Warning to Health Minister

Senior doctors have written to the Welsh health Minister, Eluned Morgan, warning that pressures on the Welsh Ambulance Service are putting patient safety at risk.

BMACymru Wales Committee Chairs and Local Medical Committee chairs signed the letter, reported in Wales Online https://www.walesonline.co.uk/news/health/doctors-tell-health-minister-patients-21664036

What does the letter say?

In the letter the doctors refer to serious delays in urgent transport of patients to hospital, leading to avoidable harm. In some cases, the Welsh Ambulance Service has refused to attend emergency requests from the public and clinicians. Some patients have had to arrange alternative urgent transport to hospital or receive treatment in inappropriate settings.

Why does this matter to Co-locate Velindre?

Velindre’s stand- alone Cancer centre in Whitchurch frequently calls on the Welsh Ambulance Service to transport very sick patients from Velindre to the University Hospital of Wales. Staff dial 999, just as you would if you had a medical emergency at home. Velindre patients aren’t ‘fast-tracked’ by the ambulance service, as they are deemed to be in a place of relative safety, ie a hospital.

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We have consistently called for an independent review of the Velindre stand-alone model. Many people think that the Nuffield Trust have already carried out an independent review of the Velindre model, and approved it. Velindre would certainly like you to believe this. There are just two problems:

• The Nuffield Trust didn’t carry out a review of the model, and
• they didn’t approve it.

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The recently built Guy’s Cancer Centre and Liverpool’s Clatterbridge Centres show that award winning, co-located Cancer Centres are being built on small pieces of land.

Guy’s Cancer Centre occupies a footprint of just 0.51 acres on a triangular site in central London

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We set up the Colocate Velindre website just two weeks ago. We wanted to share the strongly worded letter of warning from the Wales Cancer Research Centre’s External Advisory Board as widely as possible.

We’ll continue share facts about the weakness of Velindre’s plans and their impact on our future cancer services in Wales, and give updates on our campaign.

How are we doing?

The campaign, and the website, have been well received.

The website has had up to 500 hundred hits per day. We’ve also had many emails of support. Sadly, many people working in the NHS have asked for anonymity as they fear for the impact on their careers if their opposition to the plans becomes known.

We’ve had coverage in the South Wales Echo and Western Mail, as well as Wales Online https://www.walesonline.co.uk/news/local-news/velindre-cardiff-cancer-hospital-plan-21575745?fbclid=IwAR1vpkCtKZyJYMbFep3CVQ8yOBkRagAP_bH3gjgLmJQFbj-OpD6UYQzvTIg

and The National Wales https://www.thenational.wales/environment/19588501.legal-challenge-new-velindre-cancer-centre/?fbclid=IwAR2WwBM9bv4m49wiO2tpZj7a-5sdH0LCTSCHSEt9aI6fvdiuHqC1pXzRi4g

in the articles, Professor Neil Burnet, the Chair of the External Advisory Board, makes it clear that he is far from reassured by Velindre’s response to his letter, as in his view cancer centres work much better if they’re co-located with a big general hospital.

Our work goes on

We’ll continue to expose the weakness of Velindre’s plans, and provide new information as it becomes available. For instance, you’ll be able to watch a clinician explain her concerns on ITV Wales News at 6pm on Wednesday 22 September.

If you’d like to be involved, or just show your support, please get in touch at

colocatevelindre@gmail.com

We contacted all Welsh Government Assembly Members earlier this year. We summarised our concerns about the plans for the new cancer centre, and the process being used. We’re posting information from the letter on this site.

Letter signed by 163 Senior Clinicians.

After the Nuffield Trust published their advice on the risks of the stand alone model, 163 senior clinicians wrote to the Health Minister to draw his attention to their continuing significant concerns. There is a link to the full text of the letter at the top of this page.

Some quotes from the letter

• ‘we agree that co-location with an acute hospital would provide safer in-patient care, improve support from other specialities, create a better base for research and be in line with best practice elsewhere.’

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We contacted all Welsh Government Assembly Members earlier this year. We summarised our concerns about the plans for the new cancer centre, and the process being used. We’re posting information from the letter on this site.

Failure to fully engage the other stakeholder Local Health Boards in the planning process:

Both the Nuffield report and the minutes of the Health Social Care and Sports Committee meeting held on 30/09/2020   [https://record.assembly.wales/Committee/6443] discuss the quality of engagement.

The Nuffield Trust report makes the following points about the Transforming Cancer Services Programme

• A strong emphasis on care closer to home and the design of care around the patient’s need.
• Enhanced care within the Local Health Boards (LHB).
• Three or more Velindre@ specialist units supported by VCC, providing a range of ambulatory cancer services within LHB sites and working closely with local services.
• A VCC satellite radiotherapy unit at Abergavenny.
• A new VCC including acute care and providing the Velindre@ for the Cardiff & Vale LHB.

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We’re disturbed at so many questionable mantras offered for the New Velindre project. So we’re going to challenge some of them. Let’s start with this one:

 ‘Of course clinicians are going to split 50-50 on this cancer-centre issue aren’t they?’

 Well, no they do not. Our post, Eminent Clinical Reviewers on Velindre’s Plans is a letter intended to guide cancer research in all of Wales and it embodies clear received practice in the entire UK.  That practice is all but exclusively ‘co-location’. In Wales the picture’s simple too – mainly Velindre’s leading clinical managers versus the rest (i.e. Velindre versus Swansea and all points north). It’s true. See the post: Letter from 163 Senior Clinicians. So Velindre’s clinical managers versus the rest – that’s not 50-50 is it? More like 5-95.

The Appendix 1 to the Nuffield Advice for Velindre reassured everyone that ‘the specialist unit can still retain a distinct identity’ and ‘building’, even ‘a separate organisational form’. First-class treatment and service provision (see About Us) but also the calm and quietness of a specialised cancer centre. If cancer patients don’t receive all of this – well you know who to blame.

But only if you act now.

It’s a mere 10-15 minutes task. All you do is send a 3-sentence email to your Senedd members for both constituency and region. You can google ‘Senedd Members’ for e-mail addresses.

 The first sentence expresses your deep concern personally at this Project. 

The second sentence merely urges the MS to visit http://colocate-velindre.co.uk/ to get the real story on Velindre. The second sentence asks the MS to go on and read the short but stunning post: Eminent Clinical Reviewers on Velindre’s Plans and if possible the 13^thSeptember posts.

The third sentence should be your name and address (postcode as a minimum) as many MS will only deal with correspondence from their own constituents.

BUT THEN please print out your e-mail message and deliver or post it 1^st class to the MS c/o of their local party office. This might just by-pass any gatekeeping and stalling.

 To modify a famous line – all it’s left now for bad to triumph is for good people to do nothing.

Clinicians concerned about the future of cancer care in South East Wales have repeatedly called for an independent clinical review of the stand-alone model. Velindre and Transforming Cancer Services have responded by claiming the model has been reviewed, implying that Dr Jane Barrett reviewed the model, and that the advice from the Nuffield Trust was a review, but to date NO external clinical review of the model has taken place.

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We contacted all Welsh Government Assembly Members earlier this year. We summarised our concerns about the plans for the new cancer centre, and the process being used. We’re posting sections of the letter on this site.

Misrepresentation / Suppression of the level of concern within the Velindre NHS Trust:

In the document “Why not build a new Velindre Cancer Centre on another hospital site?”   Velindre make the following statement:

“Our plans for providing specialist, non-surgical cancer services for people across south east Wales have the support of health board clinicians, our staff and patients”

Both TCS (Transforming Cancer Services) and the Velindre NHS Trust will have been aware of the level of concern expressed by a significant number of its senior doctors and nurses.

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We contacted all Welsh Government Assembly Members earlier this year. We summarised our concerns about the plans for the new cancer centre, and the process being used. We’re posting information from the letter on this site. 

Misrepresentation of the transfer times for patients requiring urgent escalation of care:

A major weakness of the stand-alone model is the need to urgently transfer acutely unwell patients for care that can’t be provided on the remote Velindre site.

In their document “Why not build a new Velindre Cancer Centre on another hospital site?” Velindre say:

“UHW is less than three miles away and can be reached within minutes.”

The statement as it reads is very reassuring, the reality, less so.

We submitted a freedom of information request to the Welsh Ambulance Service Trust (WAST) requesting information on transfer times. We asked about how long patients were waiting before the ambulance arrived, how long the journey took and how long patients waited at UHW (University Hospital of Wales) before handover. They told us….

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Dr Frank Atherton at the Health Social Care and Sports Committee meeting held on 30/09/2020 at 09:42:50 Dr Atherton states:-

“I think perhaps, with the benefit of hindsight, having made the decision by the health boards to go ahead with the construction of the new Velindre cancer centre back in 2018, perhaps that clinical engagement should have continued, and that’s perhaps allowed—that perhaps didn’t happen as much as it needed to.”