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Stroke unit changes hailed a good move by specialists

PUBLISHED: 12:08 10 September 2009 | UPDATED: 16:26 07 September 2010

Tan Parsons STROKE specialists at the Royal Free Hospital have defended changes which mean the site is no longer the primary treatment centre for victims in the Ham&High area. Residents in Hampstead, Golders Green and Hampstead Garden Suburb were dismayed

Tan Parsons

STROKE specialists at the Royal Free Hospital have defended changes which mean the site is no longer the primary treatment centre for victims in the Ham&High area.

Residents in Hampstead, Golders Green and Hampstead Garden Suburb were dismayed to learn in July that a hyper acute stroke unit would be built in University College London Hospital.

It meant stroke victims would have to travel past the world-renowned stroke unit at the Royal Free to get to the Euston Road hospital for treatment - adding to journey times in the critical moments after the stroke.

However, consultant neurologist Charlie Davie, who is a senior member of the stroke team at the Royal Free, says that despite the longer journey patients will still receive treatment far quicker under the new system.

"In the hyper acute stroke unit the door-to-needle time, which is the time from when the patient arrives at the hospital to the moment when they receive the treatment would be 30 minutes," he said.

"Even here at the Royal Free stroke unit, which was rated the second in the country last year, that just doesn't happen. We are working towards a door-to-needle time of half an hour but it's actually closer to 60 or 70 minutes."

The Hyper Acute Stroke Unit (HASU) is one of eight that will be opened across London and, in theory, anyone suffering a stroke within the borders of the M25 will be able to get to one of the units within half an hour.

Whether this proves to be possible will be closely monitored by the North Central London Cardiac and Stroke Network once the service is up and running in February 2010.

The Royal Free stroke centre will still exist, albeit as a satellite of the hyper acute unit at UCLH.

Typically after stroke patients have spent 72hours at the HASU they would be transferred to the Royal Free for a period of further observation and treatment - on average 20 days.

The HASU will use a specialised technique which has proven to be especially effective in some patients and which is currently used at the Royal Free.

It involves a catheter being inserted via the groin to administer drugs instead of the standard intravenous injection.

The Royal Free's stroke unit is set to expand from 16 beds to 28 and the staff will expand accordingly with the number of patients treated there rising from 250 per year to around 450.

A centre for people who have suffered transient ischaemic attacks, or temporary stroke symptoms, is also being set up at the Royal Free.

Dr Davie said that as a patient he would be far more assured with the HASU at UCLH than with the current system.

He said: "This will save hundreds of lives. More patients will have the benefit of the expertise at the Royal Free. We are immensely proud of our unit and we think this is a fantastic opportunity."

Kerry Thompson, who is the Royal Free's acting stroke co-ordinator, added: "This is not change for change's sake. Throughout the process we have focused on the patients and their relatives.

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