• Three professors who reviewed standards say group of clinicians was “pressured”
  • Follows revelations of “buried” concerns and service change recommendations

Clinicians drawing up new clinical standards for child cancer services in the NHS faced “unwarranted pressure” from NHS England’s cancer team to soften their recommendations, three other experts in the field have said.

In a joint statement, three leading experts in the field, Mike Stevens, Ian Lewis and Sir Alan Craft, said members of NHS England’s clinical reference group had come under pressure to change guidance for these specialised services.

They said the change of wording to say intensive care services “should” be co-located rather than “must” followed what they said was “unwarranted pressure brought to bear on clinicians within the CRG by senior members of NHS England’s cancer team, which is led by Cally Palmer”.

CRGs are responsible within NHSE for developing guidance on the specialised services it commissions. Guidance for the child paediatric standards were published earlier this month for consultation following a long development period. 

Their claims follow concerns raised by the Children’s Cancer and Leukaemia Group, which also said the specifications had been changed without a clear rationale and against clinical evidence.

The issue has come to the fore because of claims that NHS England has covered up concerns about children’s cancer services in London and that national cancer director Cally Palmer is “hugely conflicted” due to her role as the Royal Marsden chief executive.

The three professors – who were all part of failed attempts to reform cancer services in London – said NHS England had “failed to respond appropriately to consistent, independent, professional, recommendations made about the configuration of children’s cancer services in London, and in particular concerns about the delivery of care at the Royal Marsden Hospital over more than eight years.”

They said NHS England should make an “unequivocal commitment to mandate co-location of paediatric critical care” at all child cancer centres.

They added: “Ms Palmer’s position in overseeing NHS England’s response to our independent critique of service delivery… based at the Royal Marsden Hospital in Sutton is inappropriate.

“Patient safety and patient family experience must always be the paramount concern and should be prioritised over institutional interest and the preservation of the status quo.”

NHS England told HSJ: “These vague assertions are deeply unfair to the national cancer team. The proposals signed off by the clinical reference group are being publicly consulted on and - as was always planned - Cally Palmer, as director of the Royal Marsden, will not take part in decision-making at the end of this consultation.”

In a statement the Royal Marsden said: ”The Royal Marsden’s service for children and young people is of highest quality and safety and The Royal Marsden was rated ‘outstanding’ by the CQC in 2018. There have been no serious incidents relating to the transfer of paediatric patients between The Royal Marsden, Sutton and intensive care units.

”The Royal Marsden welcomes the service specifications recommendations to review paediatric oncology shared care units but it is important that the options presented are workable and deliverable, not aspirational, to ensure that the treatment and care of children and young people with cancer is of the very highest quality.”