Agenda item

Mount Vernon Cancer Centre

Minutes:

Ms Jessamy Kinghorn, Head of Communications and Engagement for NHS England (NHSE) Specialised Services, noted that three papers in relation to the Mount Vernon Cancer Centre (MVCC) strategic review had been circulated to Members: a covering report; Clinical Advisory Panel (CAP) Review and Recommendations; and the patient and clinical engagement report from Verve Communications Ltd.  Although the CAP Review and Recommendations report had been published in July 2019, it had more recently featured in an issue of the Guardian newspaper during the previous week. 

 

Whilst it was acknowledged that a significant majority of the patients treated at MVCC were from outside of the Borough (13% were from Hillingdon), it was queried where else Hillingdon residents were receiving cancer treatment.  Ms Kinghorn would find out and forward this information to the Democratic Services Manager for circulation to the Committee.  Patients and their families were very fond of the MVCC and the care that they received there so the review was never about access as patients were happy to travel for good cancer care.  Whilst it was highly unlikely that a brand new hospital would be able to be built on the same site with all of the services needed in it, it would be important to find as local a solution as possible. 

 

It was noted that, despite the work that had already been undertaken, no final list of options had yet been agreed.  The work had been narrowed into two work streams: a short term action plan and a long term action plan.  In the short term, there had already been changes implemented to the admission policy and ward rounds.  An increase in the number of staff for acute oncology had also been approved in principle. 

 

In the short term, a number of independently facilitated events and interviews had been held and a survey undertaken.  During the events, the need for collocation of services had needed some explanation but had been understood.  Feedback had highlighted concerns about the impact on staff of the service was required to move out of Mount Vernon Hospital (MVH).  In addition, although companion services at MVH (Lynda Jackson Macmillan Centre, Paul Strickland Scanner Centre and Michael Sobell Hospice) had not been included in the scope of the review, consideration would need to be given to the impact of any options on these companion services.  It would be important to ensure that any action was not taken in isolation. 

 

The long term work stream included the need to identify a specialist provider and develop options.  Although reviews of cancer services at MVH had previously been undertaken, they had not resulted in any action.  The CAP report had included a recommendation to transfer the accountability and ownership of the MVCC services from East and North Hertfordshire NHS Trust to a current tertiary cancer centre.  Three tertiary providers had already expressed an interest in overseeing the transition and providing clinical leadership at MVCC. 

 

The CAP report had also highlighted the need for:

·         services to be provided by a specialist cancer service provider with access to research trials and the ability to attract leading clinical staff;

·         the colocation of inpatient services – access to support services would enable greater access to (and provision of) treatments such as immunotherapy (it was anticipated that NICE would approve 40 new drugs during the current year).  It was thought that temporary action would be needed to ensure sufficient inpatient capacity in neighbouring hospitals for those patients that needed it; and

·         a networked model of care – more older people with comorbidities were being treated for cancer so it was important to ensure that their care pathway was joined up. 

 

The review had looked at a number of models which had then been shortlisted to: full replacement on an acute site; or an ambulatory hub (Councillor Radia noted that her preference was for an ambulatory care hub and spoke model).  Both of these models would need an additional radiotherapy centre.  Whilst barriers were often faced with regard to funding proposals such as these, Ms Kinghorn had been surprised by the reduction in resistance from those holding the purse strings. 

 

It was suggested that MVCC had been left to become what it had become and that it was no longer clear what it was supposed to be or how it fit into the bigger picture.  As such, any proposed changes to the service would need to be linked into a range of wider expertise that would support it as well as possible plans to build a new Hillingdon Hospital.  Dr Stephen Vaughan-Smith, Cancer Lead at Hillingdon Clinical Commissioning Group (HCCG), advised that the development of a new hospital at Brunel would provide cancer patients with sufficient district hospital support and would mean that radiotherapy could be undertaken at MVCC.  Ideally, the new hospital would have an immunotherapy unit so that patients did not have to travel into London for this treatment using specialised transport.  Although it was recognised that it could be twenty years before a new hospital was built in Hillingdon, this development would need to be considered when looking at the options.

 

Members were advised that staff at MVCC were working hard and had maintained a positive attitude throughout the process to date.  However, concern was expressed that it would not be long before the dedicated and skilled staff started to leave.  As such, interim measures needed to be put in place to retain the staff.  Ms Kinghorn advised that NHSE and NHS Improvement had been working with staff to support them through the process and that, ideally, decisions needed to made quickly whilst also ensuring that the transfer to a new provider would be for the long term rather than as a quick fix. 

 

Consultation was likely to be needed in relation to any proposed changes.  Ms Kinghorn was mindful that the timing would therefore need to be planned around the purdah period.  It was anticipated that consultation on the options for the long term future of the service would be undertaken in the new year.  The implementation time would then depend on the option that was chosen but it was suggested that an outline business case would be developed by January 2021. 

 

Members were advised that, although based in Manchester, Sue Clegg and Ali Percy from Verve would be happy to attend a future meeting of the Committee during the option development stage.  Alternatively, they would be happy to be in contact in via Skype.

 

It was noted that the CQC had visited the site in July 2019.  Although the CQC report had not yet been published, there had been no significant concerns raised by the CQC during its inspection.

 

RESOLVED:  That the presentation be noted. 

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