‘There’s talk of a ‘golden hour’ – but it doesn’t exist’

Plans for the new specialist stroke units have come under fire from communities with hospitals which currently offer stroke provision, such as in Thanet, where patients will be forced to travel to Ashford for treatment.

They claim the longer journey times of often more than an hour will have an adverse effect on the outcomes for stroke patients.

But Rachel Jones, the director of the Kent and Medway Stroke Review, says the opposite will happen.

“The decision to establish specialist stroke units to provide expert care round the clock is good news for people in Kent and Medway,” she said.

“We expect the new hyper acute stroke units to save an extra life every fortnight, and to reduce disability among stroke patients.”

Four stroke specialists - among them East Kent Hospitals’ consultant stroke physician, Dr David Hargroves - have also moved to allay fears about a so-called ‘golden hour’ for treatment.

They say staff, resources and specialist expertise will be concentrated in the three new units, rather than being “spread thinly” across the current six departments.

“People who live further away from the proposed specialist centres are understandably worried about how long it will take them or a loved one to be transported there by ambulance,” they said.

“We have heard concern that stroke patients could come to harm as a result of longer travel times. There is talk of a ‘golden hour’. “We understand why these arguments sound concerning, but they have little basis in fact.

“[The golden hour] doesn’t exist for stroke.

“From the time symptoms start, national guidelines state we have four-and-ahalf hours to administer clot-busting drugs to the 15% to 20% of patients likely to benefit from them. We like to do it sooner, and under our proposals we want to give patients clot-busting drugs within two hours of calling 999.

“The reality is, sadly, that any stroke patient who dies within a few hours of having a stroke would almost certainly have died whether they were at home, in an ambulance or being cared for in the best stroke unit in the world.

“For the very small percentage of patients whose strokes are the cause of almost instant death, or who fall into a coma and never wake up, currently little can be done.

“However most people will survive their stroke, and the critical factor for them is how we can reduce their risk of dying in the following days, minimise their risk of long-term disability and therefore improve independence. “We can do that best by getting them to a specialist stroke centre where they can get clot-busting care within 30 minutes of arrival if they need it, and round-theclock care for the vital first few days after their stroke.”

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