NHS England – London is planning a new Children’s Cancer Principal Treatment Centre (PTC) covering the current PTC catchment area of south London, Kent, Medway, most of Surrey, East Sussex, Brighton and Hove. To make sure that everyone who wants to can share their view on the new centre, NHS England – London will soon reach out to children, teenagers, families, staff and communities to ask them how the consultation for this project should be designed. Patients who choose to access the service from other areas, such as West Sussex and Surrey Heath, will also have the opportunity to share their views.
Principal Treatment Centres provide diagnosis, treatments, and coordination of highly specialised care for children aged 15 and under with cancer. There are 13 of them in England.
In 2021, a new national service specification for Principal Treatment Centres was approved by NHS England after being developed and tested with patients, families, staff and charities.
It sets out how children’s cancer services should be organised and delivered across the country in the future. Among other things, it requires all PTCs to be on the same site as a paediatric intensive care unit (PICU) and other specialised children’s services such as paediatric surgery relevant to children’s cancer care.
This is because children being treated for cancer are sometimes at risk of needing to be transferred urgently to an intensive care unit. With future, cutting-edge treatments being developed for children with cancer, intensive care and other specialised children’s services will increasingly be required to be on-site.
Currently, the PTC covering the catchment area of south London, Kent, Medway, most of Surrey, East Sussex, Brighton and Hove is jointly provided by The Royal Marsden NHS Foundation Trust and St George’s University Hospitals NHS Foundation Trust. The Royal Marsden does not have a paediatric intensive care unit on-site, which means that some children are currently safely transferred between the site and St George’s Hospital every year.
To ensure that children with cancer continue to get world-leading care in London as new innovative forms of specialist treatment are increasingly used, these arrangements need to change.
Options appraisal process
Evelina London Children’s Hospital, which is part of Guy’s and St Thomas’ NHS Foundation Trust, and St George’s University Hospitals NHS Foundation Trust have both submitted proposals to become the PTC in future.*
Over 30 experts, including clinical advisers, parents, charities, nurses and research staff, were involved in evaluating the proposals as part of an options-appraisal process designed by NHS England – London and shaped by a range of stakeholders. Four panels of about 10 people each looked at different aspects of the proposals to understand:
• how the proposals would deliver the service in the future, compared to what happens currently
• what each would mean for patients, families and staff delivering clinical care
• how the proposals would deliver the clinical aspects of care
• How the proposals would support research that underpins future improvement.
Both proposals scored highly and will be taken forward for consultation. The outcome from this options appraisal process will form one part of the information shared for the public consultation and will be a factor in NHS England – London’s final decision on the location of the new PTC. However, it is important that people have an opportunity to consider all the information shared for public consultation when providing their views to us for consideration.
NHS England – London will make its final decision on the location of the new centre after hearing the views that come forward during the public consultation and taking account of all other relevant factors.
NHS England – London is now planning to undertake a public consultation on both options, in line with the legal duties of the NHS to involve the public and consider all viable options fairly.
NHS England – London is leading the work to design the consultation with input from stakeholders. The team is now engaging more widely to find out more about:
• how best to reach the different groups affected by this change
• what information should be included in any consultation materials and how that information should be presented
• the best methods to engage with stakeholders, including the public, during the consultation itself
• any communities that have not yet been reached that are affected by this change.
Subject to the usual NHS England assurance processes for major service change, the consultation is then due to launch in late June.
No decision will be made until the public consultation has concluded, feedback has been reviewed and all relevant information taken into consideration. Services are not expected to move before 2026.
Cancer care for patients aged 16 and above will continue to be delivered at The Royal Marsden, which is a leading centre of excellence for cancer care providing the highest quality of safe and specialist care including the latest cancer research.
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*This text was edited to remove a reference to all services being available on the same site. The PTC will be on the same site as children’s intensive care and children’s cancer surgery as required by the national service specification, however some other services will remain at different locations in London.