STRUCTURE: A proposed reconfiguration of urological cancer surgery has been abandoned because two groups of consultants refused to work together, HSJ has learned.

Commissioners’ plans to merge surgery teams at Heatherwood and Wexham Park Foundation Trust and Royal Berkshire Foundation Trust have been abandoned, although it is hoped a new structure can be put in place.

The reconfiguration, which would have enabled urological cancer surgery to be provided in specialist centres serving 1 million patients or more, was recommended by the National Institute for Health and Care Excellence as long ago as 2002.

NICE guidance said it would have enabled surgeons carrying out radical prostate and bladder work to perform 50 such operations per year, which would ensure competence was maintained. This requires centres to serve larger populations than the typical district general hospital trust.

Although urological cancer services as a whole are networked across a population of 1 million in the area served by Heatherwood and Wexham Park and Royal Berkshire, surgery is still provided on both sites, meaning services are not fully compliant with NICE guidance.

NHS England’s Thames Valley area team is currently leading a review of the system to identify which sites will become the specialist centres.

It is understood the area team proposed merging the two trusts’ surgical teams, but they refused to work together.

Philippa Slinger, chief executive of Heatherwood and Wexham Park, said her trust was “pursuing options to deliver a compliant network and [is] in discussion with Royal Surrey County Hospital Foundation Trust”.

She added: “The trust plans to take a proposal to the commissioners who ultimately make the decision about the nature and location of services.” 

A spokesman for the Royal Berkshire said both it and Heatherwood and Wexham Park had previously been given a dispensation by the Thames Valley Cancer Network to perform specialist urological cancer surgery at both sites.

“This continued until recently when it was decided that the [catchment] population of a million will be enforced,” he said.  “Currently a review is taking place to examine the future of urological cancer services throughout the Thames Valley.”

The spokesman did not explain why the surgery teams would not be merged to achieve the required catchment population.