Doctors and parents throw support behind South London hospital's fight to keep children's cancer services

By Charlotte Lillywhite - Local Democracy Reporter

15th Dec 2023 | Local News

Samantha, Jackson and Shaun Hall at St George’s Hospital in Tooting. (Photo Credit: Charlotte Lillywhite/LDRS).
Samantha, Jackson and Shaun Hall at St George’s Hospital in Tooting. (Photo Credit: Charlotte Lillywhite/LDRS).

Doctors and parents have thrown their support behind a South London hospital's fight to keep children's cancer services, rather than see them moved into Central London.

NHS England is proposing to move the children's cancer centre based jointly at St George's Hospital in Tooting and The Royal Marsden in Sutton to one location – either moving the entire site to St George's or transferring it all to Evelina London Children's Hospital in Lambeth.

Senior doctors at St George's told the Local Democracy Reporting Service (LDRS) they believe the hospital in Tooting is best placed for the future location of the centre as it has already built expertise, trust and relationships over 25 years of running it with The Royal Marsden. 

It also has shared care and paediatric intensive care units which look after children with cancer.

Dr Sijo Francis, consultant neonatologist and divisional chair, said: "That wider team isn't just doctors and nurses – it's the therapists, psychologists, play specialists, radiologists.

"There's a whole host of people who touch the patient throughout their journey and it's that set-up, that seamlessness of it, it just works because it's now a well-oiled machine that just knows what to do.

"That is not something that you can just take and move somewhere else."

Dr Emma Sage, paediatric consultant, added: "The services have been here for such a long time and cancer care is complex and there's subtleties to it. There's things that you learn as you're doing it and all the interactions between all the different services… it's very hard to just pick it up and move it, whereas it's here already."

Tracy Gibbons, lead play specialist, has worked at St George's for nine years and said her team prepares children with cancer "for hospitalisation, for procedures when invasive things or distressing things are happening, explains to them about their diagnosis" and "provides therapeutic play sessions to prevent regression".

The NHS has been consulting on the two options for the centre, which provides specialist children's cancer services to those aged 15 and under living in South London, Kent, most of Surrey, Brighton and Hove, Medway and East Sussex. The consultation closes on December 18.

A new national service specification in 2021 outlined very specialist children's cancer treatment services must be on the same site as a paediatric intensive care unit and other specialist children's services.

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

In consultation documents, the NHS said it preferred Evelina's proposal as it scored higher than St George's in an independent evaluation – at 80.5per cent compared to 75.3. But it added it is "open-minded about both options". 

Both hospitals would provide rooms for parents to stay and dedicated parking spaces, along with play specialists, spaces for young children and teenagers, outdoor space, parents' lounges and cafés.

Radiotherapy is proposed to be provided at University College Hospital, with specialist heart and kidney services at Evelina and neurosurgery at St George's and King's College Hospital.

St George's would convert a wing of the hospital to create the new centre, with its own entrance, while Evelina's proposal involves building a new children's cancer inpatient ward in the main hospital. 

Dr Francis described the St George's proposal as affordable and "easy to deliver".

He raised concerns moving children's cancer services away would be detrimental to all children's care at the hospital.

Dr Samantha Hettige, consultant neurosurgeon, told the LDRS St George's has "almost every specialty under one roof". 

She said: "If a child has an emergency and needs to be treated via an operation within an hour, we have the ability to do that and I think we have been practising that for years and hence it's a very well laid-out pathway.

"We have dealt with oncology emergencies in the past where they have needed urgent intervention and children have had a very good outcome because of this."

Dr Hettige emphasised the "accessibility of St George's is also a massive plus-point" for parents.

She added: "It's easy to drive, it's easy to park, relatively – if you have a sick child the last thing you want to do is take public transport and hence why St George's is in a good position in London to provide the needs of the sick child."

This was echoed by Sutton mum Samantha Hall, who praised the treatment her son Jackson received at St George's after he was diagnosed with T-cell acute lymphoblastic leukaemia, aged 2 in 2020. 

He rang the end of treatment bell in April this year.

Ms Hall raised concerns about the prospect of travelling via public transport to get to Evelina as it is closer to Central London: "I never did, throughout the whole of treatment, take him on the Underground or buses," she said.

"There's no way for our treatment I'd want to take him on [public] transport."

Her partner Shaun Hall, Jackson's dad, said public transport posed an "infection risk" and many patients would face longer journey times if they drove to Evelina.

He added the family can "vouch" for St George's where they have "a network, we've got a protocol in place and it definitely takes a bit of weight off us parents knowing that we've got that there".

Independent analysis found both options would be similar or quicker to get to by public transport than the current centre for most people, while it would be slower for most people driving to Evelina and many to St George's. 

St George's has said it is ready to build a state-of-the-art centre with "fantastic" medical and research facilities, along with dedicated parking and family accommodation.

It said children would continue to receive "outstanding and innovative care", for instance, its cancer doctors offer ground-breaking immunotherapy cancer treatment.

Evelina said it believes it is "best placed to take on a service for children and families that will provide them with the best possible care".

The hospital is the only dedicated specialist children's hospital in the region and part of Guy's and St Thomas' NHS Foundation Trust, home to the largest cancer treatment centre in London for adults.

The hospital said it would build on cancer expertise, outstanding-rated children's services and existing partnerships if it won the bid, while giving families "comprehensive travel and accommodation support".

It added moving the centre to a children's hospital would follow international best practice, while it "would be up and running as quickly as possible by utilising existing world-class facilities and capitalising on the ability to immediately begin new children's cancer clinical research trials and offer the latest immune therapies".

Jo Adamou, patient representative at Evelina, said: "My daughter has been a patient at Evelina London since she was born.

"When she was diagnosed with a complex form of cancer, she was cared for by the teams at both Evelina London and the Royal Marsden.

"Of course it was a very scary time but the teams worked so well together and she had such excellent care at both hospitals – happily she is doing well today and we are just so grateful to all the NHS teams who have cared for her.

"So I would have no hesitation in endorsing Evelina London as the best location for the new principal treatment centre."

Sujeev Mathur, paediatric cardiology consultant at Evelina, added: "We already work in close partnership with the Royal Marsden team to support hundreds of children each year that need specialist heart care before, during, and after their cancer treatment.

"Around 1 in 10 children with cancer will develop a heart condition as a result of their cancer treatment, which is why it is vital that the PTC [principal treatment centre] has full access to the breadth and depth of paediatric expertise that a dedicated children's hospital like Evelina London offers.

"This is why every other PTC in England is located in a children's hospital, and why I am confident Evelina London and the existing PTC team can build on our work together to create a comprehensive children's cancer centre that is fit for the future."

Chris Streather, medical director at NHS London, said: "Very specialist cancer treatment services for children are required to be on the same site as a children's intensive care unit that can give support to the most unwell children.

"This is a national clinical requirement designed to prevent hospital transfers of very sick children with cancer from the specialist cancer centre for intensive care, eliminating the added risks and stress these transfers bring."

"Our proposals are focused on securing the best quality care for children with cancer for years to come and the aim of the consultation is to gather views on both of the options we've identified, St George's Hospital in Tooting or Evelina London Children's Hospital in Lambeth."

The link to the consultation is here. The NHS will make a decision after reviewing feedback and considering all information. Services are not expected to move before 2026.

     

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