Major reorganisation of specialist cancer and cardiac treatment approved

The plans, which include the creation of a specialist heart centre at Barts Health Trust and specialist cancer treatment based at University College London Hospitals Foundation Trust, was voted through unanimously by NHS England and the five clinical commissioning groups in the area.

Managing director of UCLPartners David Fish - tasked with bringing together the various providers affected by the proposals - said the London reconfiguration could be a model to replicate elsewhere.

He said he was already fielding enquiries from other parts of the country engaged in cancer or cardiac reconfiguration.

The reconfiguration should be extended to include the whole of London, according to NHS England’s regional director for London, Anne Rainsberry.

She said: “This offers a model that we should look at in other parts of London because certainly I would like to see everybody in London get access to this level of care and a network where you’re getting the very best of specialist care but you’re also being supported more locally.”

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The plans will be delivered over the next four years.

Services will begin moving into the cardiovascular centre from early 2015, and changes to cancer services will begin from the middle of next year.

The reorganisation covers a population of over 3 million people, and NHS England claims the changes could save more than 1,000 lives a year.

Clinicians from the London Chest and The Heart hospitals will transfer to St Bartholomew’s Hospital, creating the largest centre for adult congenital heart disease in the world.

UCLH - 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. Royal Free will become a centre for the specialist treatment of kidney cancer.

The new structure will involve primary care and community care as well as acute trusts, with a focus on recognising early symptoms of a potential major cardiac episode or signs of cancer.

It will also see clinicians travelling to local outpatient clinics alongside the more traditional specialist set up based at UCLH and Barts Health Trust.

The widely praised stroke reconfiguration in London four years ago means that people are more open to change, Ms Rainberry said.

She said: “Things have moved on a bit. Certainly in London, everybody now talks about stroke being a fantastic example and getting fantastic outcomes but it was hotly contested by lots of people at the time.

“I think it was a bit of a watershed because when the independent studies started to come out and showed that lives were saved and it saved money; I think it became quite compelling.”

Ms Rainsberry said the “clinical energy” for the reorganisation was “very significant”.

Professor Fish said there had been a change in focus from reactive to preventative specialist care.

He said: “If you look at specialist hospitals, most of them were set up hundreds of years ago and have a disadvantage that they were set up focused on reactive specialist care.

“If the whole pathway starts with primary prevention then the clinicians are involved with that whole pathway already, they’re not waiting [for a major episode].

“It’s not true that when you create a specialist centre it won’t reach out.”