“SHAMEFUL” and “ludicrous” changes to the stroke services being offered at Yeovil Hospital have been given the green light by Somerset health bosses.

NHS Somerset consulted with residents between late-January and mid-April 2023 over the future of stroke services at Yeovil Hospital, which handles stroke patients across eastern Somerset and much of north and west Dorset.

Following a considerable backlash by local residents – including a petition signed by more than 7,000 people – the Somerset Integrated Care Board (ICB) indicated in November 2023 that the hospital could keep some stroke services, with the most serious patients having to travel to either Taunton or Dorchester.

These proposals were formally approved by the ICB in Yeovil on Thursday (January 25), despite residents’ concerns about journey times to other hospitals or the ease of family and carers being able to visit patients.

Stroke services are categorised by the NHS into two camps – hyper-acute (where emergency treatment is required within the first 72 hours) and acute (where the stroke is less life-threatening).

Both of the original options presented to the public in January 2023 envision a sole hyper-acute facility at Musgrove, with hyper-acute stroke patients being either transported to Taunton or the other neighbouring hyper-acute stroke facilities in Bath, Dorchester or Salisbury.

While Option A includes an acute stroke unit in both Taunton and Yeovil, Option B removed acute stroke services from Yeovil, forcing patients to either attend Musgrove or Dorset County Hospital in Dorchester.

NHS guidelines currently advise that any hyper-acute stroke unit should be staffed by at least six qualified consultants and should operated between 8am and 8pm seven days a week, seeing a minimum of 600 patients a year.

The ICB has argued that, given long-term recruitment issues at Yeovil, such a facility would be most ideally based in Taunton – with any changes officially taking effect from March 2025.

At its meeting in Yeovil on Thursday (January 25), numerous members of the public questioned whether removing hyper-acute stroke services at Yeovil would put patients at risk – and whether Dorchester had sufficient capacity to handle more than 200 extra patients a year that would be taken there from Somerset.

Tareth Casey, who serves on Yeovil Town Council, said: “The proposal includes the use of Dorset County Hospital’s facility, which is currently being delivered.

“The business case for additional patients has yet to be made in Dorchester – therefore, this case is being made on pure assumptions.

“Within a few years, a third of Somerset’s population will be 65 or over. Stroke treatment will be a growth industry, and two hyper-acute stroke units is a necessity.”

Somerset County Gazette: NHS Somerset consulted with residents between late-January and mid-April 2023 over the future of stroke services at Yeovil Hospital.NHS Somerset consulted with residents between late-January and mid-April 2023 over the future of stroke services at Yeovil Hospital. (Image: Daniel Mumby)

Eva Bryczkowski, who lives in Glastonbury, urged board members to “vote with your conscience” and put the interests of patients first.

She said: “You say it’s robust – Horizon said their Post Office system was robust. Ofsted said its processes were robust in spite of a suicide of a headteacher.

“Will you please vote with your heart, do the honourable thing and keep Yeovil’s facilities open and undiluted?

“This is about brain damage, about people giving up work to care for someone. We are not just numbers – this could happen to any of us.”

Ray Tostevin, chairman of the Quicksilver Community Group, said there was “widespread opposition” to the changes – including from one of the most prominent consultants within Yeovil Hospital, Dr Khalib Rashid.

He said: “Nearly six out of ten people surveyed disagreed with delivering hyper-acute services from just one site.

“In an excoriating letter, Dr Khalib Rashid says the stroke services at both hospitals are in desperate need of extra investment and strong leadership. 

“This can be solved by a strong recruitment drive without these current plans, which will have a catastrophic effect on the community.

“His proposal has not been considered, nor was it costed. Do you seriously  intend to override the overwhelming negative views of the public and your staff, and ignore the professional view of your most senior consultants and physicians?”

ICB chairman Jonathan Higman responded that Mr Rashid’s proposals had been discussed but were too similar to other proposals which were rejected at an earlier stage of the consultation process.

He added: “The views of the public will be weighed against all the other considerations in the business case. The plans have been developed by a team of clinicians and people with experience of stroke.”

Implementing the changes is expected to cost around £4.2m out of the county’s health revenue budget (i.e. day-to-day spending), along with more than £1.8m of capital funding to ensure Dorset County Hospital has sufficient capacity for the additional patients.

Health bosses estimated the proposals will save £1m in the first full year of their implementation, rising to £3.5m by 2035.

Councillor Adam Dance, who represents South Petherton and Islemoor, said that it was “ludicrous” to implement these changes given Dorchester’s own recruitment struggles.

Mr Dance – who is standing to be Yeovil’s MP at the next general election – said: “Dorset are worse off than Yeovil – why are we considering this? It’s ludicrous.”

Duncan Sharkey, chief executive of Somerset Council, asked for assurances that Dorset had sufficient capacity to make these plans workable.

He said: “What I don’t want  to be doing is to be having the same conversation about being unable to recruit in five years time.”

David McClay, the ICB’s chief officer of strategy, digital and integration, responded that he would “work closely” with his Dorset colleagues to ensure the capacity was in place, adding the current provision would “remain in place until we have a viable plan and time lines.”

After just over two hours’ debate, the ICB voted unanimously to take Option A forward – prompting cries of “shameful” from the public gallery.

Speaking after the meeting, NHS Somerset chief medical officer Bernie Marden said: “The proposals agreed today are a significant step forward for emergency stroke care in Somerset.

“The changes will mean better emergency treatment, resulting in fewer deaths and better recovery for stroke patients in Somerset.”

Dr Rob Whiting, consultant stroke physician and clinical director for neuroscience and stroke at the Somerset NHS Foundation Trust, added: “The review of urgent stroke services in Somerset has always been about improving the quality of care and outcomes for patients.

“All patients, no matter where they live in Somerset, will benefit from being admitted to a unit that is able to provide excellent stroke care 24 hours a day, seven days a week.

“These changes will see a significant investment in local stroke services. We will see improvements to patients’ diagnostic and treatment times, with quicker CT scans and thrombolysis, meaning patients will recover better and have an improved experience.”

A further report on the financial implications of the changed will come before the board at its next meeting on March 28.

Responding to the proposal to move part of the Stroke Unit from Yeovil Hospital to Dorchester, Adam Dance said: "I believe the Integrated Care Board (ICB) made a serious error yesterday when it voted unanimously to move hyper-acute beds from Yeovil General Hospital to a new unit in Dorchester.  

"Moving to Dorchester makes no sense as there is no guarantee that the unit can be delivered on time and on budget.  I want residents around Yeovil to be assured of the best possible care for stroke patients. If money is available to be spent on a Hyper-Acute Stroke Unit in Dorchester, why would the money (Somerset money) not be better spent doing the same in Yeovil?   

"The ICB needs to reassess the situation once the financial evidence is clearer. At present I am not convinced the decision to move to Dorchester will improve services for the people of Yeovil and the surrounding areas."