NHS stroke services in the county could be lost within a month unless patient numbers increase by as much as five times the present figure.
A stark warning for the future of stroke services was spelt out to a meeting of the Wye Valley NHS Trust (WVT) Board this week.
That future could see stroke patients travelling at least as far as Worcester or Gloucester for treatment.
The board heard that funding for the services is an “outstanding” issue between WVT and the Herefordshire Clinical Commission Group (HCCG) as both prepare budgets for 2014-15.
WVT, the board heard, cannot continue to provide a service that is “under-resourced" and known to be ”sub-optimal”.
Stroke services are already on the Trust’s high risk list over the provision of hyperacute stroke facilities and staff with relevant competencies to support patients needing thombolysis treatment with clot busting drugs.
WVT has developed a business case for investment in the service needed to meet national performance standards. That case has the service needing £1m a year to make it viable and handling up to five times the present demand.
But according to existing NHS service tariffs, the county, with one confirmed case a day, has too few cases to support an acute stroke service.
The Trust plan also includes provision for sufficient consultant cover for the management of patients in the acute phase of their illness and a weekend service for assessing and treating
possible transient ischaemic attacks.
Early supported discharge, however, is backed only on the assumption that any localised stroke rehabilitation service remains at Hereford’s Hillside centre since it cannot be accommodated at the County Hospital.
The board heard that a telemedicine link is also needed with another, larger service provider so that 24/7 advice on thrombolysis can be sourced.
If stroke services were not offered in the county, patients would have to go to Worcester or Gloucester, delaying their treatment with consequences for recovery and rehabilitation, the board heard.
Treatment delays are known to directly affect patient outcomes.
WVT and HCCG have until the end of this month to resolve a future for stroke services.
Paul Deneen, chair of Healthwatch Herefordshire, said stroke patients in the county should expect the delivery of a high quality service “as locally as possible” to achieve the best possible outcomes.