‘Where are the Velindre Minutes then? A routine enquiry has thrown up major questions about the legitimacy of the new Velindre Cancer Centre being built away from a general hospital. A recent Freedom of Information response (13th January) signals that Velindre did not generate key documentation for this decision. In particular, the reply clearly can’t confirm that there are minutes or even agendas for the crucial clinical meetings behind the choice of site.

So when the FOI requested dates, agendas and minutes in September 2021, none proved forthcoming in the reply. Rather, it reported that no ‘separate outputs’ from the meetings existed, not even ‘notes’, so inevitably no minutes.


What happened instead? The FOI statement seems clear. ‘Healthcare planners…transposed outputs from these meetings… directly into’ a programme document. The SOP document also makes mention of a Velindre ‘sub-group’, but its composition is not revealed. The FOI letter does tell us that Velindre invited all ‘stakeholders’, to the meeting, but then we can’t know who actually attended as there are no ‘outputs’, especially minutes, to tell us.

Wales NHS requires minutes to be taken at all Trust meetings. It does not consider entering formal ‘evaluations’ into histories as enough. It requires ‘an accurate and detailed record of the meeting which captures the discussions and the decisions that have taken place.’ (NHS Wales Standard Operating Procedures, UHB 2017). Only this, it seems, would verify the legitimacy of the new Velindre Cancer Centre and its ongoing programme today.

The chosen option itself, a ‘stand-alone’ cancer centre, has also run into heavy criticism. The distinguished panel of cancer professors who monitor all of Welsh cancer research made its opposition clear (repeated in Welsh media in October 2021). It insisted that the decision would be bad for patients and a threat to the Velindre brand. The same view appeared in a letter from 163 senior clinicians working in cancer, their names and specialities known to government.

The Nuffield Advice to Velindre went still further (Dec 1 2020, p.11). It described what the choosing process for deciding a site should look like. It must be ‘a large-scale exercise… taken by all involved.’ And minutes then become even more indispensable, for a large-scale exercise needs a big evidence-base. Even good minutes would not be enough. We get no assurance from the FOI response that this size of process ever took place.

So it seems New Velindre can’t go on claiming its compliance with Nuffield’s requirements. It’s not surprising then, that the 163 senior clinicians soon called for a fresh start in the name of best cancer care (January 2021). It argued for a new options process (‘done at pace’) and an independent external clinical review Nuffield denied that it was a review. The clinicans do seem now to have been wholly vindicated.

SOURCES

The FOI letter :

Ref: CORP 2021 – 119                                                                                           Date: 13/01/2022

Dear

Request under Freedom of Information Act 2000

Thank you for your request for information relating to meetings and discussions around the Velindre NHS Trust Strategic Outline Programme: Transforming Cancer Services in South-East Wales’ Draft Final Version 15.0, Date October 23rd 2014, which we received on 27/09/2021. 

Your Request is shown below; [27th September 2021]

  • Reference to a document produced by Velindre NHS trust: ‘Velindre NHS Trust Strategic Outline Programme: Transforming Cancer Services in South-East Wales’ Draft Final Version 15.0, Date October 23rd 2014 (Redacted version).
  • In section 3.9.3, page 137, heading New Build (co-located with an acute site), it states: ‘The Trust held a number of clinical meetings and discussions before discounting this option’
  • In relation to these clinical meetings and discussion on co-location, please provide the following information.
  • A list of the clinical meetings and discussion held, the dates held and a list of participants (if names cannot be disclosed, the number of participants and a summary of participants by institution and clinical position)
  • Minutes of these meetings. If no minutes are held, any summary documents that were produced from these meetings/discussions
  • Please provide the information in the form of emails with electronic copies.

Velindre University NHS Trust response: [13th January 2022]

The Trust meetings to support the development of the Strategic Outline Programme during 2013 – 2014.  These meetings covered a range of areas for discussion and consideration.  All key stakeholders were invited to attend these meetings including clinicians, nurses, allied health professionals, managers and patient representatives. 

A range of options to meet the objectives of the Programme were developed, considered and formally evaluated.  The healthcare planners supporting this work transposed the outputs of these meetings / option appraisal workshops directly into the Strategic Outline Programme (‘Velindre NHS Trust Strategic Outline Programme: Transforming Cancer Services in South-East Wales’ Draft Final Version 15.0, Date October 23rd 2014).   

There were no separate outputs from the meetings (e.g. notes) as the information was written directly into the Strategic Outline Programme.

I trust this answers your request for information, however, should you not be satisfied with the information supplied or the process of supplying it, you have a right to complain and request a review.  You should forward your complaint to:-

Mr Ian Bevan via FOI.VUNHST@wales.nhs.uk

Head of Information Governance

Velindre University NHS Trust

Other Links:

http://www.transformingcancerservices.wales/wp-content/uploads/2020/09/Strategic-Outline-Programme-Redacted.pdf p.131, 3.3.1

‘Large-scale options appraisal’. Nuffield to Velindre.

Jaguar Electric v Rickshaw?

Letter from 163 Senior Clinicians

Eminent Clinical Reviewers on Velindre’s Plans