More than 1,000 extra lives could be saved in London every year, if care for patients with cancer and heart disease is more joined-up and new ‘super centres’ within a network of services across north and east London are approved.
The case for change, put forward by cancer and heart disease doctors and nurses, could see a greater focus on joined-up care spanning prevention and earlier diagnosis through to treatment. The proposals suggest that fewer designated centres could provide world-class care to those needing the most specialist treatment. This is in response to the fact that in London, two thirds of early deaths are a result of cancer and heart disease.
Under the proposals, St Bartholomew’s Hospital would become the centre for specialist treatment of heart disease, and University College Hospital, working within a system of hospitals including The Royal London, St Bartholomew’s, The Royal Free and Queen’s in Romford, would become a centre for the specialist treatment of cancer.
These centres would act as hubs in a new connected system of care including local hospitals, primary and community care services that would provide consistently excellent services and deliver most care close to patients’ homes.
If approved, these new arrangements would be delivered progressively over the next four years with the specialist centres open by April 2015. This would ensure patients needing complex procedures, such as stem cell transplants and intricate heart surgery have access to highly-trained senior consultants and diagnostic facilities, 24 hours day.
Further work is now underway to develop a full business case before taking any final proposals forward for further consideration and testing with the public.
Dr Andy Mitchell, Regional Medical Director at NHS England which is leading the review, said:
“Clinicians have recommended that most people with cancer and heart disease should continue to be cared for locally, but that the small number of patients who need complex treatment are cared for in specialist centres.
“One of the great NHS success stories is the creation of hyper-acute stroke services in London, which have saved nearly 400 lives and have driven improvements across the whole care pathway since introduced in 2010. This plan could replicate this success in cancer and cardiovascular care.
“Currently, the care available for cancer patients and cardiovascular disease is variable. If we were to improve local survival rates for heart disease and all cancers in line with the rest of England, more than 1,200 lives could be saved each year – that’s around 200 extra lives saved for cancer and 1,000 for heart disease.
“Patients need senior consultants to assess their condition and agree the best treatment, but consultants are not available 24 hours a day in all places. Evidence shows that dedicated specialist centres staffed by expert teams and equipped with the best technology and research capability save lives.”
The recommendations build on the UK strategy to bring equity and excellence to specialised services, and the London-wide reviews in 2010 which found that Londoners with cancer and heart disease had poorer outcomes and experience than those treated elsewhere in the country. Professor David Fish, Managing Director of UCLPartners, which facilitated the early work for these proposals with local clinicians, said: “There has been great progress in cancer and cardiovascular care in recent years but unfortunately these diseases are still responsible for around two-thirds of early deaths in London.
“We have some of the best cancer and heart experts in the country, but our services are often not joined up, leading to later diagnosis, poor patient experience and less favourable outcomes. Our specialist care lacks the critical mass of expertise to achieve the best for patients and we fail to make the most of new technologies and innovations that we know could help more patients.
“All of this has led clinicians to recommend that commissioners develop whole systems of integrated care that include fewer, larger centres for specialist services for cancer and heart disease. This will save lives and benefit thousands of patients by providing the latest treatments, research and medical innovation.”
Dr Edward Rowland, Clinical Director of the Heart Hospital, said: “The new heart centre is a once-in-a-lifetime opportunity. It’s a chance for staff from the current hospitals to work together to design and deliver world-class care for our patients.”
Professor Kathy Pritchard-Jones, Chief Medical Officer of London Cancer said: “Too many Londoners die early from cancer and we have to do something about it now. Joining up services and creating centres for specialist care will allow us to invest in the people, technology and research that will give patients the best possible chance of having an uncomplicated operation and fewer long-term side effects.”
NHS England as the main commissioner of these services, together with clinical commissioning group partners, is keen to work with local people explore these clinical recommendations in order to consider and develop any options for change.
A series of local events, starting on 12 November 2013, will be an opportunity for anyone who is interested in these recommendations to hear more and give their feedback to NHS England and local clinicians.
NHS England would like to hear views on the recommendations by 4 December 2013.