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Well, how did they select the location of New Velindre? And why plump for that particular choice of clinical underpinning for the new cancer programme? Only a few brief paragraphs are publicly available to answer these questions, and resting on an even smaller number of key lines (see extract end of this blog). But there’s a big back-story available.

Evidence missing.

The public has only recently learnt of Velindre’s admission that it does not hold any evidence to verify the historical roots of this major 2014 decision (see link at the foot of this blog: Freedom of information. ‘But where are the Velindre minutes?’ January 31 2022). And there’s more to it than even the shocking news that New Velindre’s programme lacked these absolutely critical minutes to support it. For also we have no clarity about how Welsh Government played into the whole process. So this cloud of mystery received a little speculative attention in our newly updated blog: The Birth of New Velindre. The mystery solved. November 7th 2021 (link at the foot below).

Money v. clinical consensus?

Things get tricky here. For the quote in the extract later implies the unthinkable. This is because government seemingly pre-empted expert clinical consensus expressed through the region on cancer care. So government decided the clinical model (a stand-alone cancer centre) and nailed it down as a condition for financing. Hence 1.2.3. below tells us what politicians and managers together achieved. It reveals that they eliminated the current science in advance, the trend of co-locating a new cancer centre with a general hospital.

Deviation from universal good practice

This inexplicable choice above diverged not just from universal good practice but from Welsh good practice too. For this flaw make it not just a local issue but a disruption of cancer practice in all of Wales. Also it flies in the face of expert cancer consensus long available to government and apparently spurned even to this day.

Exceptional government intervention before the choosing starts

1.2.3 quoted below describes the content of that decision. According to this, the government’s choice excluded any co-location options before the contest opened. Hence it formed an intervention unheard of in cancer care planning. For the New Velindre Programme Business Case ([PBC] 2017) clearly reveals that government pre-emptively precluded best cancer care from the start.

Chronology contradictions

  • So Velindre claimed that it was government that set the options range, and it excluded co-location . AND YET THAT DOESN’T SEEM POSSIBLE BECAUSE
  • the same passage also claimed that the government decision occurred later – actually in 2015 (1.2.1 below). In that case the government decision surely came after Velindre’s own choice already to discard co-location (September 2014 in the Strategic Outline Programme [SOP].

Such a contradiction can’t easily be resolved. And neither sequence looks good.

For Either Velindre decided this issue of Wales-wide significance in a private corner without any record of proceedings (see blog Freedom of Information above). And then it pressed government to hard-line the choice before any proper options appraisal began. All the time, we remember that this contradicts the clear 1.2.3 summary saying the opposite.

Or government contravened its own official advice that clinical decision should always lead service change. And why did they do this? For political or financial reasons? Or something else?

Questions nagging

More recently, how is it that government approved this timeline muddle a second time round? For it financed the soaring costs in March 2021 by waving through pretty much the exact same paragraphs, but this time as the 2020 final Outline Business Case. So, we wonder, didn’t it realise that fixing the location so narrowly and so early could easily pressure other official bodies in the process to follow suit (like, say planning committee, Nuffield, , IIB, etc)? Wouldn’t they all be too cagey to scupper a new, government-backed cancer programme?

Answers will do on a postcard thanks.

Sources

Extract from the SOP: Transforming Cancer Services Programme Business Case 2017 (bold italics ours)

1.2.1 The Welsh Government, during 2015, approved the Trust’s Strategic Outline Programme (SOP) for the delivery of Cancer Services in the South East Wales. The approval of the SOP resulted in the establishment of the Transforming Cancer Services programme…(more supplied)

1.2.2   The funding arrangement attached to the approval of the SOP also included a number of conditions as follows.

  • The entire nVCC should be built in Whitchurch, Cardiff and on land under the ownership of the Trust.
  • The nVCC should be clinically operational during 2022/2023; and the capital costs set at 2013/14 prices.

REDACTED SPACE HERE

1.2.3 The funding conditions set out above are important within the context of this Programme as they have restricted the range and scope of options which can be considered as part of the economic case.

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