Purpose

Background Information
Currently, the
Principal Treatment Centre (PTC) for children with cancer who live
in South London, Kent and Medway, most of Surrey, East Sussex and
Brighton and Hove, is The Royal Marsden Hospital in Sutton
(“the Marsden”), with intensive care and cancer surgery
provided at St George’s Hospital in Tooting (“St
George’s”).
In 2023, NHS England undertook a statutory consultation exercise
regarding the reconfiguration of this service, putting forward two
proposals:

i)            
to relocate the principal treatment centre to St George’s and
to retain services currently provided at St George’s at that
hospital, or

ii)           
to relocate the principal treatment
centre and transfer most services currently provided at St
George’s to Evelina
Children’s Hospital in central London.
In each case
radiotherapy services would be provided at University College
Hospital in central London.

This Council engaged with the consultation through the South West
London and Surrey Joint Health Overview and Scrutiny Committee
(JHOSC) which established a sub-committee to respond to the
consultation.

The Sub-Committee submitted their formal response to NHSE’s
consultation on the proposals on 14 December 2023, within the
statutory consultation period. The sub-committee was of the clear
and unanimous opinion that, should this specialist service be
required to move, then St George’s was the clear and
preferable choice for numerous reasons set out in it’s report, including its strong working
partnership with The Royal Marsden and its location which would
provide easier access when compared to the Evelina for the vast majority of patients and their
families.
 
An independent consultation summary report shared with the
sub-committee on 29 January 2024 did not sway the
Sub-Committee’s view, reiterating, in its opinion, the issues
and strong feelings from patients, families and clinicians with
regards to any move of service, and in particular a move of service
to the Evelina. These views were
informally conveyed to the NHSE on 12 February and subsequently
ratified by the JHOSC at its meeting on 7 March 2024.

The JHOSC agenda for 7 March 2024, which includes as an Annexe the
Sub-Committee’s response to the consultation, can be found on
the Council’s website.
On 14 March 2024, NHS England held a meeting to announce their
decision to adopt the proposal to
relocate the PTC treatment centre and transfer most services
currently provided at St George’s to the Evelina Children’s Hospital. The decision is
not likely to be fully implemented until 2026.

Pursuant to Schedule 10A of the National Health Service Act 2006,
the Secretary of State, of their own volition or on request, can
call-in a decision such as the one taken by NHS England on 14 March
2024. A request to call-in a decision can be made where
i) there are concerns with the process
that has been followed by the NHS commissioning body or NHS
provider (for example, adequacy of the content of consultation or
the time allowed for consultation; how options have been
developed), and/or ii) where a decision has been made and there are
concerns that a proposal is not in the best interests of the health
service in its area.

As detailed above, the views of this Council on the proposals were
conveyed as part of the response to the consultation submitted by
the sub-Committee of the South West London and Surrey JHOSC in
December 2023 and reiterated in its response to the independent
consultation summary report.

A joint letter, from the Leaders of the Councils of the constituent
authorities comprising the JHOSC was sent to the Interim Regional
Medical Director and CCIO for NHSE, on 26 April 2024, expressing
concern at the decision, indicating that the option of call-in was
being explored but also expressing a willingness to explore any
further areas not already covered through the consultation
process.

Reason for Urgency

The scrutiny of health matters in respect to reconfiguration of
local health services rests with the Council’s Health
Overview Panel (HOP).

However, HOP is required to set up a Joint Committee with one or
more authorities where an NHS body consults on a substantial
development or variation to health services that extends beyond the
area covered by the Committee.

Whilst HOP is required to set up a Joint Committee to scrutinise
the proposals, the decision regarding any matter of referral (now
call-in) must be exercised by the Panel, taking into account
whether or not the proposals are in the best interests of the
residents of this Borough.

This matter was due to be considered by HOP at its meeting on 12
June 2024 but pre-election considerations meant that it was
considered that it was not appropriate to hold this meeting and
this authority is not alone in this regard.

Richmond Council had already published its agenda papers by the
date of the announcement of the election and therefore has already
made its decision on referral. It is understood that the other
constituent authorities of the JHOSC are working towards a decision
to request a call-in by the 15th July.

Content

The Executive Director of Children's Services,
in consultation with the Chair of the Health Overview and Scrutiny
Panel, took the decision to authorise the Executive Director of
Children's Services to make a request to the Secretary of State for
Health and Social Care to call in the decision NHS England on the
reconfiguration of the future location of very specialist cancer
treatment services for children in South London and much of South
East England.