Public invited to share their views on the proposed future location of specialist cancer services for children
NHS England (London and South East regions) has launched a public consultation on the proposed future location of very specialist cancer treatment services for children living in south London and much of south east England.
The consultation will help NHS England decide where the proposed future Principal Treatment Centre for these children should be.
Children’s cancer centres (known as Principal Treatment Centres) provide diagnosis, treatments, and coordination of very specialist care for children aged 15 and under with cancer. There are 13 of them in England.
The current Children’s Cancer Centre (covering south London, Brighton and Hove, East Sussex, Kent and Medway and most of Surrey) is provided in partnership between The Royal Marsden NHS Foundation Trust at its site in Sutton and St George’s University Hospitals NHS Foundation Trust at St George’s Hospital in Tooting. It treats about 1,400 children, most aged one to 15, at any given time.
In 2021, a new national service specification set out that very specialist cancer treatment services for children – like those at The Royal Marsden – must be on the same site as a level 3 children’s intensive care unit. This is because children being treated for cancer are sometimes at risk of needing urgent intensive care. 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 the same site.
The Royal Marsden does not have a children’s intensive care unit on site, meaning that the current arrangement needs to change. At present, a small number of very sick children with cancer who need or might need intensive care are transferred safely from The Royal Marsden to St George’s Hospital every year. This is a journey of eight miles and is done safely by ambulance with an expert team on board. However, urgent transfers of very sick children to another hospital add risks to what is already a very difficult situation and are stressful for children and their families.
The public consultation launched today proposes two options for the location of the future Principal Treatment Centre:
• Evelina London Children’s Hospital in Lambeth, south east London, run by Guy’s and St Thomas’ NHS Foundation Trust
• St George’s Hospital, in Tooting, south west London, run by St George’s University Hospitals NHS Foundation Trust.
Dr Chris Streather, Medical Director, NHS England (London) explained:
“The Royal Marsden has an impressive track record of delivering high quality care for children but the pace of innovation in children’s cancer treatment means that, to be fit for the future, the centre must move to be with intensive care. Like other major centres worldwide, the new centre will then be ready to offer innovative life-saving new treatments that wouldn’t be possible under the current arrangements, as they have a greater risk of complications and needing intensive care expertise. “We have two strong options for the future location of the Centre and want to get feedback from children, families and staff throughout this consultation.”
Sir Terence Stephenson, Nuffield Professor of Child Health is an independent expert adviser to the NHS England Programme Board for the proposed reconfiguration. He added:
“When a child is ill with cancer it’s hugely stressful for them, their parents and families. While the current service provides a safe, high-quality service for children with cancer, the service at The Royal Marsden’s site in Sutton does not, and cannot, meet the latest requirements to be on the same site as a level 3 children’s intensive care unit.
“The vision for the future Principal Treatment Centre is that it will build on the many strengths of the existing service, give best quality care and achieve world-class outcomes for children with cancer for decades to come.”
Both options in the consultation also propose that children’s conventional radiotherapy move from The Royal Marsden to University College Hospital (part of University College London Hospitals NHS Foundation Trust) in central London.
Over the course of the last three years lots of discussions have taken place with patients, families, charities and members of staff to understand what is most important to them, and this has helped shape the proposals unveiled today.
Ashley Ball-Gamble, Chief Executive of children’s cancer charity, Children’s Cancer and Leukemia Group commented:
“Having a child with cancer brings worry and upheaval for the whole family, and it is important we do all that we can to make their experience of cancer care as smooth as possible. Whichever location is chosen, the changes proposed will provide all services that a Principal Treatment Centre must have on site in one location, resulting in more seamless care for children and a high-quality experience for their families.”
Both options for the future location deliver children’s services which are rated outstanding by the Care Quality Commission. Both could deliver a future Principal Treatment Centre that meets the national requirements.
Michelle McLoughlin CBE, is an independent expert adviser who chaired the stakeholder group that helped with the development of the proposals. Michelle said:
“It was clear from our discussions in the stakeholder group that there is a huge strength of feeling about cancer services for children, and understandably so. All the individuals and organisations involved were incredibly generous with their time and their feedback has been invaluable. I am confident that whichever option is chosen, the future of specialist cancer services for children in south London and much of south east England will be enhanced.”
The public consultation launches today and is open for 12 weeks, closing at midnight on 18 December 2023. The consultation document with full details of the proposals will be available on the website once the consultation is live, along with information on how to provide feedback and get involved: www.transformationpartnersinhealthandcare.nhs.uk/childrenscancercentre
Dr Christopher Tibbs, Medical Director for Commissioning, NHS England (South East) is encouraging as many people as possible to share their views:
“Thankfully cancer in children is very rare and there have been huge advances in the treatments available in recent years. Our proposals will continue to improve services for the small, but important group of children who need very specialist cancer care.
We are grateful to all those who have already helped to shape our plans for the future. We now want to hear from the public and all interested groups about what they think of our proposals.”
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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Notes to editors
· Specialist cancer care for children is led and coordinated from what we call a Principal Treatment Centre, which is responsible for making sure every child with cancer gets the expert care they need. There is one Principal Treatment Centre covering south London, Kent, Medway, East Sussex, Brighton & Hove, and most of Surrey.
· This consultation is led by NHS England London and NHS England South East; two of NHS England’s seven regional teams. Between them, they are responsible for the quality of services and financial and overall performance of all NHS organisations in London and South East region.
· The consultation proposes two options for the future location of the Principal Treatment Centre; Evelina London Children’s Hospital or St George’s Hospital. Both currently have children’s services rated as ‘outstanding’ by the CQC.
· Around 1,400 children, aged one to 15, are under the care of the Principal Treatment Centre for south London and much of south east England at any given time. More than 60% of the centre’s patients are from outside London.
· In 2019/20, 35 children were transferred from The Royal Marsden to St George’s because they needed or might need intensive care.
· The Royal Marsden service currently provides high quality conventional radiotherapy treatment for children as part of their care. However, the proposed move of specialist children’s cancer services, alongside advances in radiotherapy treatment, means that this service would be provided differently in the future.
· All radiotherapy (conventional as well as proton beam and other types) rather than some, as now, would be provided as part of a larger, combined service at University College Hospital. Bringing all radiotherapy services together in a larger centre would create opportunities to improve outcomes for children in the future.
· Our proposals do not affect radiotherapy services for teenagers and young adults or for other adults provided at The Royal Marsden.
· Dr Chris Streather is Regional Medical Director and CCIO for NHS England in London. He worked in Royal Free London group as chief medical officer from 2018 following his role as chief executive of the Royal Free Hospital in 2017. Prior to joining the Royal Free, he was chief medical officer of HCA International, and previously, the managing director of the Health Innovation Network, leading on patient safety nationally, and chief executive officer of South London Healthcare NHS Trust in 2009.
· Sir Terence Stephenson is Nuffield Professor of Child Health at the University College London Great Ormond Street Institute of Child Health and Honorary Consultant Paediatrician at UCL Hospitals NHS Foundation Trust & Great Ormond Street Hospital for Children NHS Foundation Trust. Sir Terence is an independent advisor to the NHS England Programme Board for the reconfiguration of the children’s cancer Principal Treatment Centre for south London and much of south east England
· Ashley Ball Gamble is Chief Executive of Children’s Cancer and Leukemia Group and a member of the NHS England Programme Board for the reconfiguration of the children’s cancer Principal Treatment Centre for south London and much of south east England. He is a founding member of the Children and Young People’s Cancer Coalition.
· Michelle McLoughlin CBE is a former Chief Nurse of Birmingham Women’s and Children’s NHS Foundation Trust (one of the 13 Principal Treatment Centres across England). Michelle chaired the NHS England Programme stakeholder group for the reconfiguration of the children’s cancer Principal Treatment Centre for south London and much of south east England.
· Dr Christopher Tibbs is Medical Director for Commissioning, NHS England (South East). He trained as a gastroenterologist and is the former Medical Director and Responsible Officer at the Royal Surrey County Hospital in Guildford.