A mum has slammed a proposal which could see children’s cancer care moved from two South West London hospitals, claiming parents’ concerns have not been met with “realistic responses”.
The children’s cancer centre at St George’s Hospital, Tooting, and The Royal Marsden Hospital, Sutton, would be moved to the Evelina Children’s Hospital, Lambeth under the proposal.
The option is one of two being considered by NHS England as it plans to move the children’s principal cancer treatment centre for South London, Kent, Medway, Surrey, East Sussex, Brighton and Hove to one location.
St George’s and the Evelina have put forward bids for the centre, which are being taken forward for public consultation.
It follows NHS England approving a new national service specification for principal treatment centres in 2021, which requires them to be on the same site as a paediatric intensive care unit.
The Royal Marsden does not have a paediatric intensive care unit on site, which means some children are transferred between the site and St George’s.
Chris Streather, medical director of the NHS in London, told the South West London and Surrey joint health overview and scrutiny committee on June 7 the Evelina’s bid scored slightly higher in an NHS England evaluation process. But he said both bids “are strong, they are both viable and we will go out to consultation presenting both options as serious possibilities”.
Mum Jenny Houghton, from the parent and stakeholder group involved in the process, argued there is not a “business case” for the proposed move.
She said: “Everything that you’re seeing, there is no justification in terms of listening to people – everything we’ve fed back on.
“The transportation discussion has been hugely traumatic as a parent of a child with cancer. I don’t believe anybody who is taking part in this understands what it is like to try and travel with a neutropenic child who is very, very sick. You cannot get on a bus.”
She added: “It is not the majority of people who get their neutropenic child on public transport. All of our concerns are not met with realistic responses.”
About the evaluation process, Ms Houghton said: “I cannot tell you how bad this process has been in terms of being able to actually significantly mark both of these proposals.”
She continued: “I have no faith in this. This does not need to be happening. We are talking about one child a month from The Royal Marsden that needs this transfer.
“We have spoken to specialists. We know the level of care when they treat and transfer.
“They have a full clinical team travelling with them, so why the need to remove them from where they’re being treated, taking them away from their research centre?”
Richmond councillor Jim Millard said: “I’m absolutely appalled to see how they’ve been made to feel.
“I don’t know if it’s fair or not but it would be a good thing to know that you’ve taken those criticisms on board.
“I’d like to see this consultation process move forwards in a way that the parents aren’t made to feel like that.”
Catherine Croucher, consultant in public health at NHS England, said: “I think it’s fair to say that obviously car travel in private vehicle would be a preference for many, many families and therefore it’s very important how we look at the mitigations available for how to make that as easy as possible when it comes to a longer journey.
“That said, we do have to acknowledge that there are some parts of the catchment where we can see from census data that car ownership is actually quite low so we can’t reduce the notion of public transport use to zero.”
Mr Streather said: “What we have to consider over the period of consultation is not whether the service moves from what it is now because it’s not fit-for-purpose.
“It’s as good as it can be in its current format, but by having it in a children’s facility, in a facility that’s used to looking after large numbers of sick children, we will potentially improve the care to children and improve the safety of children.”
Mr Streather said the NHS hopes disruption to existing patients is “kept down to a minimum, if anything at all”.
He said it will take another three years for the changes to be implemented, when treatment for most children currently being cared for will have finished.
He said there are “inevitably trade-offs” in the process, adding: “We will have to take real care in implementation to make sure we look after the children who are travelling 40 or 50 miles, as well as the children that are travelling five miles.
“And we’ll look after the children who come in their families cars, as well as the children of families who can’t afford cars and have to make other means.”
Introducing the proposals earlier in the meeting, Mr Streather said the current arrangement with St George’s and The Royal Marsden delivers high-quality care.
But he said: “It’s certainly not ideal for patients to have more interruption than is absolutely necessary in the continuity of their care.
“So part of the principle and the case for change is, although the current arrangement is providing excellent care for children with cancer, to provide the very best, and we’re ambitious about it being world-leading care, for the majority of sick children to spend the majority of their time in a single place without transfers which we think will provide both better outcomes in cancer and a better patient experience.”
An NHS England report said analysis comparing travel times to the current centre’s main site, at The Royal Marsden, to either future location showed positive impacts for children living in the most deprived and rural areas when travelling by public transport, along with negative impacts for children living outside London or rural areas when driving.
It said: “Residents of South West London would, on average, experience an increase in journey time of 18 minutes to Evelina and no change to St George’s.
“However, this masks a difference between the boroughs where Sutton, Merton, Croydon and Kingston see increases of up to 30 minutes in driving time compared to decreases or no change for Wandsworth or Richmond.”
About the overall report, Kingston councillor Anita Schaper, chairing the committee, said: “You’ve produced sort of quite high level key findings in this report and what we need really is for them to be evidenced.”
A public consultation on both options is due to begin in early summer.
NHS England will make a final decision after reviewing feedback and considering all information. Services are not expected to move before 2026.
