The Joint Health Overview & Scrutiny Committee met to discuss the reprovision of services at the Mount Vernon Cancer Centre (MVCC) and updates on the 'care closer to home' initiative. The meeting's agenda included a scrutiny response to the public consultation on proposed changes to MVCC services.

Mount Vernon Cancer Centre Reprovision Consultation and Care Closer to Home Updates

The committee was scheduled to receive an update on the public consultation regarding the proposals for the Mount Vernon Cancer Centre. This included information on how the consultation was being delivered and governed, participation data, and emerging themes from the first half of the consultation period. The report pack indicated that the programme team was taking actions to address gaps in engagement and responses before the consultation closed.

Concerns raised at a previous committee meeting about the consultation progressing before capital funding was secured were clarified. It was explained that the assurance process began in early 2025, with national agreement on the approach. Capital funding was agreed in January 2026, after which the consultation proceeded. The MVCC scheme was to be aligned with the Watford scheme, with feasibility tested, but subject to the outcome of the public consultation.

The committee was also to be updated on the delivery programme, noting that the NHS was in wave two of the West Hertfordshire delivery scheme with a provisional start date of 2031/32. Aspirations to bring this timeframe forward were noted due to the need to relocate the cancer centre, but the consultation period needed to be completed before finalising these details. Feedback from this scrutiny was expected by the end of June 2026.

To encourage greater community involvement, a programme was developed to support structured engagement with groups facing barriers to traditional consultation methods. This involved direct funding to cover costs and access to an additional participation fund to help remove barriers to engagement.

Questions were raised about whether consultation responses submitted after the closing date of 29 March would still be considered. It was explained that while the NHS wished to receive as many responses as possible, a cut-off date was necessary to complete the final report.

Regarding engagement with cancer patients, the consultation questionnaire included a question asking respondents if they had been a patient. Patients were also informed about the consultation through the cancer centre, referring hospitals, and cancer support groups. Banners were displayed at Mount Vernon Hospital directing patients to the consultation website. The hospital was unable to write directly to current patients due to consent requirements, but information was included in appointment letters. It was noted that most attendees had been former patients or family members of former patients.

For carers, it was noted that a number of consultation attendees were carers and that carers' groups had been contacted. The Integrated Care Board was asked to support engagement through its communications and engagement teams. Local social prescribers were also contacted to help disseminate information.

Patients were drawn from a wide geographical area, and engagement had been ongoing with oncologist leads at neighbouring hospitals to ensure wider sharing of consultation information.

Questions were asked about modelling undertaken regarding potential travel costs and impacts for each council. It was noted that a travel and access survey was running alongside the consultation, with updated modelling of demand and footfall for the Watford site. Some of this work would inform consultation responses, particularly public and patient views on 'care closer to home'. If there was strong support for this, certain treatments could potentially be delivered at home, removing the need for travel. The modelling aimed to understand how much care could be delivered locally, after which transport implications would become clearer, requiring more detailed transport planning in collaboration with local authorities.

An update was requested on views relating to radiotherapy provision, including whether an additional, networked radiotherapy unit should be established at a second site. The committee was advised that three options had been presented: A) relocating all radiotherapy services to Watford only; B) relocating services to Watford with an additional unit at Lister Hospital, Stevenage; or C) relocating services to Watford with an additional unit at Luton and Dunstable Hospital. Based on responses received to date, support for options B and C was broadly even, although option A continued to attract significant support.

Criteria for radiotherapy relocation had also been considered, but consultation responses had not yet been analysed. Key factors anticipated to be included in the analysis were the availability of acute services on site, car parking provision, public transport links, health inequalities, rurality, and the number and range of patients who could be treated.

Regarding the decision on whether to establish additional provision at site B or C, or to prioritise care closer to home, it was noted that Watford is a considerable distance from the east of the county, whereas Stevenage and Luton are significantly closer. The committee was informed that weight would be given to consultation responses compared with the principle of providing care closer to home. It was explained that unless there was strong public support for centralisation, radiotherapy is a highly specialised service requiring dedicated equipment and specialist staff. Any satellite service would be delivered by the Mount Vernon team, based at either the Lister or Luton & Dunstable hospitals. No decision had been made at that stage regarding the most appropriate location for satellite radiotherapy, but it was considered that providing radiotherapy at more than one site could benefit a larger number of patients. Criteria had been developed to ensure decisions would best meet the needs of the whole population.

The low proportion of male respondents compared to female respondents was highlighted, along with the fact that responses from ethnic minority groups accounted for less than 15% of the total so far. Queries were made about engagement activity to encourage greater participation from these groups. It was noted that extensive engagement work had been carried out in collaboration with NHS trusts and communications leads. Consultation materials were translated, paper advertisements were used, and work was undertaken with diverse FM radio. Visits were made to organisations that might not typically respond to questionnaires. Engagement took place through voluntary sector networks, forums, carers' organisations, and attendance at community and support groups, with targeted engagement through a microgrant programme.

Engagement activity to ensure good attendance at an event scheduled for Wembley on 14 March was questioned. It was noted that communications were coordinated through relevant Integrated Care Boards and trusts within the network, who held established local contacts. Colleagues within North West London ICB had made appropriate local contact. Additional promotional activity included geo-targeted newspaper advertising and social media campaigns. Wembley was selected as the venue due to its central location.

During consultation meetings, efforts were made to clearly explain the clinical need for change and address concerns about access. It was highlighted that, within the current configuration, the NHS was able to treat all clinically eligible patients.

The query about an additional option (Option D) for radiotherapy at home was addressed by explaining that all elements of Option A were incorporated within Options B and C. The key difference would be the potential provision of a slightly smaller radiotherapy unit, enabling services to be delivered at an additional location in support of care closer to home. It was also noted that chemotherapy delivered at home could be an option for some patients, subject to clinical suitability and patient preference.

The committee noted that the public consultation was live from 19 January to 29 March 2026, compliance with legal and regulatory requirements for NHS major service change, participation levels to date and the approach to monitoring representativeness, actions underway to address under-representation, early themes being raised, and additional local intelligence that the committee believed should shape the remainder of the engagement programme.

Mount Vernon Cancer Centre Transport and Access Update

The committee received an update on the work taking place around transport and access in support of the Mount Vernon Cancer Centre consultation.

Transport and accessibility were noted as the most frequently raised issues in relation to the proposed site and were a significant concern for patients. Key themes included car parking availability and cost, as well as public transport connectivity across Hertfordshire, particularly east–west travel. Access to Watford Hospital and car parking provision were viewed unfavourably by some respondents; however, it was confirmed that a large multi-storey and surface-level car park was in place. The proximity of Watford Football Club was also considered, and it was noted that match days did not currently coincide with cancer treatment schedules, with any potential future clashes expected to be minimal.

NHS England had received suggestions to mitigate access issues, including park-and-ride facilities, minibus services, and the use of voluntary transport.

To ensure travel and access issues were fully understood, NHS England commissioned an independent social research organisation to carry out a separate engagement exercise examining how patients accessed the centre. The findings would inform the Decision-Making Business Case and focus on patients' current travel patterns, behaviours, circumstances influencing travel and access choices, and any barriers affecting patients' ability to use MVCC services. This survey was due to close at the end of May 2026, with indicative feedback to be provided at the 16 June meeting.

A suggestion for a dedicated bus service linking the hospital with mainline railway stations was noted, particularly in light of limited east–west transport connectivity. It was noted that this would be considered, but the NHS had limited influence over bus routes. As further modelling progressed, discussions would take place with local authorities to explore innovative solutions. The committee emphasised the importance of public health considerations when assessing transport route access.

The committee considered it would be helpful to have a visit to the Watford site to experience the journey and see the proposed site, which would be arranged by the Programme Director, Ruth Derrett.

Discussions with bus service providers had not yet taken place, as no formal decision had been made. It was recognised that the development of the hospital would take time, allowing scope for these discussions once a decision was confirmed. In the meantime, intelligence was being gathered on travel hotspots and areas where changes might be required, to ensure the NHS had the necessary evidence and data to inform future planning.

The committee noted the ongoing work around travel and access and considered that, as part of the JHOSC response to the consultation, they should write to Local Authorities urging them to partner with the NHS in improving access to a new cancer centre in Watford for cancer patients from across the three regions and ten local authority areas.

The committee noted that patients currently travel to London for haematology services. Under the proposals, these services would move to the Watford site, improving accessibility for patients, particularly from Hertfordshire and Bedfordshire, those requiring overnight stays, and for their visitors. With UCLH managing both the London and Watford cancer centres, greater flexibility would be available in determining the most appropriate treatment location, while supporting patient choice.

The wider consultation was concerned with the future configuration of services, including where services might be located and how they might be delivered. The survey was introduced to address an identified gap in understanding patients' travel choices, the underlying factors influencing those decisions, and the difficulties they faced.

It was asked whether the transport consultation focused solely on physical hospital sites or also considered the potential for services like chemotherapy, blood tests, and phlebotomy to be delivered closer to home. It was queried whether this formed part of the discussion. In response, the committee noted that the separate survey was designed to explore how patients currently made their travel choices, with a particular focus on the challenges and barriers they experienced.

MVCC Relocation Case for Change

The committee was scheduled to receive an update on the clinical case for change underpinning proposals to relocate the Mount Vernon Cancer Centre (MVCC). The report aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report highlighted that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background to the case for change detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report updated the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, the testing of these proposals with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

Between January and March 2026, a public consultation sought views on these proposals and associated service changes. Over 3,500 people participated through surveys, public meetings, roadshows, and community-led discussions. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation demonstrated a range of views. Many respondents recognised the clinical challenges faced on the current site and supported relocation to secure the future of specialist cancer services. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of aspects of the current patient experience, particularly the calm environment at the current cancer centre.

The consultation findings provide an evidence base for the Decision-Making Business Case. Commissioners were considering the findings, reviewing additional suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal to relocate MVCC is the result of several years of clinical review, public involvement, and options development. Local Authority Health Overview and Scrutiny Committees had been engaged since early in the review, and more recently through the MVCC Joint Health Overview and Scrutiny Committee (JHOSC), formed in December 2024. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, including critical care and specialist medical and surgical support, and that maintaining the status quo was not a viable long-term option.

A wide range of options were considered, including maintaining services at the current site, dispersing services across multiple other centres, building smaller centres in each region, and relocating services to a new purpose-built facility adjacent to acute hospital services. Patients, carers, staff, voluntary organisations, local authorities, and stakeholders were involved throughout the process.

Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation, workforce sustainability, capacity, and patient experience. Building smaller centres was ruled out as they would not be large enough to provide necessary specialist expertise and treatments.

A range of acute hospital sites were assessed, with Watford General Hospital emerging as the preferred option as it met the required clinical criteria while having the lowest overall impact on travel times. The core clinical criteria were the presence of critical care and a range of medical and surgical specialties. Four core travel criteria were also applied: no material increase in average drive times, no significant increase in patients with drive times over 30 minutes, no material increase in average public transport times, and no increase in the proportion of patients travelling more than 75 minutes each way. Only Watford General Hospital met all these criteria.

The consultation findings showed that 48% of respondents supported the proposals, with 42% opposing them. Support was generally stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access, rather than disagreement with the clinical case for relocation. Support was primarily determined by whether respondents believed access would improve or worsen for their locality.

Improvements in access were a key factor for those supporting the proposals, with many accepting the need for change due to the current site's unsustainability, the safety benefits of co-location, and access to the latest treatments and clinical trials. Those opposing the proposals most commonly raised concerns regarding travel times, transport options, parking, costs, reliance on family or carers, and the potential loss of the current site's environment and patient experience. People living in London boroughs were most likely to oppose the proposals.

Travel, transport, and accessibility were the dominant issues raised throughout the consultation. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the cancer centre culture, and transition arrangements. Many respondents expressed support for the clinical ambition while questioning whether sufficient mitigation had been developed for access impacts.

Themes requiring further consideration included travel and accessibility, with mitigations needed for geographical areas perceived to maintain and improve access, particularly where they correlate with deprivation. A joint travel and access working group was being established. Revised transport modelling was underway, and a deep dive into patient experiences was due to report. Concerns about losing valued aspects of the current centre, such as its calm environment and specialist identity, were also noted. Patient experience and design groups were reviewing responses. Health inequalities required further investigation, particularly potential impacts on older, disabled, and lower-income groups. A revised Equality Health Impact Assessment was underway. The Patient Reference Group was being relaunched as a Patient Partnership Group with an expanded membership. Questions regarding the deliverability of proposals and transition arrangements were raised, including funding, timescales, workforce recruitment, and continuity of care. Concerns that decisions may have already been made were noted, stemming from the presentation of a preferred proposal. The programme was undertaking further consideration of alternative suggestions received during the consultation.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality specialist cancer care; minimising unnecessary travel; reducing the practical burden of accessing treatment; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; ensuring solutions are realistic and sustainable; maximising research and innovation opportunities; ensuring coordinated and easy-to-navigate pathways; and basing decisions on transparent assessment of evidence and feedback.

The conclusion stated that the consultation does not appear to challenge the underlying clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered before the final decision.

MVCC Relocation Case for Change

This report updated the committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It aimed to refresh members on the reasons for the proposed changes and provide high-level feedback from the recent consultation.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire, and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services required for modern cancer treatment. Advances in cancer care have made treatments more effective but also more complex, with patients living longer and often requiring access to critical care, specialist medical teams, inpatient support, and emergency clinical services not available on the current site.

Consequences of the current site's limitations include the departure of inpatient and outpatient haematology services, the inability to undertake early-phase clinical trials, and patients needing to receive specialist treatment elsewhere. Some patients require ambulance transfers to acute hospitals when they become seriously unwell during treatment, and certain treatment options cannot be offered due to unavailable clinical support. Recruiting and retaining high-quality clinical staff is becoming more challenging as services diminish.

The public consultation identified concerns about travel, transport, parking, and accessibility. While views differed on the proposed solution, the consultation feedback and alternative suggestions did not challenge the underlying clinical evidence that specialist cancer services require access to acute hospital services for modern, sustainable care.

The committee was asked to note the challenges and consider the case for change. The background detailed concerns about MVCC's sustainability, amplified by evolving cancer treatments. An Independent Clinical Advisory Group in 2019 concluded that maintaining the status quo was not viable, requiring urgent action to secure the future of specialist cancer services due to the lack of comprehensive medical and surgical support.

The report detailed how cancer treatment has evolved, with newer treatments causing severe complications requiring immediate access to critical care and specialist teams. Patients living longer with cancer and multiple health conditions necessitate close collaboration with a wide range of acute medical and surgical specialties, which are unavailable on the current site.

The limitations are not theoretical, as haematology services have already moved due to a lack of clinical support. Patients requiring highly specialised treatment must travel outside the local area, and acutely unwell patients require emergency transfers. Other patients cannot access particular treatments due to unavailable inpatient and specialist support. Access to clinical trials is increasingly dependent on acute hospital infrastructure. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff.

Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments and trials, recruitment and retention difficulties, greater reliance on other organisations, and increasing fragmentation of patient pathways. This ultimately places the long-term future of specialist cancer services at risk. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications, while also supporting research, innovation, and workforce development.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site presenting a real risk of closure. There was no evidence presented during the public consultation to undermine this case for change. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys for complex care and closure of the specialist centre.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Advances in treatment, patient complexity, and the need for acute hospital services mean the gap is widening. The public consultation highlighted concerns regarding travel, transport, accessibility, and the impact of relocation, which will continue to inform proposals and mitigating actions. However, consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

Scrutiny Response to Consultation on Proposed Changes to Services Currently Provided at Mount Vernon Cancer Centre

This report presented the Joint Health Overview and Scrutiny Committee (JHOSC) with a proposed collective response to the NHS consultation proposals regarding services at Mount Vernon Cancer Centre (MVCC). It sought agreement on the content of the JHOSC Response, the Committee's formal statutory position, and whether further action or escalation was required.

The background outlined that MVCC provides regional non-surgical specialist care for over two million adult patients across Hertfordshire, London Boroughs of Hillingdon, Harrow, Brent and Ealing, Buckinghamshire, Luton, Central Bedfordshire, Bedford, and Slough. Between January and March 2026, NHS England conducted a public consultation on proposals including moving MVCC to a new centre adjacent to Watford General Hospital, increasing chemotherapy at home and establishing new units at Hillingdon and Northwick Park Hospitals, repatriating haematology services for Hertfordshire and Bedfordshire residents to Watford, increasing local diagnostics and monitoring, and providing an additional radiotherapy unit at either Lister Hospital (Stevenage) or Luton and Dunstable Hospital.

Given the scale and cross-border impact, constituent local authorities established the JHOSC for coordinated scrutiny. The committee had previously considered the clinical case for change, co-location at Watford, UCLH as the preferred provider, the consultation plan, interim responses, transport and access, and 'care closer to home' plans. The Committee Chair was invited to submit a formal response to the consultation by 16 July 2026.

The committee was asked to agree its formal response under Regulation 23 of the Local Health Scrutiny Regulations, considering options: A) satisfaction with the consultation process and no further recommendations, or B) broad satisfaction but with recommendations to address outstanding concerns.

The report stated there were no financial or legal implications arising from the report. It also noted that no Equality Impact Assessment (EqIA) or Sustainability & Equality Evaluation Decision Support (SEEDS) assessment was undertaken as they were not applicable.

The report included a letter from Jessamy Kinghorn, Head of Partnerships and Engagement for NHS England, thanking the JHOSC for their support and assistance in promoting the public consultation. She advised that the formal public consultation closed on 29 March and initial analysis of the draft report had been undertaken. Notification of the regulation 23 consultation with the committee was given, asking that the committee use its session on 16 June for this purpose. The draft consultation report had been circulated for public scrutiny between 18 May and 1 June. The final report would be published with the papers for the JHOSC meeting on 16 June. Work was also underway to involve patients and the public in looking at suggestions made during the consultation. The first part of the meeting on 16 June was designed to look at 'care closer to home', and the second session would be for the formal regulation 23 consultation, where the full feedback report would be shared and how it was shaping further development of proposals. The JHOSC was asked to respond to the regulation 23 consultation by 16 July 2026, with the feedback to be incorporated into the Decision-Making Business Case, with a decision hoped for by 31 October 2026.