The must-read stories and debate in health policy and leadership.

There have long been concerns over a specialist cancer treatment centre on the outskirts of London. 

Mount Vernon Cancer Centre was once a sanitorium in the early 1900s, with buildings in poor condition. There are also concerns over the lack of co-located acute services for patients. 

There are plans for a rebuild on another site, with satellite radiotherapy elsewhere. But there has been no luck so far — including a bid to join the 40 “new hospitals” — to get the money required for this. 

A chief executive of an integrated care board has raised the alarm over the impact for local patients, for whom travel is tricky to the current site, and the plans would move services closer to home.

She said a handful have opted for palliative care instead of regular treatment at the centre, and any further delay in securing capital risks these numbers going up. 

Felicity Cox from Bedfordshire, Luton and Milton Keynes ICB said the issue centred around Luton, which is one of the system’s most deprived areas, with large numbers of people in jobs without paid leave. 

For these patients and their dependants, she said difficult and long travel to the centre, as well as the costs, can be prohibitive. 

The Department for Health and Social Care was right to prioritise hospitals with risky concrete to add to the New Hospital Programme, and it would make sure trusts knew how to apply for a promised capital investment programme beyond 2030.

Low acuity not so high

Emergency departments are not being overwhelmed by low acuity patients — and the proportion is far smaller than expected, an NHS England review has found.

An NHSE trial of proposed new acuity measures at 17 accident and emergency sites found the proportion of low acuity patients was just 4 per cent of attendances in 2023 — when they had expected this to be between 20 to 40 per cent.

An internal review of the trial, shared with HSJfound a “clear operational need” to better distinguish patients of low acuity — who can often be seen by services such as urgent treatment centres.

The overall aim of the project was to trial new measures for A&E patients, which give scores between one and five for how severe their conditions are. This was in response to NHSE finding that many cases with “significant” conditions are waiting too long for initial assessments.

The Care Quality Commission has previously raised “great concern” about variation in the quality of initial assessments and the harm suffered by A&E patients as a result. The trial sites have said the new acuity measures have had a positive impact.

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The latest instalment of ImPatient focuses on David Gilbert’s unsettling experience in hospital, and Mythbuster Steve Black reviews the old and new arguments against the four-hour target and why the NHS should not give up on it.