What’s more disconcerting than misinformation?

Especially misinformation about major medical issues as serious as cancer.

A constituent recently emailed Senedd MS Julie Morgan calling for an independent external clinical review of New Velindre’s stand-alone model before the proposed building works go forward. This was her reply, received by email on 3rd December, 2021:

‘The Nuffield Report was quite clear that the build should go ahead.’

This is very serious misinformation. It illustrates why we should always look twice at claims to be following the Nuffield advice. For Nuffield made no such recommendation.

What the Nuffield advice rather said was that ….

‘….we are not making any judgement about the decision to site the new VCC on the Northern Meadows. Such a large scale option appraisal exercise is not only well beyond our terms of reference but is fundamentally about values and the choices that need to be assessed and taken by all involved.’ https://www.nuffieldtrust.org.uk/project/independent-advice-to-velindre-nhs-university-trust pg 11.

So Nuffield could never have recommended that ‘the new building should go ahead’. It does not give such direction anywhere. The current new project lay outside its terms of reference as agreed in advance with its New Velindre customer.

Those ‘terms of reference’ kept the Nuffield panel within strict bounds: the ‘risks and benefits’ of a particular cancer networking proposal. No judgements allowed on Velindre’s prior decision to build away from a hospital, whether for or against it.

This statement by an MS is a serious piece of misinformation effectively stifling the constituent’s request- a request which went totally ignored and unaddressed.

Thanks anyway, Ms Morgan

However, thank you anyway, Ms Morgan. You’ve succeeded in drawing everyone’s attention to what the Nuffield panel really says here. You’ve spotlighted what should have been done long ago: ‘a large-scale option appraisal exercise.’

Everyone in medicine knows what the term means. At the start of a major project, the options should be compiled and processed with stakeholders, ie all involved. To see how its done, look at this blog: https://colocate-velindre.co.uk/jaguar-electric-vs-rickshaw/.

Nuffield’s statement implies that New Velindre leaders should have ensured a region-wide, formal, recorded consultation on the underpinning question: a stand-alone cancer centre or co-location with an acute hospital. To be considered not just by Velindre clinicians and management, or even the region’s clinical leads, but the wider clinical community and big numbers of patients and the community. All recorded for analysis as part of the options appraisal process.

Why did Nuffield decide to write like this?

Could they have worked out there had never been such a large-scale option appraisal exercise behind the underpinning issue? The panel saw past the trumpeting of post- appraisal presentations (‘engagements’). Now it indirectly asserted the very opposite of what Ms Morgan has claimed. Nothing should ever be built until after proper appraisal.

Someone needed to spell that out to the public and Welsh Government. And they did- it’s exactly what the 163 senior clinicians said in their January 2021 letter- written after the Nuffield advice was published. They knew always to look twice.