Richmond council opposes NHS move of children's cancer services to central London

By Charlotte Lillywhite - Local Democracy Reporter 3rd Jun 2024

St George's Hospital has specialist children cancer services (credit: Charlotte Lillywhite/LDRS).
St George's Hospital has specialist children cancer services (credit: Charlotte Lillywhite/LDRS).

The NHS is facing growing opposition from councils over its decision to move specialist children's cancer services from South London into Central London.

Richmond Council voted to ask Health Secretary Victoria Atkins to intervene in NHS England's decision to move the children's cancer centre based jointly at St George's Hospital, Tooting, and The Royal Marsden, Sutton, to Evelina London Children's Hospital, Lambeth, at a special meeting on May 28.

It comes after the NHS consulted on two options for the future location of the centre last year – either moving it entirely to St George's or to the Evelina. 

The centre provides specialist children's cancer services to those aged 15 and under living in South London, Kent, most of Surrey, Brighton and Hove, Medway and East Sussex.

The NHS said it has to move the centre as a new national service specification in 2021 outlined very specialist children's cancer treatment services must be on the same site as a paediatric intensive care unit and other specialist children's services.

The Royal Marsden does not have a paediatric intensive care unit, meaning a small number of children with cancer requiring intensive care are transferred safely by ambulance to St George's every year.

The NHS announced its decision to move the centre to the Evelina on March 14. Services are not expected to move until 2026 at the earliest.

Members of Richmond Council's health committee said they disagreed with the NHS' decision and raised concerns about whether it had properly taken families' concerns into account at a special meeting on May 28 – including over the prospect of having to travel via public transport into Central London to reach the Evelina.

Lib Dem councillor Jim Millard said parents of children with cancer had described taking an immunosuppressed child on public transport as 'terrifying' and stressed 'how important it is to be able to take them by car'.

He said the council is 'very concerned' about residents 'having to undergo the stress' of reaching the Evelina, as they won't want to use public transport, and argued this would 'disadvantage those who are more disadvantaged, less well-off, who don't have as many options and it may expose children to unnecessary risk'.

Councillor Millard also told the meeting St George's and The Royal Marsden have built an 'amazing amount of specialism' over 25 years of running the existing centre.

He said: "You can't just detach this whole process, plop it somewhere else and expect the same level of expertise to just grow – it takes decades, and we'd be throwing away a harmonious system of experts who work very well together and very effectively and the value of that is incredibly important."

Lib Dem councillor Stephen O'Shea argued the NHS' evaluation of both options had not 'fully recognised the fact that the great majority of patient carers and parents said that they wanted to be going by car'.

He said both hospitals are 'high-quality institutes' but the Evelina does not have the 'paediatric oncology expertise that Royal Marsden and St George's currently have'.

Councillor O'Shea also raised concerns the NHS had not put forward robust evidence for the 'assumption' staff currently working in Sutton and Tooting would be happy to move into Central London.

He said the 'only feedback' the council had received about the options from parents and formal groups were 'purely negative' and questioned whether they had been properly listened to in the evaluation process.

The council put forward concerns about the NHS' decision in a joint letter on April 26 to Dr Chris Streather, London medical director at NHS England, which was also signed by the leaders of Wandsworth, Kingston, Croydon, Merton, Sutton and Surrey councils.

A report by council officers said Dr Streather's response, on May 9, did not adequately address the concerns raised in the letter, which led to the special meeting of the committee on May 28 to decide whether to ask Ms Atkins to review the NHS' decision.

The report recommended the committee ask Ms Atkins to call in the NHS' decision as it said moving the centre to the Evelina is 'not in the best interests of the health service in the region'.

The committee agreed to the recommendation at the end of the meeting, although it may not submit the referral form until after the general election on July 4.

A St George's spokesperson described the decision as 'disappointing' at the time it was made, and said it would 'continue to provide outstanding care to children with cancer and work with NHS England, our partners and communities as this process continues'.

An NHS London spokesperson said: "Evelina London has been chosen as the future location for the children's cancer centre following a rigorous process, including involving clinical advisers, parents, charities, nurses and research staff. The future centre will stand ready to give cutting-edge treatments that require intensive care on site, like other major centres worldwide.

"Service reconfiguration is rarely easy and we recognise that during consultation, parents and families raised a number of concerns about the change in location, including about travelling further into London, and what that will mean for them. Our focus now is on detailed implementation planning which takes all of these concerns into account to support families and staff."

An Evelina spokesperson said: "We are fully committed to working with patients, their families, staff from the current service, and other partners to design the new service with children, young people and staff at its heart, to ensure continuity of care during the transition period and to agree a plan for the transfer of the service." St George's has been contacted for further comment.

     

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