Agenda item

PETITION - GYNAECOLOGICAL SURGICAL CANCER UNIT

The panel will receive a petition regarding the transfer of the Gynaecological Surgical Cancer Unit from Derriford Hospital in Plymouth to Treliske Hospital in Truro, Cornwall.

Minutes:

The panel considered a petition submitted to the Council against the proposals for a Designated Specialist Gynaecological Cancer Surgery Unit in Treliske Hospital, Truro. Three petition organisers introduced the petition. It was reported that –

 

  1. the petition was started at the end of 2009 when the proposals were first made; the petition was closed on the number10.gov.uk petition website in April due to the general election. The petition contained in excess of 3,000 signatures and it was felt by petitioners that there would have been further signatories had the petition not had to close;

 
  1. the petition highlighted the strength of feeling against proposals for a  Designated Specialist Centre based in Cornwall. This could lead to women in Plymouth having to travel for their care. It was felt that the travel distance was excessive and too far from family and friends which could cause additional stress at a difficult time;

 
  1. continuity of care was extremely important for women undergoing complex surgery. When undergoing this sort of surgery it was important to build up trust with the surgical team, this trust could not be built if surgery took place in one hospital and follow up care in another;

 
  1. first class care was already available at Derriford Hospital with reported outcomes among the best in the country, people should not be made to travel when excellent care was already provided in Plymouth;

 
  1. the proposals had not been widely publicised to members of the public or former patients of Derriford Hospital’s Gynaecological Cancer unit. The Petitioners’ felt that former patients and the wider general public needed to be engaged and have the opportunity for their concerns and opinions to be listened to;

 
  1. clinical aspects of recovery were extremely important but recovery was also aided by personal aspects such as the ability of friends and family to visit a patient and continuity of care.

 

Representatives from NHS Plymouth Primary Care Trust (PCT) and the Peninsula Cancer Network (PCN) attended the meeting to respond to the petition. John Richards, Chief Executive of the PCT reported that –

 

  1. the PCT and PCN appreciated the opportunity to attend and respond to the petition. The issue was taken very seriously and the PCT valued and respected the views of the petitioners;

 
  1. the PCT had not carried out adequate consultation on the proposals and were open to suggestions on how to consult better in the future;

 
  1. the situation since the 27 January 2010 when the panel first considered the proposals had changed significantly. The criteria against which the process for service change of this kind is tested has now been set out by the government and took into account patient choice and impact of choice;

 
  1. no decision had yet been taken and the Peninsula PCTs and PCN were currently working in collaboration to identify a new way forward.

 

Dr Simon Rule, Clinical Director for the Peninsula Cancer Network (PCN), in response to the petition reported that-

 

  1. some cancer treatments benefit from centralisation and improved outcomes could be identified. No decision had yet been made on Gynaecological Cancer treatment in Plymouth;

 
  1. thePCN was charged with achieving the best outcomes for patients and with providing those outcomes as locally as possible. However, whilst looking to achieve better outcomes for patients a certain degree of service change could be required;

 
  1. the specialist Gynaecological Cancer Centre at the Royal Devon and Exeter Hospital was working well and achieving good outcomes, whilst looking for a similar configuration in the west of the Peninsula clinicians proposed that services continue to be provided over the two sites, the proposal was not acceptable to the Government of the day;

 
  1. clinicians were being asked by PCN to suggest changes in the way that services were provided in the west of the Peninsula and provide clinical evidence to support proposals;

 
  1. with regard to patient engagement there were improvements to be made, although there were difficulties in approaching former patients because of data protection concerns.

 

In response to questions from members of the panel it was reported that –

 

  1. there were no new models for Gyneacological Cancer Surgery in the Peninsula proposed. Patient choice was paramount but the service could improve;

 
  1. any proposal would need to demonstrate a clear clinical case for change, the new criteria had moved from an inflexible centralisation model to flexible model based on outcomes and patients’ views;

 
  1. key areas where care services were delivered would be identified in an attempt to engage with patients and public;

 
  1. there were benefits that could be gained from centralisation, Devon and Cornwall were very fortunate in that Radiography Services were available in four of the five hospitals in the Peninsula;

 
  1. there was a balance to be achieved between treating less complex cases locally and the possibility of the centralisation of specialist treatments, but no decisions had been made;

 
  1. patient and public engagement did need to be improved and the PCN would be meeting with the lay member of the Independent Reconfiguration Panel to discuss how this could be improved.

 

In summing up the petitioners expressed satisfaction that they had been afforded the opportunity to provide the panel, representatives of NHS Plymouth and the Peninsula Cancer Network with their concerns and worries. If better outcomes could be achieved then this needed to be backed with robust evidence. The petitioners reiterated that the care package offered at Derriford Hospital was excellent and provided very good outcomes for women during an extremely difficult and stressful time of their lives.

 

The Chair closed the debate and the panel considered the following recommendations-

 

Agreed that-

 

  1. that a timetable for considering proposals and an option appraisal for service reconfiguration is made available to the panel at the earliest opportunity;

 
  1. a detailed consultation plan for patients and the wider public with regard to the formation of service reconfiguration proposals is made available to the panel at the earliest opportunity;

 
  1. where possible NHS Plymouth and the Peninsula Cancer Network engage current and former patients in the service reconfiguration proposals and take advice on consultation from partner agencies.

 

Supporting documents: