Stroke unit closure 'putting lives at risk'

THE closure of a hospital stroke unit is putting lives at risk. Dr Steve Evans, of the Medical Specialist Group, made the comment following demands by UK campaigners this week for more awareness of the country's third biggest killer.

Since his arrival in 2002, the UK-trained expert has worked to pull together a specialist team at the Princess Elizabeth Hospital to provide a one-stop assessment and treatment centre.

However, in November the unit was disbanded following the closure of Sherwill Ward, leaving it split across two sites.

Although acute care remains at the PEH, rehabilitation is now at the King Edward VII.

Dr Evans maintains that a co-ordinated centre is a vital factor in stroke recovery.

The island sees about 120 first-time cases every year and about 30 TIAs (similar episodes lasting less than 24 hours).

'If you look at all the trials, having a unit is shown to have the biggest impact on saving lives,' he said.

'We had a multi-disciplined team and it was a joint approach.'

Before, patients were seen first by the unit's doctor then the rest of the team worked together to nurse them back to health.

That core group included physiotherapists, occupational therapists, communication and speech experts and a dietician.

They could also arrange support from the psychology and social work departments.

According to Dr Evans, the running costs were minimal because all the experience and resources were on hand.

He puts the closure problem down to the recruitment of nurses because those in the team had to be transferred to other wards to fill vacancies.

Now he fears they may have to start again from scratch if those with the specialist skills decide to leave and use their talents elsewhere.

'It is a shame that it is not there any more. The team were all committed to the ethos of the service and put a lot of effort into turning Sherwill from an assessment ward for the elderly into this special unit.'

Any decision on its long-term future remains unclear while talks continue about the cost of a new medical block at the hospital. 'Over the last 10 to 15 years, stroke care has changed beyond all recognition,' he said, 'so not having a stroke unit in place does impact.

'The studies support that people will do better if they are looked after in a stroke unit.'

Health minister Deputy Peter Roffey said bed occupancy in medical wards had dropped to a level where the department had to rationalise and split the acute and rehabilitation services between two hospitals.

Ideally the two strands should be together, he said, but a lot rode on the new clinical block at the PEH - something the States is due to debate this year.

Responding to Dr Evans' concerns, he said: 'I do see his point. We obviously went to a lot of expense training people in stroke care. Those skills have not been entirely lost. We are trying to keep those people in particular in Brock Ward.

'But it's not quite the same as a separate, dedicated stroke unit. We are being driven at the moment to keep costs as low as we can while trying to keep the service at the optimum level.'