To receive a presentation and update from officers from the North East London Commissioning Support Unit on the programme to change cancer and cardiovascular services for North and East London.
Minutes:
The BHRUT chief executive confirmed that the proposals to move radical prostatectomy surgery from BHRUT to UCLH had been taken to the Trust Board and that the Board felt the proposals were the right ones. It was emphasised that a great deal of cancer and cardiovascular care would continue to take place at King George and Queen’s. The chief executive was unsure at this stage if only having robotic prostate surgery based at Queen’s would reduce patient choice, feeling that this was also a matter for commissioners.
An officer from the North East London Commissioning Support Unit explained that cancer and cardiovascular disease were the main causes of early death in the local area. In order to address this, a new cardiac centre was being built at Barts and tours of the site were available. The new centre would open in September 2014 at which point patients would transfer from the London Chest and Heart Hospitals.
The cancer proposals had been commissioned by NHS England and proposed reducing the number of sites at which surgery for several different types of cancer had been performed. This was based on work first undertaken in 2010 which had concluded that some specialist procedures were being carried out in too many hospitals. The preferred option to reduce the number of sites at which e.g. brain or kidney cancer operations were performed had been agreed by NHS England and CCGs in May 2014 and final decisions would be taken at a meeting of commissioners on 25 July.
Implementation, if the proposals were agreed, would take place between 2014 and 2018 and implementation timescales would be different for each pathway. Discussions were currently taking place with Local Healthwatch organisations to discuss the next phase of engagement.
Feedback from the public had generally supported the proposals but some concerns had also been raised. There was a need for better prevention and early diagnosis (which commissioners supported) and some concerns over travel issues had also been raised. Additionally, local campaign groups had not supported the proposals for prostate cancer. Officers explained that the London Clinical Senate had reviewed and supported the prostate proposals although it was accepted that the two sites (BHRUT and UCLH) could not be compared directly. Latest guidance was that a site carrying out robotic prostatectomies should conduct 150 operations per year but BHRUT currently only carried out 80 such operations annually.
If the proposals were approved by commissioners, it was not expected that services would change straightaway. A gateway process would be established by commissioners of tests that would need to be met before services were changed.
Clinicians would not transfer under the proposals. Patients would continue to have pre and post-operative treatments at their local hospital with only the operation itself taking place at a specialist facility. Staff consultation would be carried out if the proposals were approved. The gateway process would ensure that patient concerns would still be considered. There would also be a Joint Development Group for patients to feed into the gateway process.
The Committee AGREED that presentations on items at the meeting should be circulated before the meeting, if available.
The Committee NOTED the update.