Go ahead announced to revolutionise cancer and heart disease care for millions


At the time of issue the below information referencing a decision by NHS England was believed to be correct, but is now known to be inaccurate.  An update is now available to view.

Pioneering approach, designed to save over 1,000 lives a year, will link local hospitals and GPs with specialist ‘centres of excellence’, including the largest heart surgery centre in the country[1]

Millions of people can expect improved care for cancer and heart disease – combining cutting edge technology and expertise with excellent local care to speed recovery– as part of an innovative new system given the go-ahead today.

Cancer and cardiovascular disease cause nearly two thirds of early deaths in England and Wales[2].

Covering a population of three million people across north and east London and west Essex, the new system could save over 1000 lives a year[3] by giving patients world-class care at every stage – from prevention and diagnosis, through to treatment and beyond. In addition, the new structure will deliver savings of over £94 million and will benefit the UK economy through the development of globally competitive research into cancer and heart disease.

Evidence shows that dedicated specialist centres, treating a high volume of patients, staffed by expert teams and equipped with the latest technology and research capability save lives[4] and reduce complications. This has been the result of the creation of specialist stroke centres in London four years ago, which have saved more than 400 lives and driven improvements in outcomes and care[5].

Based on a case for change put forward by heart disease and cancer doctors and nurses, new centres at St Bartholomew’s Hospital and University College London Hospitals respectively will act as ‘hubs’ within a comprehensive network of care including local hospitals, GPs and other community services. This integrated system will focus on the needs of patients, providing the safest care and a more highly skilled workforce available 24/7, whilst ensuring people are still able to receive the majority of their care locally – all aimed at giving patients the best outcomes and a better experience of their care. It will also ensure services are sustainable for the future.

Under the new system, St Bartholomew’s Hospital will become the centre for specialist treatment of heart disease, including the largest cardiovascular surgery centre in England, the Barts Heart Centre. The new centre will combine the services and staff from the London Chest Hospital in Bethnal Green and The Heart Hospital in the West End, along with those already running at St Bartholomew’s hospital. Bringing together cardiac services onto one site will create the world’s biggest centre of excellence for adults with congenital heart disease[6] and the new centre will perform more heart MRI and CT scans than any other centre in the world[7].

University College London Hospitals, working within a system of hospitals including The Royal London, St Bartholomew’s, The Royal Free and Queen’s in Romford, will become a centre for the specialist treatment of five types of cancer – brain, prostate and bladder, head and neck, oesophago-gastric and blood cancers.[8] The Royal Free Hospital will become a centre for the specialist treatment of kidney cancer. The vast majority of other cancer services, including radiotherapy and chemotherapy for these and other cancers, will still be available in local hospitals, as they are at present.

Anne Rainsberry, Regional Director of NHS England London, said: “This programme is a brand new way of delivering care and a once-in-a-lifetime opportunity to improve services for today’s patients and future generations. These ‘centres of excellence’ should also position London as a leader in research into cardiovascular disease and cancer, attracting some of the brightest and best clinicians and academics to work and study in the UK.

“We know that when people need specialist care, they should be treated in centres with the most highly trained and experienced staff and best facilities. However, people also need to receive high quality care close to home too and this new approach will ensure they get that at every stage.”

Professor Sir David Fish, Managing Director of UCLPartners said: “It is unacceptable that so many lives are lost across our population every year through inadequate prevention, late diagnosis and fragmentation of services for cancer and cardiovascular disease. Doctors, nurses and patients from hospitals and GP practices across the region have been working relentlessly to change this. Through their efforts, the specialist centres will be embedded in joined-up systems of care that together will drive up standards of care, teaching and research. This will deliver safer care, better outcomes – saving lives and reducing complications – and improve experience of people with cancer and heart disease. This is what patients deserve and it can’t come too soon.”

Now approved, these new arrangements will be delivered progressively over the next four years. Services will begin moving into the cardiovascular centre at St Bartholomew’s Hospital from early 2015, and patients can expect to see changes to cancer services from the middle of next year.

  1. Consolidating services in north east and north central London would create the largest cardiac centre in terms of activity
  2. Office for National Statistics, 2012, data on avoidable mortality in England and Wales.
  3. If the NHS in London were to reduce early deaths from cardiovascular disease in people aged 75 and under in north central and north east London to the rate for England, we would save an estimated 1,117 lives per year (statistics from Public Health England).  Similarly, if the NHS in London we were to improve five year survival rates for all cancers in people aged 75 and under in line with at least the rate for England, we would save an estimated 190 lives per year (statistics from Public Health England/NCIN/UKACR).
  4. UCLPartners’ clinical case for change for cardiovascular and London Cancer’s clinical case for change for cancer
  5. Impact on Clinical and Cost Outcomes of a Centralised Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model (August, 2013). RM Hunter, C Davie et al
  6. UCLPartners’ clinical case for change for cardiovascular
  7. Bringing cardiac services together onto one site at St Bartholomew’s would make it the largest in the world in terms of Cardiac MRI and cardiac CT volume.
  8. The changes to specialist cancer services cover bladder, prostate and kidney cancers (urological cancers), bone marrow transplant and acute myeloid leukaemia (haematological), head and neck cancer, brain cancer and cancers of the stomach and oesophagus.
  9. Every year, over 27,000 Londoners are diagnosed with cancer and nearly 13,000 people die from the disease. The number of new cases each year in London is predicted to increase to 28,500 by 2022.
  10. The decision, at 12.30pm today, was made by the organisations responsible for commissioning these services: NHS England, Camden CCG, City and Hackney CCG, Enfield CCG, Haringey CCG and Islington CCG.
  11. UCLPartners is a leading academic health science partnership that supports the healthcare system serving over six million people in parts of London, Hertfordshire, Bedfordshire and Essex. Together, its member organisations from higher education and the NHS form one of the world’s leading centres of medical discovery, healthcare innovation and education. They have come together through UCLPartners to improve health outcomes and create wealth for the local population at scale and pace.
  12. Proposed specialist cancer services locations:
Pathway Configuration Royal Free Barts Health UCLH Barking Havering Redbridge Barnet, Chase Farm Homerton North Mid Princess Alexandra
Brain Current S S S
Recommended S S
Head & neck Current S S S
Recommended S
Bladder & Prostate Current S S S S
Recommended S
Renal (kidney) Current S S S S S S S
Recommended S
HSCT (blood) Current S S S
Recommended S S
AML (blood) Current S S S S S S
Recommended S S S
OG (stomach) Current S S S
Recommended S S