Controversy over children's cancer services

Where will the service go?

The service for children with cancer is currently based at the Royal Marsden Hospital. The options for the new sites are the Evelina Hospital and St George’s Hospital. NHS England says that from their assessment of both potential new sites so far, that there is a slight preference for Evelina Hospital. They stress that the ongoing public consultation will influence the final decision.

St George's Hospital is running a campaign for the service to be located with them. Evelina is also making its case. It's the first time we've seen hospitals competing with each other in this way.

Who does the change impact?

In 2019/20, the Royal Marsden treatment centre served 536 children with cancer as inpatients in South West London, South East London, Kent and Medway, Surrey, East Sussex, and Brighton and Hove.

NHS England does not plan to move the site until at least 2026. Most current patients will have completed their treatments by then.

The move will therefore primarily impact future patients and their parents, carers, and friends. Some Royal Marsden staff will also be invited to take up posts at the new treatment centre. NHS England has spoken with current patients and staff to understand the impact of the move. This is captured in their consultation report. (An Easy Read version is also available).

Other people will be affected as well. For example, if staff move from the Royal Marsden, this will impact other patients under their care. The result of moving patients to a new site might also impact other patients already being treated at that site.

The site move might also impact children, their loved ones, and staff in paediatric oncology centres in neighbouring catchment areas, especially Southampton Hospital. This is because not all future patients will want to travel to Central London for care, which might lead to more people seeking care in these alternative hospitals.

Why are there plans to move the treatment centre?

New NHS England national guidance states that the primary treatment centre for children with cancer must have a paediatric intensive care unit on site. This is to reduce the risks inherent to transferring very sick children who need these services. Currently a small number of children are transferred each year from The Royal Marsden to St George’s for intensive care. The vast majority are transferred safely, though in 2011 the transfer was linked to the fatality of a young child.

What do current and former patients and their parents think about this change?

Consultations with parents in the initial phase to determine whether there was a need to move the treatment centre at all suggested agreement with the idea for the treatment centre to be located in the same place as an intensive care unit for children. The report is available here.

However, a group of parents are now working hard to fight this move and to keep the children's cancer centre at the Royal Marsden. They think that it is unlikely that either of the proposed sites can offer the quality and overall experience of care available at the Royal Marsden. Many are also concerned about increased travel times and other travel complications with reaching these sites. They have approached local council members in South West London and are circulating a petition.

How can I let NHS England know my views?

The consultation period is now open and will close on 18 December 2023. You can share your views here.

What role has Healthwatch played in these consultations?

The South West London Healthwatch collaborative (comprised of Healthwatch Croydon, Merton, Kingston, Richmond, Sutton, and Wandsworth) are watching NHS England patient engagement closely. We have so far:

• Participated in a pre-consultation with NHS England to help guide their approach to the now open public consultation.
• Provided representation at meetings where we have heard from concerned patients.
• Requested assurance from NHS England that they are demonstrating best practices in meaningful engagement.
• Advocated that NHS England respond to the points that parents raise.
• Shared NHS England’s responses and patient concerns with the Mayor of London’s office, which is conducting an independent assessment about this service change.