Minutes:
The Board considered a report of
the Strategic Director, Communities which sought to provide information on the
work that had been taking place in Cheshire and Merseyside to consider and bring
forward proposals for the development of World Class Cancer Services in
Cheshire and Merseyside through the establishment of a new Cancer Centre in
Liverpool and the further development of services across the area.
The Board was advised that the report was
requesting Members support for the delivery of a wide-ranging communication and
involvement exercise designed to share the proposals with a wide range of
stakeholders across Cheshire and Merseyside and further afield where
appropriate.
Leoni Beavers, MD
Liverpool Primary Care Trust and Jackie Robinson, Head of Engagement and
Involvement, NHS Merseyside gave a verbal update at the meeting. It was reported that in autumn 2010, Pricewaterhouse
Coopers (PwC) had been engaged by Liverpool PCT to undertake a high level
affordability study to review the cost and affordability of building a new
comprehensive Cancer Centre co-located with a redeveloped at Royal Liverpool
Hospital. The final report had been
published in March 2011. The study had
reviewed two options – a Standalone Cancer Centre and a Cancer Centre with an
element of shared services with the RLBUH. The capital cost of both options (based
on 80 inpatient beds) was £116.5m and £105.2m respectively (both excluding
VAT).
The Board was further advised that both Trust Boards had worked together to
consider and bring forward an affordable proposal which incorporated:-
·
A new
build Clatterbridge Cancer Centre adjacent to the
proposed new build Royal Liverpool Hospital (RLH);
·
A
separate dedicated entrance for the Cancer Centre;
·
The
majority of cancer inpatient services provided by Clatterbridge
Cancer Centre, to be accommodated within the RLH scheme with flexibility within
the cancer centre to provide additional, flexible inpatient/day care services;
·
Radiotherapy,
chemotherapy, dedicated imaging and outpatient services to be provided within
the Cancer Centre;
·
Appropriate,
dedicated patient and staff access links between the Cancer Centre and RLH
buildings with required clinical adjacencies conducive to effective and
efficient delivery of patient care and clinical trials;
·
A
dedicated adjacent free car parking facility for cancer patients;
·
Clinical
Trials unit to be provided in collaboration with RLH and the University
assuming essential laboratory support of the Cancer Centre;
·
Cytotoxic
pharmacy to remain on the CCO Wirral site; and
·
A
satellite facility to remain on the CCO Wirral site comprising ambulatory,
radiotherapy and chemotherapy, outpatients services and proton therapy.
In making the above recommendations it was recognised that certain
patients would have to travel further for certain elements of their care. However, it was emphasised that radiotherapy
and chemotherapy services would continue to be provided on the original Clatterbridge site.
Outpatient chemotherapy services and radiotherapy services for patients
with more common cancers such as breast, prostate and lung would also continue
to be provided on the site for local patients.
Only those patients who required more complex treatment, or required
inpatient facilities, would be required to travel to the new centre in
Liverpool.
The impact assessment was circulated prior to
the meeting for information.
It was
reported that when the Business Case had been approved in approximately 6 – 12 months time there would be a formal consultation process.
The following
comments arose from the discussion:-
·
Concern
was raised that placing all the specialist centres on one location could create
difficulties. In addition, it was
reported that a meeting of the Joint Health Overview and Scrutiny Board had
taken place today to consider the vascular proposals. Senior highways officers
from the three authorities had confirmed that they had not been consulted about
the proposals. It was reported that this
was not acceptable;
·
Concern
was raised at the future of Halton and Warrington
Hospitals as services were being removed and centralised in another
location. There was a fear that they
would become ‘minor’ hospitals and this would result in closure;
·
It was
highlighted that the points being raised to encourage people to support the
cancer proposals were the same arguments the three authorities were using to
reject the vascular services proposals;
·
It was
suggested that the Board receive a report on the ‘bigger picture’ in respect of
services in the future and the consequences of all the proposed changes. In response, it was reported that the Board
could request the Clusters to report on what the proposed changes would mean
for Halton.
However, it was highlighted that what was currently provided at Halton Hospital re local cancer services would remain
unchanged. Services that currently went
to Clatterbridge would be re-located to the Royal in
Liverpool for the reasons set out in the report. In addition, it was reported
that it needed to be the best journey possible for most people and then any
issues/difficulties would be considered;
·
It was
noted that the centre would be the equivalent of ‘Christies Hospital’ in the
area;
·
The
Board supported the idea of centres of excellence. However, it was highlighted that because of
the location, Halton was vulnerable and a specialism
/ centre should be sited in the local area. Concern was also raised that
private patients may be allowed to buy a better service and go to the top of
the waiting list. In response, it was reported that the Clinical Commissioning
Groups (CCGs) were emerging and GP’s worked closely with the community and they
were best placed to balance clinical need and what was best for patients. It
was highlighted that CCGs would not allow residents to receive a worse service
which would include going to the top of the waiting list;
·
It was
reported that Merseyside was not attracting funding for cancer services like
other parts of the country because of the way they were currently being
provided and would not do so until improvements were implemented;
·
Concern
was raised that currently 13 hospitals provided cancer treatment and this would
be removed. It was suggested that the same could happen with chemotherapy treatment
in the future. In response, it was reported that the only change in services
would be at Clatterbridge Hospital;
·
It was
noted that there were so many changes emerging in a short timescale as a result
of the health reforms that it was impossible to understand the wider picture
and significant implications for the residents of the Borough. It was suggested that the Board consider
arranging a Special meeting to try to ascertain an overview of the impact of the
changes for the residents of Halton. In response, it was reported that this would
be difficult as the CCGs were not as yet accountable for the investment of
services and the wider picture was unclear at the present time;
·
It was
noted that premature deaths from cancer was reducing due to screening, early
diagnosis and more effective treatments.
However, it was also noted that in deprived communities, cancer tended
to be presented very late because of a wide range of complex issues; and
·
Concern
was raised that the whole of the health service was being compromised, People
were losing their jobs in the Primary Care Trust and the service would still
need to be delivered. It was noted that
the cancer proposals had been developed before 2008 and the changes to the
Primary Care Trust. However, it was
reported that the concerns raised would be raised with the Clusters.
RESOLVED: That
(1)
The report and comments made be noted; and
(2)
Leoni Beavers be thanked for her attendance at the
meeting.
Supporting documents: