On 14th March 2024 NHS England will make a decision to move children’s cancer services in South London, Kent, Surrey and Sussex to either St George’s or the Evelina London Children’s Hospital. NHS England have said that both of these options are viable, but their preference is for the whole service to move to the Evelina London Children’s Hospital. We have concerns about this choice.
Paediatric cancer is a rare condition, requiring highly specialist services on the same site as paediatric intensive care. The current model for South London and the South East region must therefore change, with those elements of the service provided by the Royal Marsden moving to a site with children’s specialist care and intensive care.
Currently the majority of surgery, expertise from regional paediatric specialists (such as gastroenterologists, neurologists, dermatologists, infectious disease specialists) and all of the intensive care for the very sickest children is delivered by St George’s.
St George’s is rated outstanding for paediatrics by the CQC, and have been delivering cancer services for children in partnership with the Royal Marsden for 25 years. St George’s proposal is to consolidate the Primary Treatment Centre (PTC) onto the St George’s site in a new, state-of-the-art children’s cancer wing – delivering outstanding facilities to match the outstanding care they already provide.
It is clear to us that this option would be of most benefit to children with cancer and their families in our constituencies. Why?
- The services that matter most for children with cancer are available on site at St George’s: for some 80% of children with cancer, St George’s can offer or is poised to offer key treatments that the Evelina will not, or will have to develop.
- St George’s can deliver what parents of children with cancer say they want. Above all, expertise and experience. The current PTC service at St George’s and the Royal Marsden has been built up over 25+ years. In many cases, it is reliant on the experience of individuals with extremely rare expertise. For instance, paediatric oncology surgery requires surgeons with uncommon skill and expertise. There are only around 20 in the country, of whom 3 are at St George’s. St George’s is the only hospital in South London with such expertise.
- Parents have also said that when you have a child with cancer, potentially on immunosuppressants, you take them to hospital by car not on public transport. The current children’s cancer centre at the Royal Marsden in Sutton is outside of central London, with good parking provision. Now the Marsden has been dismissed as an option, St George’s will and does offer this, with dedicated parking spaces and a drop-off zone for the families of children with cancer, directly outside the entrance of their proposed new, state-of-the-art Children’s Cancer Centre.
- Consolidating the children’s cancer centre at St George’s will be easier and less costly for the NHS to deliver. A large part of the service is already at St George’s, and at St George’s, an existing non-clinical space can, at relative speed, be transformed into a new state-of-the-art cancer centre. Beyond the financial impact on each individual institution, there will be wider costs to the NHS as a whole. This includes stranded costs at St George’s if the children’s cancer service moves to the Evelina. St George’s has estimated these costs at c. £2.5m in the first year if the service moved.
- If children’s cancer services are transferred from St George’s to the Evelina London Children’s Hospital, this will have an impact on other children’s services at St George’s. Children’s cancer services are not neat, stand-alone services. The expert staff supporting children with cancer could leave St George’s and weaken strong multidisciplinary teams who currently work together to provide surgery and pathology to children in South West London and Surrey.
- St George’s already support more children into trials of medicinal projects than any other provider in South London, and are uniquely placed to support the Primary Treatment Centre’s ongoing partnership with the ICR,
- Given their proximity and the Government’s support to build a new hospital in Sutton that would see the St George’s, Epsom and St Helier Group co-located with the ICR.
- Now, with City University of London and St George’s, University of London having agreed to merge and developing ambitious plans to invest in the St George’s campus, the opportunities are stronger still.
We believe that the Secretary of State for Health and Care should look to use her call-in powers to take a decision on the future of children’s cancer services in SW London and Surrey.
