The NHS in the East of England and in North London is working together to review the services at Mount Vernon Cancer Centre.
The Mount Vernon Cancer Centre is run by East and North Hertfordshire NHS Trust and delivered from a site in North Middlesex managed by the Hillingdon Hospitals NHS Foundation Trust. It is a standalone cancer centre and primarily serves a population of over 2 million people in Hertfordshire, south Bedfordshire, North West London and Berkshire. The patient pathways involve 16 other hospitals and arrangements with 6 other NHS trusts. There is an extremely small number of patients who use the service from other parts of the country. The services are commissioned by NHS England’s Specialised Commissioning team and local Clinical Commissioning Groups.
The Centre provides outpatient chemotherapy, nuclear medicine, brachytherapy and haematology as well as radiotherapy for these populations. There are also inpatient and ambulatory wards.
We are working with the staff at Mount Vernon, with other local hospitals and commissioners, and with the local Cancer Alliances to look at how we can best meet the needs of local people, and develop options that will build on the services, research and patient experience the Centre already delivers.
Why do things need to change?
We want to organise services in ways that provide the best modern care for patients, including access to research trials and new technology and treatments, from good quality buildings and facilities.
Many of the buildings are not in a good state of repair, and concerns have been raised in relation to the long-term clinical sustainability of the Cancer Centre.
As well as ageing buildings, there are limited support facilities on site. For example, there are no high dependency or intensive care beds so patients who become very poorly are sent in an emergency ambulance to Watford General Hospital, or other nearby hospitals.
The limited support at the site creates challenges for the patients and staff, resulting in many patients receiving treatment in a number of different places because of this. As cancer treatment becomes more advanced and as demand for cancer treatment grows, this is becoming less sustainable for patients at Mount Vernon.
The staff at the Mount Vernon Cancer Centre have done a good job despite the conditions, in providing high quality treatment and ensuring patient safety. Patient survey feedback regularly shows that most patients are happy with the services they receive. However, everyone agrees that a more permanent solution needs to be found to ensure the sustainability of the services in the long term.
How will the review work?
The review started in May 2019. It is being led by a Programme Board chaired by the Regional Director of Specialised Commissioning and Health and Justice for the East of England. It has representatives from Healthwatch Hillingdon and Healthwatch Hertfordshire, London and East of England Cancer Alliances, local STPs, CCGs, and a number of acute hospitals, including East and North Herts and Hillingdon Hospitals NHS trusts.
The first stage of the review is about developing options and consists of four parts:
- Reviewing data – for example, looking at where patients come from to Mount Vernon and which parts of their treatment they have elsewhere, what patient outcomes are like, travelling times for services such as radiotherapy.
- Interviewing clinical staff and stakeholders – asking the staff who work at Mount Vernon and key stakeholders for their opinions on what the options should be.
- Independent Clinical Review Panel – leading clinicians from other parts of the country accompanied by representatives of Healthwatch Hillingdon and Healthwatch Hertfordshire reviewing the suggestions of clinical staff, speaking to clinical staff and to patients, and visiting the site, before producing a report in July 2019 making recommendations on the long term options and any short term actions that need to be taken. This report was published on 25th July 2019.
- Patient and public engagement – analysis of existing patient feedback, and hearing patient views and ideas through public events, focus groups and a bespoke survey. Through July, August and early September, patient and public workshops are taking place in Stevenage, Luton, Uxbridge, North London, Watford and at Mount Vernon. Structured interviews are being held with representatives of some patient groups and a patient survey is available for all patients to complete. The patient feedback is being analysed independently and the final engagement report will be published at the end of September. The patient survey can be found here. Details of remaining patient events can be found here.
Timescale for decisions:
A detailed shortlist of options is being developed from the feedback from staff and patients, and the independent review panel. This shortlist should be decided during the autumn of 2019. If the proposals require changes for patients that require public consultation, a 12-week consultation is likely to take start at the end of 2019 or early in 2020. Only once the feedback from public consultation has been fully considered can a final decision be made.
The independent clinical panel has made some recommendations that will not require changes for patients and these may be made more quickly.
Independent Clinical Panel Report:
The Independent Clinical Panel Report (July 2019) was commissioned by NHS England to help inform the development of options for the Mount Vernon Cancer Centre services.
The current provider – East and North Herts NHS Trust, NHS England specialised commissioners and the rest of the Programme Board have welcomed the report.
If you would like to find out more, or be added to the patient or stakeholder mailing lists, or invite us to attend a patient or community group meeting, you can email email@example.com.