In order to ensure that a small group of seriously ill patients continue to receive safe care and the very best possible treatment, the inpatient haematology service at County Hospital in Stafford will temporarily move to Royal Stoke University Hospital and New Cross Hospital in Wolverhampton on 7 September.
Local clinical commissioning groups will launch a six week public consultation in September to gain views on the recommended long term move of the inpatient haematology service. However, difficulties in recruiting doctors and nurses, the absence of important supporting services at the hospital and the outdated facilities have led to a decision to move the service temporarily on the grounds of clinical safety, until a final decision is made following the public consultation.
Haematology outpatient and day case services will continue to be available at County Hospital and these services will be enhanced with a brand new £2m chemotherapy suite opening in the summer of 2016. The existing daycase unit at County Hospital is being upgraded and refurbished to the same standards as the unit at Royal Stoke which is recognised nationally as an excellent example of a modern chemotherapy unit and has won a number of awards. The unit will be larger than the current facility at County Hospital and will include more single side rooms and additional space for patient counselling and support.
Inpatient haematology is a small, very specialist service currently provided on a split eight bed unit within a medical ward and is available for patients requiring intensive inpatient care. It provides treatment, usually by aggressive chemotherapy, to those with blood disorders and cancers such as myeloma, lymphoma and leukaemia. One side effect of this is bone marrow suppression, neutropenia and thrombocytopenia leading to serious consequences for patients.
National good practice and evidence sets out that inpatient haematology services are better when they are delivered from specialist haematology centres such as those available at Royal Stoke University Hospital and New Cross Hospital in Wolverhampton.
At Royal Stoke University Hospital patients will receive their care within a modern, purpose built clinical centre which is being further improved with the introduction of five additional beds in August.
Patients can also receive their care at Cannock Hospital or New Cross Hospital in Wolverhampton. Cannock Hospital will also benefit from a brand new chemotherapy suite opening in August 2015, along with new outpatient and day case services for oncology and haematology patients.
Services will also be enhanced at New Cross Hospital and, in addition to the inpatient beds and day case chemotherapy service already available, new outpatient clinics will be introduced.
Dr Jonathan Odum, Medical Director for Royal Wolverhampton NHS Trust said: “The developments at Cannock Hospital mean that patients in this area can, for the first time, receive oncology and chemotherapy treatment close to home and attend this hospital for their outpatient appointments.
“The new outpatient clinics which will be available at New Cross Hospital will also ensure people receive more of their care and treatment closer to home.”
The permanent move of this service from County Hospital to Royal Stoke University Hospital and New Cross Hospital in Wolverhampton was due to take place in August as part of plans to implement the Trust Special Administrators’ (TSAs) recommendations following the review into Mid Staffordshire NHS Foundation Trust. The TSAs’ report made a general recommendation that specialist services should be transferred in order to benefit from the care and treatment available at specialist centres. While it is clear in the report that the movement of specialist services is supported, it is acknowledged that there was no explicit recommendation regarding the move of specialist inpatient haematology services.
To ensure that the local NHS can evidence that a full debate has taken place about the proposed service move, a six-week consultation is being held on the long term move of inpatient haematology services.
Professor Gavin Russell, Associate Medical Director for University Hospitals of North Midlands, commented: “We welcome the additional consultation, however, it is extremely important for us to ensure we continue to provide safe services and the best possible care for our patients, particularly those who are very unwell and have the potential for their health to further deteriorate, whilst this debate is underway.
“Following the retirement of one of our haematology consultants and another leaving the Trust in the coming weeks we have had to carefully consider how we will ensure our patients continue to receive good medical care 24 hours a day, seven days a week in the short term.
“We will need to recruit new consultants and, unfortunately, our Trust, along with others right across the country, experiences difficulties in recruiting staff to this type of service due to preferences of doctors and nurses to work in a large specialist centres. We would therefore need to look at recruiting temporary doctors but this can lead to problems with the quality of the service provided. It can also be difficult to recruit specialist haematology nurses.
“We have also considered the absence of support services available at County Hospital. Services such as interventional radiology, high level critical care and renal replacement have transferred to Royal Stoke University Hospital and New Cross Hospital in Wolverhampton over recent months. It is important that haematology patients have direct access to these types of services.
“Furthermore, the inpatient haematology facility at County Hospital is inadequate for these very ill patients. This particular area is outdated, in need of modernisation and within a general medical ward which, clinically, is not the best environment for them.
“As part of our plans to improve hospital services, five new inpatient haematology beds will open within the state of the art centre at Royal Stoke University Hospital in August. These additional beds will allow us to treat those patients currently admitted to the haematology wards at County Hospital in a better environment, staffed by sufficient specialist haematology medical and nursing teams and with access to all the necessary support services.
“The treatment for these patients can lead to bone marrow suppression, neutropenia and possible sepsis and Royal Stoke University Hospital and New Cross Hospital in Wolverhampton are the best and safest place for these patients to be cared for.
“We have therefore have taken the decision to temporarily move the service to ensure patients receive their care and treatment in the best and safest place until the outcome of the public consultation is known.”
Professor Charles Craddock, Clinical Director of Blood and Marrow Transplant at the Queen Elizabeth Hospital, Birmingham and Professor of Haemato-oncology for the University of Birmingham, was asked to offer an expert opinion on the proposal.
Professor Craddock confirmed that the case to move the service was convincing. He stated: “I agree that there are compelling reasons why the proposed move of in-patient services is delivered as quickly as possible and am convinced this will be of significant benefit to both patients and the development of a sustainable high quality service capable of delivering increasingly complex curative therapy.” He went on to say that he does not believe the current situation is sustainable.
Andy Donald, Chief Officer for Stafford and Surrounds Clinical Commissioning Group, said: “We support the temporary move of this service and believe it is in the best interest of patients. However, I would like to assure people that no decision on the proposed long term site for this service will be made until we have undertaken the public consultation.
“I encourage people to get involved and give us their views. There will be a number of events where people can find out more and have their say and a survey will be available on our website.”
Notes to editors:
· The inpatient haematology service at County Hospital is a small service with eighty three patients using the facility during 2014/15 (114 admissions).
· Level 3 critical care transferred from County Hospital to Royal Stoke University Hospital in March. Level 2 critical care, with short-term level three capability remains at County Hospital.
· The Cancer Centre at Royal Stoke University Hospital opened in 2009 and provides a range of specialist services. For more information please visit www.uhnm.nhs.uk/OurServices/Cancer
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