Essential insight into England’s biggest health economy, by Ben Clover.

A solution for child cancer services?

In the row over where children seriously ill with cancer should be treated in south London, there is a potential solution.

The Royal Marsden has faced significant criticism for treating patients at its Sutton site and moving them in a hurry to hospitals with the necessary paediatric specialties (neurosrugery and intensive care, among others) if there is serious deterioration.

Its site in the outer London borough does not have the capacity to deal with some of these cases – a situation others say is unsafe.

A solution could lie with the neighbouring acute trust.

For many years, management teams at Epsom and St Helier University Hospitals Trust have tried to get ministers to agree to a reconfiguration of its crumbling estate.

Its two sites, one in a Tory seat often represented by Cabinet ministers, and the other in a key swing seat between the Conservatives and the Liberal Democrats, have so far resisted reconfiguration.

If – although it’s a big if – the Treasury does sign off on a complete rebuild of ESTH at Sutton, then it would be a logical place to base the Marsden’s Sutton services, given that it could have the necessary facilities on-site.

“No learning, no remorse”

Worrying to see the board of Great Ormond Street Hospital for Children act as if a line has been drawn over its gastroenterology scandal.

Last week, the trust revealed the full version of a 2017 report into how that service line had improved since a 2015 report from the Royal College of Paediatrics and Child Health.

The 2017 RCPCH report had first been released in 2018, but had mysteriously omitted an appendix containing fierce criticism of the trust from parents.

Parents were distinctly unhappy at how the trust had handled the fallout from the 2015 report.

Last week, GOSH said it had been unable to establish how the appendix had been left out of the version provided to the regulators.

The trust’s chief operating officer, who was responsible for the report, has since left but the then interim medical director, who wrote the report accompanying the RCPCH paper, still works at GOSH.

Did he have no idea? Was he asked? These questions have gone unanswered by the trust.

The Care Quality Commission said it was “reviewing” the extra information from the appendix.

NHS England and Improvement London has nothing to say on the matter.

One part of the 2017 report noted how defensive the trust was in response to criticism and said it was still not clear there had been “organisational learning or remorse” from those involved.

One way to signal both, and to really draw a line under the issue, would be to release the 2015 report.

It is bizarre to release two versions of the RCPCH’s follow-up report (one a year since it was completed) and not release the 2015 report it is follow-up to. In spite of a TV documentary and some follow-up in the nationals, it is still not clear what happened to these children and how it was allowed to happen.


*This piece was amended at 17.09 on 23/7/2019 to clarify the sorts of service the new build at Sutton would need to have to be considered safe according to most paediatric oncologists