[To receive a report from the RWHT on Cancer Treatment Services].
[Report is marked: To Follow].
Minutes:
The Chief Executive of the Royal Wolverhampton NHS Trust gave a verbal report on cancer treatment services at the Trust. He stated that the Trust had very significant problems. They used to have 1300 referrals for cancer a month but were now averaging 1800. They had received 600 referrals in the last ten days. He did not understand why there had been a sudden increase in the number, but he had people working on trying to analyse why. A rise in referrals normally correlated with a TV soap storyline but he was not aware of a cancer related storyline at the current time. The last ten days had probably put the Trust two months behind on the plan they had to recover their position. There had been a significant increase in the DNA (Did Not Attend) rate in the run up to Christmas and the DNA rate between Christmas and the New Year was substantial. His team were working extremely hard but could not deal with the volume of work.
The Chief Executive of the Royal Wolverhampton NHS Trust commented there were a lot of people electing to come to Wolverhampton to have robotic surgery. In his position as Chair of the West Midlands Cancer Alliance, he wanted to ensure the Queen Elizabeth Hospital Birmingham (QE) fully utilised their robot. Coventry and Stoke were using their robot at full capacity. There needed to be an overall strategy for robotic surgery, as there was no national strategy in place.
The Chief Executive of the Royal Wolverhampton NHS Trust stated the Trust was not equipped to be able to deal with the current volume of cancer referrals. They had four mobile scanners on site because the fixed MRI (Magnetic Resonance Imaging) and CT (Computerised Tomography) scanners were being used to capacity. He was also utilising the capacity at the Nuffield but was still having to use two mobile MRI scanners and two mobile CT scanners. For patients having to use the mobile scanners, it was not a pleasant experience because they had to be pushed on a trolley across the car park in all weather conditions. The Trust was going to have to invest in at least another two MRI scanners and two CT scanners, but he did not have the capital.
The Chief Executive of the Royal Wolverhampton NHS Trust stated that they had been visited by the National Medical Director of NHSI (National Health Service Improvement) who concluded that they had a major capacity problem. In addition, they had a significant problem with the centres who referred into the Trust, who were referring in late and with incomplete information. NHS Improvement had said they would assist with this problem, as the Trust had no jurisdiction over the centres. The Trust had outsourced significant amounts of endoscopy work. Whilst the Trust had an endoscopy room at Cannock Chase Hospital, he did not have the finances available to equip the facility.
The Chief Executive of the Royal Wolverhampton NHS Trust commented that thirteen years ago the Government had been proud to announce that they had acquired 45 linear accelerators from the Heritage Lottery Fund. Approximately five years ago he had commenced lobbying people such as the Secretary of State to try to achieve the same outcome again. Unfortunately, his proposal had not been implemented. The Trust had been forced to replace the linear accelerators themselves at a cost of £24 million. To have the extra required fixed MRI and CT scanners would cost £10 million.
The Chief Executive of the Royal Wolverhampton NHS Trust stated that there was a problem in the workforce for cancer treatment services, as the Trust was four Consultant Oncologists short. This staff shortage situation was not unique to Wolverhampton, it was a national problem. They were prioritising the patients to the best of their ability. He would ensure the Health Scrutiny Panel received a detailed report on cancer treatment services for the next meeting of the Panel. He also invited anyone on the Panel to contact him if they wished to visit Newcross Hospital’s Cancer Treatment Services.
A Member of the Panel asked if the Chief Executive of the Royal Wolverhampton NHS Trust had any information on the capacity of cancer treatment services across the West Midlands. He responded that they had tried everywhere to re-route some of the work but had not achieved any success. All the National Tertiary Centres were in trouble. It was not just the levels of capacity of the scanners, but also the problem of having to have a Consultant available to interpret the results of the scan. He did not want to send scan results overseas due to bad experiences in the past. Nationally, some Consultants were leaving the NHS when they reached their Pension Cap tax limit. He felt the cap limit being reduced had caused an adverse effect of consultants leaving earlier than they would have otherwise. They were losing highly skilled staff with twenty years or more of experience. The introduction of IR35 (UK’s anti-avoidance tax legislation) had meant he could not pay people through a limited company. Consequently, people would work for an agency who would then charge 30% more.
A Member of the Panel asked why people would wait longer to have robotic surgery. The Chief Executive of the Royal Wolverhampton NHS Trust responded that it was because the recovery time was much quicker. He cited the example of a hysterectomy, where a person could be expected to be back at work on average in two weeks if the surgery had been completed by a robot. He saw robotic surgery as the way forward in the future, it did however take a long time to train the surgeons. It would take a highly skilled surgeon, 18 months to two years to become competent.
A Member of the Panel paid praise to their recent experience of cancer treatment services at Newcross Hospital. They highlighted that the one area which needed improvement was the waiting time for the patient to receive the results, which she was told stood at 2-3 weeks. They praised the staff at the hospital for doing their best in difficult circumstances.