The NHS in Gloucestershire has agreed to move the Hyper Acute Stroke Unit (HASU) part of the acute hospital stroke service temporarily to Cheltenham General Hospital.

The change is part of One Gloucestershire’s response to increasing winter pressures (emergency attendances and hospital stays), COVID-19 and Stroke Consultant and Stroke Specialist Nurse workforce challenges.

Taken together, these factors have the potential to affect the Trust’s ability to provide a consistently high-quality stroke service.

The change is being implemented this week (on 1 February 2022) as an emergency, temporary service change in line with the agreed Memorandum of Understanding with the county’s health overview and scrutiny committee (HOSC).

This is in addition to the existing emergency, temporary service change that resulted in the Acute Stroke Unit (ASU) moving to Cheltenham General as part of the local NHS’ response to the first wave of COVID-19.

The HASU, which provides highly specialist care to patients after suffering a suspected stroke or Transient Ischaemic Attack (TIA – mini stroke), is currently located on a shared ward with Cardiology on the Gloucestershire Royal Hospital (GRH) site. 

The majority of stroke patients are admitted directly to HASU for up to 3 days. After this time, many patients who require on-going inpatient hospital care are transferred to the ASU, which is currently on Woodmancote ward at the Cheltenham General Hospital (CGH) site.

TIA and outpatient clinics will also be centralised at CGH under the temporary changes. 

Consultant Stroke Physician at Gloucestershire Hospitals NHS Foundation Trust, Dr Kate Hellier said:

“This temporary change, which will consolidate acute stroke services and specialist staff on the Cheltenham site, is the right course of action to take at this time.

By making the move now, the service will be well placed to maintain the highest standards of care with patients benefitting from timely assessment and decision making from senior stroke specialists, scans and other treatments when they arrive at hospital.

Given current pressures, having all our doctors, nurses and therapists supporting all aspects of the acute stroke care journey on the same site should minimise delays and improve patient experience and outcomes. It should also result in faster and improved training arrangements.”

Other benefits include reduced pressure in Gloucestershire Royal Emergency Department (and on the Cardiology ward), with direct admission to CGH for suspected stroke patients.

Clinical Chair of NHS Gloucestershire Clinical Commissioning Group (CCG), Dr Andy Seymour said:

“We fully support this change which is a sensible and pragmatic move at this challenging time for the service.  

As with all the temporary changes implemented over the last two years, service resilience, quality of care and health outcomes have been the guiding principles and it is right to take decisive action now.”   

Additional information 

There will be an agreed protocol with South Western Ambulance Service NHS Foundation Trust to take all stroke/suspected stroke patients directly to CGH.

Any patient arriving at GRH would be assessed in the GRH Emergency Department and if required would be transferred to CGH for admission or referred to the Trans Ischaemic Attack (TIA) Clinic.

The two stroke temporary service changes will be reviewed at the end of March 2022.