Agenda item

The Board considered a report of the Strategic Director, Communities which sought to provide information on the work that had been taking place in Cheshire and Merseyside to consider and bring forward proposals for the development of World Class Cancer Services in Cheshire and Merseyside through the establishment of a new Cancer Centre in Liverpool and the further development of services across the area.

 

The Board was advised that the report was requesting Members support for the delivery of a wide-ranging communication and involvement exercise designed to share the proposals with a wide range of stakeholders across Cheshire and Merseyside and further afield where appropriate.

 

Leoni Beavers, MD Liverpool Primary Care Trust and Jackie Robinson, Head of Engagement and Involvement, NHS Merseyside gave a verbal update at the meeting.  It was reported that in autumn 2010, Pricewaterhouse Coopers (PwC) had been engaged by Liverpool PCT to undertake a high level affordability study to review the cost and affordability of building a new comprehensive Cancer Centre co-located with a redeveloped at Royal Liverpool Hospital.  The final report had been published in March 2011.  The study had reviewed two options – a Standalone Cancer Centre and a Cancer Centre with an element of shared services with the RLBUH.  The capital cost of both options (based on 80 inpatient beds) was £116.5m and £105.2m respectively (both excluding VAT).

 

The Board was further advised that both Trust Boards had worked together to consider and bring forward an affordable proposal which incorporated:-

 

·       A new build Clatterbridge Cancer Centre adjacent to the proposed new build Royal Liverpool Hospital (RLH);

 

·       A separate dedicated entrance for the Cancer Centre;

 

·       The majority of cancer inpatient services provided by Clatterbridge Cancer Centre, to be accommodated within the RLH scheme with flexibility within the cancer centre to provide additional, flexible inpatient/day care services;

 

·       Radiotherapy, chemotherapy, dedicated imaging and outpatient services to be provided within the Cancer Centre;

 

·       Appropriate, dedicated patient and staff access links between the Cancer Centre and RLH buildings with required clinical adjacencies conducive to effective and efficient delivery of patient care and clinical trials;

 

·       A dedicated adjacent free car parking facility for cancer patients;

 

 

·       Clinical Trials unit to be provided in collaboration with RLH and the University assuming essential laboratory support of the Cancer Centre;

 

·       Cytotoxic pharmacy to remain on the CCO Wirral site; and

 

·       A satellite facility to remain on the CCO Wirral site comprising ambulatory, radiotherapy and chemotherapy, outpatients services and proton therapy.

 

In making the above recommendations it was recognised that certain patients would have to travel further for certain elements of their care.  However, it was emphasised that radiotherapy and chemotherapy services would continue to be provided on the original Clatterbridge site.  Outpatient chemotherapy services and radiotherapy services for patients with more common cancers such as breast, prostate and lung would also continue to be provided on the site for local patients.  Only those patients who required more complex treatment, or required inpatient facilities, would be required to travel to the new centre in Liverpool.

 

The impact assessment was circulated prior to the meeting for information.

 

It was reported that when the Business Case had been approved in approximately 6 – 12 months time there would be a formal consultation process. 

 

The following comments arose from the discussion:-

 

·       Concern was raised that placing all the specialist centres on one location could create difficulties.  In addition, it was reported that a meeting of the Joint Health Overview and Scrutiny Board had taken place today to consider the vascular proposals. Senior highways officers from the three authorities had confirmed that they had not been consulted about the proposals.  It was reported that this was not acceptable;

 

·       Concern was raised at the future of Halton and Warrington Hospitals as services were being removed and centralised in another location.  There was a fear that they would become ‘minor’ hospitals and this would result in closure;

 

·       It was highlighted that the points being raised to encourage people to support the cancer proposals were the same arguments the three authorities were using to reject the vascular services proposals;

 

·       It was suggested that the Board receive a report on the ‘bigger picture’ in respect of services in the future and the consequences of all the proposed changes.  In response, it was reported that the Board could request the Clusters to report on what the proposed changes would mean for Halton.  However, it was highlighted that what was currently provided at Halton Hospital re local cancer services would remain unchanged.  Services that currently went to Clatterbridge would be re-located to the Royal in Liverpool for the reasons set out in the report. In addition, it was reported that it needed to be the best journey possible for most people and then any issues/difficulties would be considered;

 

·       It was noted that the centre would be the equivalent of ‘Christies Hospital’ in the area;

 

·       The Board supported the idea of centres of excellence.  However, it was highlighted that because of the location, Halton was vulnerable and a specialism / centre should be sited in the local area. Concern was also raised that private patients may be allowed to buy a better service and go to the top of the waiting list. In response, it was reported that the Clinical Commissioning Groups (CCGs) were emerging and GP’s worked closely with the community and they were best placed to balance clinical need and what was best for patients. It was highlighted that CCGs would not allow residents to receive a worse service which would include going to the top of the waiting list;

 

·       It was reported that Merseyside was not attracting funding for cancer services like other parts of the country because of the way they were currently being provided and would not do so until improvements were implemented;

 

·       Concern was raised that currently 13 hospitals provided cancer treatment and this would be removed. It was suggested that the same could happen with chemotherapy treatment in the future. In response, it was reported that the only change in services would be at Clatterbridge Hospital;

 

·       It was noted that there were so many changes emerging in a short timescale as a result of the health reforms that it was impossible to understand the wider picture and significant implications for the residents of the Borough.  It was suggested that the Board consider arranging a Special meeting to try to ascertain an overview of the impact of the changes for the residents of Halton.  In response, it was reported that this would be difficult as the CCGs were not as yet accountable for the investment of services and the wider picture was unclear at the present time;

 

·       It was noted that premature deaths from cancer was reducing due to screening, early diagnosis and more effective treatments.  However, it was also noted that in deprived communities, cancer tended to be presented very late because of a wide range of complex issues; and

 

·       Concern was raised that the whole of the health service was being compromised, People were losing their jobs in the Primary Care Trust and the service would still need to be delivered.  It was noted that the cancer proposals had been developed before 2008 and the changes to the Primary Care Trust.  However, it was reported that the concerns raised would be raised with the Clusters.

 

RESOLVED: That

 

(1)              The report and comments made be noted; and

 

(2)              Leoni Beavers be thanked for her attendance at the meeting.