PLOS ONE, were undertaken by health economists from across the NHS in London and Massachusetts General Hospital and UCLH consultant neurologist Dr Charlie Davie.

“Our study shows that a system directing patients to high-quality stroke units in the first 72 hours following a stroke, saves lives and money,” said Dr Davie.

“The centralised model worked well in London because of the high-density population and the hospital distribution that permitted ambulance travel times to remain within viable limits.”

The emergency stroke unit at the Royal Free had been named the second best in the country by the Royal College of Physicians shortly before it was shut down under the changes.

In 2010, the Conservative candidate for Hampstead and Kilburn constituency Chris Philp told the Town Hall: “Time is critical when it comes to strokes – every minute makes a difference.

“If you live in Hampstead, Brent or Barnet, it will take longer to travel to UCLH.”

Labour ward councillor for Somers Town  Roger Robinson said: “I agree totally with Cllr Philp – and it’s not often I do that. This idea is unbelievably stupid.”

But the Lib Dem councillor John Bryant argued that the decision was based on “clinical evidence”, adding: “This is a scurrilous campaign that makes him [Cllr Philp] unfit for public office.”

Speaking this week, stroke patient John Parker, 67, from Tufnell Park, said he was happy with the service.

He was taken to the Royal Free three years ago after having a stroke, but in July, when the problem happened again, he was taken to the new Hyper-acute Stroke Unit.

He said: “I feel very lucky to live in London and I really saw the benefits of going to a specialist centre this time. When I arrived at UCLH, I was seen straight away and they were really geared up for treating me.”

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