Changes to treatment for people who suffer a stroke in Scarborough

The temporary change to stroke service delivery at Scarborough Hospital has been made due to “ongoing medical staffing challenges”.

Patients who suffer a stroke in the Scarborough and Bridlington area will now receive hyper acute stroke care (typically up to the first 72 hours of care) at York Teaching Hospital, Hull University Teaching Hospital or James Cook University Hospital in Middlesbrough, rather than receiving initial assessment and care (scan and thrombolysis where appropriate) at Scarborough Hospital, as of May 4 2020.

The decision about which centre a patient is taken to will be based on travel times, and the Yorkshire Ambulance Service (YAS) will transport patients to the nearest centre, in terms of travel time.

Stroke patients who self-present at Scarborough Hospital or have a stroke at the hospital will be transferred to York Hospital.

Hyper acute stroke care is typically needed for about 72 hours after a stroke has been confirmed. Once medically stable, patients will be either transferred back to Scarborough Hospital to receive the appropriate level of ongoing support and rehabilitation, or discharged home for on-going support in the community. This decision will be made by the medical teams, based on individual circumstances.

Insufficient medical cover

In 2015 the Acute Stroke Service at Scarborough Hospital came under pressure with the retirement of two consultants and, despite recruitment efforts, no replacements were found. This meant that there was insufficient medical cover to continue with the same model of acute stroke care in Scarborough.

In response to this, a new pathway was introduced. Patients with symptoms of a stroke who present as ‘walk-ins’ or who are brought by ambulance to the emergency department at Scarborough Hospital have been triaged and treated at the site. This has meant that initial scans, and where appropriate thrombolysis, have been carried out at the Scarborough site and all patients requiring on-going hyper acute care have been transferred to York Teaching Hospital.

Patients are then discharged home from this unit or transferred back to Scarborough Hospital for further rehabilitation, usually within 72 hours, a process will also apply under the new temporary model.

The British Association of Stroke Physicians (BASP) describes that the workforce requirements for a stroke service to cover York and Scarborough is eight consultants. The review was prompted by the consultant covering the service in Scarborough giving notice to leave at the end of March 2020, meaning there will be only three consultants across the two sites.

This vacancy reflects the national context, as about four in 10 hospitals providing stroke care have at least one unfilled consultant post.

The arrangement will remain in place until a review of the sustainable options for hyper acute stroke delivery across the region has been undertaken by the Humber, Coast and Vale Integrated Stroke Delivery Network. It is thought this may take up to nine months.

Healthwatch North Yorkshire is the independent champion for people using health and social care services in the county. It is our job to make sure those running services put people at the heart of care.

You can give us your feedback on services in the county, and how potential changes might affect you and your family, and we will share your views with those with the power to make change happen. You can contact us via email or phone on 07882 421394.  Due to the coronavirus pandemic we are working remotely and using a mobile number, but we’ll be happy to call you back to save your phone bill.