Improving local cancer services
Questions and Answers November 2015
What are the changes to cancer services that are being discussed?
Regrettably University Hospitals Birmingham advised us in August 2015 that they have decided to
cease providing visiting oncologists to City and Sandwell Hospitals from April 2016. Given their
decision, we are working with partners to ensure that a stable service is maintained on our sites
from that point. Together with Trusts in Dudley and Walsall we are looking to develop shared local
cancer services in the Black Country by 2017. We want more specialist care locally not less.
Existing on site cancer services will remain and we are investing hundreds of thousands of pounds to
achieve improved care across the range of cancer services that we provide.
At Sandwell & West Birmingham Hospitals NHS Trust, we are proud of our cancer services. Our
gynae-oncology service has the lowest mortality in the UK, our breast team have won awards for
excellence and we have invested to ensure that we have seven day a week acute oncology presence
on our sites. In developing our cancer services further we need consistent multi-disciplinary care,
rapid access to clinics, and short waits for radiotherapy. It is the search for this which lies at the
heart of the changes that will happen next spring and where we have not been able to secure UHB’s
support.
How does Sandwell & West Birmingham Hospitals NHS Trust currently deliver oncology services?
The Trust provides chemotherapy at Sandwell and City Hospital sites. Visiting Oncologists currently
come from University Hospital Birmingham to review patients and their treatment.
I currently go to the Queen Elizabeth Hospital for radiotherapy services. Will that arrangement still
be in place?
Yes. We are in fact expanding the number of partners we work with, so that for some specialist
treatment and surgery, patients will have more of a choice over where they can be referred. We are
also looking to develop more treatments within the Black Country through our partnerships with
Dudley Group NHS Foundation Trust and Walsall Healthcare NHS Trust. If people have to travel
further than they do currently, we will look to support any additional travel for patients for superspecialist care. Our plans are for local services to remain on our sites.
How can patients get involved?
In early November we held the first of a series of regular forums to make sure we are talking with
and listening to existing patients about what is important to them. We heard strongly that most
patients are very happy with the current services and that the relationship with the consultant and
the patient is of paramount importance.
Any change can be unsettling, especially when rumours circulate but we are using these discussions
to reassure everyone involved about the nature of the changes and the clinical motivation to
improve quality.
We will be developing a range of ways for patients to contribute to how we can best shape future
cancer services and a number of other patient meetings have been set up.
I have been with my consultant oncologist for a long time. Can I still be seen by them?
Yes, existing patients can still have continuity of care with the consultant that they are currently seen
by, however, this may mean that you need to see them at the Queen Elizabeth Hospital rather than
at Sandwell or City Hospitals.
We are putting in place transitional arrangements for the next 12-18 months and we aim to have by
April 2017 a fully established service.
What happens to the nursing and other staff that work at City and Sandwell Hospitals?
There is no change for any of the staff who are employed by Sandwell & West Birmingham Hospitals
NHS Trust, which is everyone apart from the consultant oncologists. They will continue to work at
City and Sandwell Hospitals as part of the cancer services team.
I am on a drug trial. Will this be able to continue?
Yes, all current drug trial patients will be unaffected by these changes and their contract for trial
treatment remains in place. Sandwell & West Birmingham Hospitals NHS Trust is a centre of
excellence for research and will be further developing our extensive range of clinical trials that
patients can participate in. A few patients are on clinical trials with complex treatments that only
run from the Queen Elizabeth Hospital, they will continue to receive their treatment and follow up
there.
Will I be able to be cared for by the existing consultant oncologists at City and Sandwell Hospitals?
We are talking to all of the consultant oncologists about their options including whether they would
like to work for Sandwell & West Birmingham Hospitals NHS Trust directly. We continue to talk to
our partners at neighbouring NHS Trusts including the University Hospitals Birmingham about
developing our cancer services in partnership to deliver the best care for patients.
What is meant by ‘Oncology Services’?
Oncology is part of cancer services. There are two types of oncologists:
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Medical Oncologist – treats patients who require chemotherapy
Clinical Oncologist – treats patients who require chemotherapy and radiotherapy
Is this all about money?
Sandwell & West Birmingham Hospitals NHS Trust have invested substantially in Oncology services
and we significantly increased the amount of money we were willing to pay University Hospitals
Birmingham. Alongside that investment we wanted to see improved patient care. We do not think it
is acceptable to double the investment in oncology services without seeing service improvements.
How does the new Midland Met hospital affect future plans for oncology services?
Existing patients will be given the choice to stay with their current oncologist as part of ensuring they
have continuity of care, but will also be given the choice to see a different oncologist. The new
Midland Met Hospital will not have outpatient facilities and the chemotherapy units will remain at
both the existing City and Sandwell sites. However, patients who need to be admitted to hospital as
inpatients and need acute oncology services will be treated at Midland Met.
In the future, where will patients go for radiotherapy treatment?
Patients currently go to University Hospitals Birmingham for their radiotherapy treatment. Existing
patients will be given the choice to stay with their current oncologist as part of ensuring they have
continuity of care, but will also be given the choice to see a different oncologist. We are in fact
expanding the number of partners we work with for radiotherapy service provision so that patients
get more choice about where they receive radiotherapy.
In the future, where will patients go for in-patient treatment (i.e. surgery)?
The current arrangements for cancer surgery are not changing. The surgery that we currently do
within Sandwell & West Birmingham Hospitals NHS Trust (for example Breast) will continue. Surgery
for some rarer cancers is currently treated at other centres and this will continue to be the case. The
centres at which these operations take place may change in the future.
Will this mean more patients need to travel to access services?
We are committed to making sure that patients can still receive the existing services provided at
Sandwell & West Birmingham Hospitals NHS Trust at City and Sandwell Hospitals. Should patients
wish to remain with their existing consultant oncologists they may need to be seen at the Queen
Elizabeth Hospital. We are also looking at other centres that will add more choice for patients for
provision of radiotherapy and certain rare tumour treatments.
We will absolutely be supporting patients with their transport needs and recognise that this is a vital
part of the service. We recognise that lots of patients are not mobile and we will be ensuring that we
support patients with the transport we provide.
What other improvements are you looking at for cancer services?
A Cancer Task Force has been set up focussing on improving quality of current services and this
includes reform of chemotherapy services.
I am scared and anxious about the future – who can I talk to?
We recognise this can be a stressful and anxious time for you and your family. You can speak to your
clinical nurse specialist and we will be holding further regular patient meetings to update and
involve you in the on-going process.
What authoritative bodies / scrutiny committees are overseeing the trusts plans?
NHS England is overseeing the Trusts plans.
What is the Black Country Alliance?
Together with Trusts in Dudley and Walsall we are looking to develop shared local cancer services in
the Black Country by 2017. We want more specialist care locally not less. The Black Country Alliance
is a partnership that was launched in July 2014 and aims to develop sustainable patient services
within the Black Country. Oncology is one of the service areas that will benefit from a partnership
approach with Dudley Group NHS Foundation Trust and Walsall Healthcare NHS Trust.
I am unable to attend engagement events, how can I still participate and share my views?
We will be looking at numerous ways to engage with patients and families to ensure all views are
taken into consideration and will undertake to share any answers we receive in a timely fashion,
through various communication channels such as the Trust website, regular patient and staff
meetings and information in the clinics and treatment areas.