Wednesday 16 November 2016

You know about HASUs so what about ASUs?

In previous blogs I have reported that that 3 Clinical Commissioning Groups have collectively decided that the number of Hyper Acute Stroke Units (HASUs) in Surrey should be reduced from 5 to 3 and be located in Frimley, St Peters and East Surrey hospitals. The Royal Surrey will lose its HASU and those who have stokes in Guildford will be taken to St Peters and those south of Guildford to Frimley. There will be consultation in Jan/Feb next year but I cannot see this decision being changed.

However the question arises as where patients will go when their spell in the HASU has ended. The argument may be that those from Guildford in St Peters HASU should transfer to an Acute Stroke Unit (ASU) in St Peters itself assuming acute care is still required. However many patients having completed a HASU spell, might wish to be transferred to the Royal Surrey for further acute care prior to going home or to a rehabilitation unit in a non-acute setting. This would allow patients to be close to family and friends during what is often a difficult time.

The downside would be moving away from the clinicians who have treated you at the most dangerous time. However that is soluble given some joint working between St Peters and the Royal Surrey. The same issues arise of course between Frimley and the Royal Surrey.


Here then is an area where consultation could actually be meaningful provided of course the authorities are prepared to listen !!
Another hospital rating system

We have become familiar with Care Quality Commissioner’s inspections and ratings. In the last round Royal Surrey was ‘Good’, Frimley ‘Excellent’ and St Peters ‘Requiring improvement’.

Now the NHSI (NHSImprovement) has introduced ‘The Single Oversight Framework’ designed to help NHS providers attain, and maintain, Care Quality Commission ratings of ‘Good’ or ‘Outstanding’.

The Framework aims to help NHSI identify NHS providers' potential support needs across five themes:
·         quality of care
·         finance and use of resources
·         operational performance
·         strategic change
·         leadership and improvement capability

The Royal Surrey has received a rating of ‘3’, Ashford and St Peters ‘2’ and Frimley ‘1’.


The meaning of the ratings are roughly:

1.    No potential support needs identified.
2.    Targeted support needed: there are concerns in one or more themes.
3.    Mandated support needed for significant concerns: there is actual or suspected breach of licence, and a Regional Support Group has agreed to seek formal undertakings from the provider or the Provider Regulation Committee has agreed to impose regulatory requirements.
4.    Providers in special measures.

Whilst not good, this is not surprising given the Royal Surrey’s very poor financial position and that it is seriously missing some key targets such as cancer waits. Whereas every effort is being focussed on improving it is going to take time to get back to past performance. At least the hospital has decided not to merge with Ashford and St Peters allowing senior staff to concentrate on getting the hospital back onto an even keel.