Act Now to Stop the Felling of Forest Farm Nature Reserve Trees
On the 7th of December 2021 Velindre will continue what we perceive to be enabling works on the Northern Meadows, with permission from Cardiff Council to drill in the Forest Farm Nature Reserve.
From January 2022, developers will be felling and trimming up to 95 trees, the majority of which are within Forest Farm boundaries, leading to an environmental disaster in Cardiff.
Join us and call on the Welsh Government and Cardiff Council to act now to stop this disaster!Forest farm is a much loved protected green open space which is owned and managed for the people of Cardiff by Cardiff Council. We are calling on Cardiff Council as the owners of the land, and the Welsh Government as the funders of Velindre’s enabling works to step in and stop the destruction of our trees and natural open spaces.
The felling of these trees is the first stage of the construction of a new Velindre Cancer Centre which is being built as a stand-alone facility on the Northen Meadows.Though the medical model is a separate concern, the medical risks provide context to the whole issue. The majority of NHS staff have long argued for this new Cancer Centre to be co-located with an acute hospital for patient safety reasons. More information is available at Co-Locate Velindre.
Over the course of four years of construction, hundreds and hundreds of trees will be felled, and the twenty-three acre Northern Meadows, recently described by Iolo Williams as one of the last wild green spaces in Cardiff, will be destroyed. Listen to what Iolo had to say about the meadows here.
Sign our petition and ask the leaders of the Council and the Welsh Government to intervene and end this disaster project.
Join us to resist the destruction.
To find out more follow us on Facebook and Twitter, and take a look at our website www.savethenorthernmeadows.wales
An Invitation to the Community to Visit the Northern Meadows from the 6th of December
From Monday, the 6th of December, Save the Northern Meadows invites you to observe the continuation of enabling works at Forest Farm Nature Reserve.
Gather at Lady Cory Field to witness the work being carried out by Velindre, as they prepare to fell trees in January 2022.
Work being completed on site, over the Public Right of Way, and within Forest Farm Nature Reserve includes:
- The drilling of two boreholes in the floor of the railway cutting;
- Four samples from the embankment slopes if the conditions are suitable;
- Two boreholes on the new Velindre Cancer Centre site.
This work will result in the felling of some trees, the destruction of habitat, and result in the beginning of the construction of the new Velindre Cancer Centre in 2022-3.
Velindre and the Welsh Government state construction on the cancer centre will not begin until 2023. However, enabling works were granted full planning permission in 2017 under a ‘hybrid’ planning process created by Cardiff Council, which allows Velindre to begin enabling work, without planning permission or even a realistic and detailed design for the Cancer Centre itself.
This means trees will be felled to build roads to a cancer centre which doesn’t presently exist, and is hugely contested by local people, doctors, nurses, environmentalists, and local organisations.
Roads will be built, but:
- There is no understanding the impact the centre will have on flooding in the local community as our weather patterns change;
- Construction will occur within forest farm nature reserve;
- Cardiff has declared a nature emergency;
- Spending at least £500 million of public money with a public financing model which sees private companies make 4 times the amount of the £500 million in interest for funding the cancer centre – amounts which could pay for all kinds of cancer treatments currently unavailable to patients;
- The building of a cancer centre which goes against medical best practice and will put lives at risk.
How and why is this destruction being led by the Welsh Government in 2021?
Visit the meadows this week, join the community and see what this place means to local people.
- Surveyors on the meadow and railway cutting;
- Site security;
- A land rover pulled drilling rig and multiple drill points on the Upper meadow and railway cutting (both within Forest Farm boundaries).
If you come to the meadow, please do the following:
- Wander the meadows and talk to local people to find out how you can help and get involved.
- Record landscape with your phone what workers and site security are doing.
- Ask questions –
- If it’s security – what is your name and badge number. Security MUST HAVE BADGES ON DISPLAY. If not please take a picture.
- Ask them where the site ecologists are. Talk to the ecologist. Ask what work they’re doing. Ask them to produce the ecology report – if they can’t produce it they can’t work.
- Slow walking is also a fun way to observe and talk to site workers.
Send all recordings and images to email@example.com
Keep in touch on our social media.
Email politicians and ask them to intervene. This work is enabling works and Velindre and the Government are acting unlawfully in completing this work. We are simply asking the Velindre, Cardiff Council, and the Welsh Government to enforce their own rules.
Experience the wildlife before it is gone forever.
In love and rage,
Save the Northern Meadows
Why Velindre and Cardiff Council are operating unlawfully on the Northern Meadows
Below is a letter sent by a member of Save the Northern Meadows to the Head of Planning at Cardiff Council, Mr. Simon Gilbert. It outlines why we believe the work which happened on the 25th – 29th of October, and which will start again from the 6th of December, constitutes clearance works, is enabling works, and should have planning Condition 17 (17/01735/MJR) in place before work can start.
Right now, Velindre and the Welsh Government are working without the correct environmental conditions in place, and there are many significant unanswered questions about the development.
Dear Mr Gilbert,
I write in response to the email sent on your behalf by Justin Jones on the 26th November 2021.
My email addresses the first point only due to the severity and immediacy of the situation with further work due to start in 3days time, on Monday 6 th December 2021.
In your email you said: Conflict with condition 17 (CEMP) of the cancer centre approval, reference 17/1375/MJR I note your concern in regards to an alleged breach of condition 17 by undertaking vegetation removal on the site and the adjoining Whitchurch hospital. I understand condition 17 of planning application reference 17/01735/MJR uses the term “clearance and enabling works” but that must be read in terms of the development that the permission has authorised, and the condition relates. The planning system can only regulate development that is controlled under section 55 of the Town and Country Planning Act 1990 and Planning (Wales) Act 2015 and I am informed by my officers who have undertaken site visits, that the removal of vegetation is not “development” under the planning Acts and therefore cannot be controlled through the planning permission. As a result, the Local Planning Authority concludes that the actions undertaken are not in breach of condition 17.
In your statement above, you appear to have misquoted Condition 17, which actually states:
“Prior to the commencement of any site clearance, construction works or development (except to demolition) a CEMP for the whole site shall be first submitted to and approved in writing by the LPA.”
The extract above from Condition 17 clearly lists the site clearance, construction works and development as three separate and distinct categories which require approval by the LPA before commencement. Yet in your reply above you claim “that the removal of vegetation is not development” and so is not controlled by planning permission.
Your claim that the actions which occurred between the 25th – 29th October 2021 sit outside of planning is illogical. The CEMP and Condition 17 were generated out of your own planning process, with the conditions put in place by your own planning committee and officers.
The approval of the CEMP, to include any site clearance is a stipulation within Condition 17.
Your own document clearly states that “prior to the commencement of any site clearance…” yet you then claim that the site clearance that took place between the 25th – 29th October does not count as being governed by Condition 17.
The key word in the condition is “ANY”. Any is a definitive term which covers ANY SITE CLEARANCE and is not open to interpretation, yet this is what you have done to justify the actions which took place.
Cardiff Council Planning Department is not above the law. You cannot manipulate and mould facts within official documentation to suit yourself and a developer. The documentation is clear, was created by your department, sets out the requirements for commencing works, and yet you are choosing not to adhere to it.
Members of the community on the ground on Monday 25 th October attempted to explain and show this documentation to Police along with showing them the online Council Planning Portal which clearly showed that the CEMP had not been approved. A call was then made to your department by a police officer present who
was told it was fine for the work to happen. By this action you misled the police, contravened your own rules, enabled Velindre to act unlawfully and demonised and criminalised distressed local people.
Works should not have taken place during that week as Condition 17 had not been fully discharged by the LPA and so your claim is refuted in the strongest possible terms that a breach has not taken place. It clearly has.
In addition, the work carried out was not simply the removal of vegetation as you state in your email. It involved site clearance involving an excavator – removing roots and soil, a lorry and crane, an extensive workforce and the use of chainsaws in the removal of trees, of which we have video footage. This is clearly enabling works.
During the course of these works many health and safety breaches occurred which have been reported to the HSE.
Additionally, Project Director, Mr David Powell, advised the community that Velindre had been required to gain consent from Welsh Government to undertake the works between the 25th – 29th October 2021. The Welsh Government is funding the enabling works. This is irrefutable evidence that the work undertaken was in fact enabling works.
Our assertion that this was enabling works is further supported by the NRW Protected Species Licence S089035/1, which clearly states that this licence is granted under Regulation 55(2) (e) of the Conservation of Habitats and Species
Regulations 2017…….whilst undertaking enabling works…”
Further, the second page of the licence document, point 3, states:
“All the work carried out under this licence will be undertaken in accordance with: The method statement entitled Velindre Cancer Centre Enabling Work V5 dated 10.09.2021…”
received by NRW on the 13th September 2021, with the licence being issued on the 20th September 2021. There were paid ecologists working for Velindre and supervising all of these enabling works, as set out in the NRW licence. If your claim that the works undertaken were not enabling works then in fact, Velindre were working outside of the licence granted by NRW.
Velindre has now issued information to certain sections of the community advising they will be re-commencing works on 6 th December without any of the above issues being addressed or corrected. Further, Julie Morgan has contacted Velindre on behalf of a constituent and confirmed in writing to the constituent that she has: “double-checked and have been categorically told by Velindre that none of the work involves Forest Farm land. The Nature Reserve will remain untouched.” The work commencing on December 6 th will take place only on Velindre owned land.”
For Velindre to inform Julie Morgan, our elected representative, that the Nature Reserve will remain untouched by the borehole work is simply untrue and has only distressed and angered local residents even further. Velindre’s actions are yet again inflaming an already tense situation and it is now important that Cardiff Council take action to defuse it.
Additionally, no work has taken place to make-safe the proposed PROW diversion, which remains unsafe and utterly inappropriate for community use.
Nothing has changed. Because of the unresolved issues listed above it is imperative that you pause the enabling works that are due to commence on 6th December.
Again I reiterate, the CEMP has not been approved, Condition 17 not fully discharged, the PROW diversion not improved and Velindre has once again misled the community.
The work planned for the 6th -17th December must not go ahead. I await your reply without delay.
Kate, on behalf of Save the Northern Meadows.
Map of Forest Farm boundary
Images of the location of clearance and upcoming enabling works:
Katrina Sullivan sheds light on the human impact of 10 years of delays and £20 million in spending by Velindre.
Katrina Sullivan, who is currently undergoing chemotherapy treatment for cancer, joined the community to support Cat Lewis in court on Wednesday.
She shares her reflections on the judgement below.
“It is time to put egos away and focus on doing the right thing for the people of Wales. We cannot accept this already obsolete and fundamentally dangerous stand alone model, as the judge repeatedly said today it is not the desired or wanted option.
We as a Nation cannot accept such poor quality healthcare because Velindre have spent so much money on the plan thus far and wasted so much time it is now considered the only option.”
Kat has previously spoken out against the standalone cancer centre on the northern meadows.
“I am a current patient receiving chemotherapy treatment following surgery for cancer.
I am really scared for my future if the current plan goes ahead as it is just not safe.
I am really lucky to have been able to get a place at The Prince Charles Hospital in Merthyr Tydfil for my chemotherapy, as having no A/E on site at Velindre is and will be terrifying for patients.
I am safer having my chemotherapy in Prince Charles hospital, knowing that if I have a bad reaction to any of my treatments, emergency care is there for me.
I will be needing continuing cancer care from Velindre in the coming years, and I don’t understand why my life and safety is worth less to Welsh Government and Velindre than a vanity project which is not fit for purpose.
Without access to the best current research I and other patients will be excluded from potentially life extending treatments and trials. Research cannot take place without having on site access to A and E at the new Velindre site, so this excludes from opportunities available elsewhere in the UK.
This is such a backward step by all to pursue this outdated and unsafe model for the new Velindre site.
Life with cancer means every day is precious to patients, it is devastating to know that the managers responsible for Transforming Cancer Services in Wales and the Welsh Government seem to have no interest in providing the current best practice for cancer care.”
Thank you Kat for raising your voice in support of saving the meadows. Kat has joined the voices of patients and clinicians who have spoken out against the stand alone model.
Velindre have violated the trust of patients – past, present, and future; failing to cooperate with other health boards to create a cancer centre fit for the future, and suitable for patients, staff, and students.
7 years on from the decision not to pursue the building of the new cancer centre on the grange site at Whitchurch Hospital, Velindre and the Welsh government continue to put the people of South East Wales at risk. As ambulances spend hours waiting outside A&E, we know there’s a human cost to the decade of delay by Velindre.
Read more about save the northern meadows reflections on the judgement here.
Find Cat Lewis’ reflections immediately after the judgement here.
More information about the medical model can be found at Co-locate Velindre’s website. Co-locate Velindre are a group of clinicians shedding light on the risks associated with the medical model chosen by Velindre.
from Cat Lewis.
i’m sorry –
to all of you who gave time , gifts and money,
to all of you who stood strong and said no,
to the wildlife now more in peril,
to the patients present and future who won’t get the best model of treatments,
for the patients who will die,
for the ministers and planners who know this is wrong in their hearts but don’t have the courage to say so.
The judge believes that even if presented with all the additional things we have found out and linked, all that the judicial review would clarify – that the senedd ministers would still have come to the same decision: that they need to build a short term fix to a space issue, as fast as possible.
and fuck the future.
Save the Northern Meadows reacts to the decision to deny Cat Lewis the judicial review into the build of the new Velindre Cancer Centre on the Northern Meadows.
The rejection of Cat Lewis’ application for judicial review of the decision to build on the northern meadows is a failure of the legal system to hold the Welsh Government accountable for decisions which are not in the best interest of the public, the climate, or future generations.
The decision made today ensures the people of South East Wales will always receive worse cancer care than what is provided in England, and slapped with a higher economic, clinical, and personal cost for it. As children’s cancer services in London are held responsible for failing to colocate their centres, Wales is pushing forward with what we know is a highly dangerous and backwards model of care, that leaves patients receiving palliative care in the back of ambulances to die. We do not accept this future for us, our families, and our communities.
It raises questions over the purpose of Welsh Environmental law if the Welsh Government is not going to held legally accountable against them. It shows that politicians – regardless of the Environment (Wales) Act and the Wellbeing of Future Generations Act – will not be held accountable or responsible for environmental destruction, and do not have to apply sustainable development in all they do. Regardless of what Mark Drakeford told world leaders at COP26, the Welsh government is not a leader on climate. In fact, their policies amount to greenwashing, and the lacklustre language will spell tragedy for biodiversity across Cardiff and the whole of Wales.
This issue is compounded as Wales still does not have an environmental regulatory or enforcement body following the exit from the EU. In effect, we the public have no support to scrutinise the Welsh Government, or seek accountability and justice on environmental matters.
No matter how many protected species, the variety of biodiversity, or the importance for mental health and wellbeing, if the Welsh Government wants to bulldoze green space in your community, it can do it, and you’ll be charged extortionate amounts for the privilege of simply trying to hold them accountable.
Campaigners will continue to stand with Cat Lewis, a cancer patient, in support of her plight for just cancer care model. Campaigners pledge to stand with those in their community at risk of increased flooding due to this development and with the senior clinicians from across the country who have been bullied, and suffered career damaging consequences for daring to voice their informed concerns regarding the development of a stand alone cancer centre for Wales.
Cat Lewis and other campaigners will continue to fight any development on the meadows because it is the right thing to do for our community, for our environment, for our children, and for our future generations.
Cancer Survivor Takes on Welsh Government against “Dangerous Cancer Centre” plans
16 November 2021
Available for Immediate Release
Cancer Survivor Takes on Welsh Government against “Dangerous Cancer Centre” plans
On 18 June 2021, Catherine Lewis, a Velindre patient and resident of the Hollybush Estate launched a legal challenge against the Welsh Government’s decision to approve plans for a new Velindre Cancer Centre to be built on the Northern Meadows in the Whitchurch area of Cardiff.
Her initial application was refused permission to proceed to judicial review on 21 September 2021 by a High Court Judge.
Ms Lewis is now requesting a review of that decision which will be heard at an oral hearing before a High Court Judge at the Administrative Court in Cardiff on Wednesday 17 November 2021.
The Court previously ordered that Ms Lewis should pay the Welsh Government’s and Velindre University NHS Trust’s legal costs, which at that date, amounted to over £46,000.
Ms Lewis, who lives on a low wage in a council flat in Whitchurch and is only able to work part-time due to her cancer recovery believes that these costs are inappropriately excessive. While the Welsh Government and Velindre are employing very expensive lawyers in the form of a QC and two corporate law firms.
Ms Lewis’ solicitors, Deighton Pierce Glynn Solicitors, argued that the Judge misunderstood the legal arguments put forward.
The controversial plans have received widespread opposition from clinicians and the local community who have continued to highlight serious concerns regarding the model of having a standalone cancer centre away from acute medical services. Clinicians state that this will pose a danger to patients and not allow for the provision of advancements in cancer treatment which are becoming increasingly toxic and require close proximity to an acute ward and clinicians from a wide range of specialisms.
Parallels can be seen with the recently uncovered scandal in children’s cancer care in London. With NHS England stating that it will adopt recommendations that will see London’s cancer services brought up to national standards in requiring that children’s cancer services must be based in hospitals with full pediatric intensive care units. Campaigners and medics in Wales state the current plans will endanger children receiving cancer treatment and question why NHS Wales and the Welsh Government are not ensuring that these children receive care of the same standard as those in England.
For this reason, it is widely accepted, including by the Welsh Government, that the best option is to co-locate with the University Hospital Wales. The plans have failed to properly consider this option and engage with the medical community both within and outside of Velindre.
The plans only seek to meet a short term need and fail to address the long term needs of cancer treatment, which will trap Wales into an outdated cancer care model. They therefore fail to balance the needs of future generation as required by sustainability principle in the Well-being of Future Generations (Wales) Act 2015
Moreover, the construction will take place on the Northern Meadows, an important and sensitive habitat to a wide range of fauna and flora, many of which are protected. The meadows are surrounded on three sides by a nature reserve that an access road will cut through, which includes one of Cardiff’s largest and oldest heronries. The Welsh Government has a non-deferrable duty to seek to “maintain and enhance” certain listed living organisms and habitats under the Environment (Wales) Act 2016.
Campaigners plan a demo outside of the Court starting from 9am on Wednesday, which will include a samba band.
Notes to editors
- Catherine (Cat) Lewis received treatment for breast cancer at Velindre between March 2018 and January 2019 and continues to access services there.
- Cat is a resident of the Hollybush Estate which is adjacent to the Norther Meadows.
- She is being represented by Sue Willman (Senior Consultant) and Ahmed Ali (Trainee Solicitor) of Deighton Pierce Glynn solicitors, a law firm specializing in judicial review.
- Her barrister is Christian Howells and Nia Gowman of 30 Park Place Chambers.
- Attached photo is of Catherine Lewis taken on the Hollybush Estate adjacent to the nature reserve.
- For more on the scandal on cancer care for children in London see https://edition.independent.co.uk/edition/uk.co.independent.issue.131121/144360/index.html
- For more information on the Co-locate Velindre campaign, please see www.colocate-velindre.co.uk
- For any enquiries please contact, Gareth Sims, her legal consultant, on 07882218732 or firstname.lastname@example.org .
TV presenter Iolo Williams supports Save the Northern Meadows during visit
Nature Observer, author, and BBC and S4C presenter Iolo Williams visited the Northern Meadows in Cardiff on Thursday, meeting with campaigners and discussing our efforts to save the site from a medically and economically unsound plan by Velindre University NHS Trust for a new, standalone day centre for Cancer patients (a move opposed by 160+ Medics and many residents from the North Cardiff community, including Cancer patients).
Having already supported our campaign through social media, today he spent some meaningful time walking the meadows and surrounding nature reserve, disused railway cutting (which the community uses as a footpath), Iolo was able to experience what we are trying to save from the bulldozers. During the hour and half walk, Iolo listened to our concerns and the broad complexities involved here, stopping to chat and take photos with members from the community and supporters of the campaign. He heard about the extremely serious medical case for not locating the new Velindre cancer centre here, as well as the local flooding concerns and the obvious huge environmental loss as well.
Iolo personally and passionately appeals to those in a position of power to step in and make the right decision and stop the development before the destruction begins.
We hope that his visit to the Northern Meadows, especially during the week of the COP26 climate talks taking place in Glasgow, will allow more people to take on board and understand why local people are so against the destruction of this beloved area.
We Need Your Help
Velindre University Health Board use Shameful Back-Door, Last Minute Announcement to Mark the Start of Clearing Work on the Northern Meadows.
The community in Whitchurch and Coryton is in shock, after the Hollybush Estates Tenant Association and local Councillors were served a letter from Velindre stating they are seeking to begin clearing the Northern Meadows on Monday the 25th of October.
Sent at 4.20pm on Friday the 22nd of October, the cynical and harmful letter treats the community with contempt, when we have engaged consistently in due process over this matter for over 25 years. Most recently with over 100 individual objections, and 367 signatories opposing planning application 21/01954/MJR on Thursday the 21st of October.
The letter ignores due process, which requires any use of a public right of way to be notified by the relevant ‘authority‘ – Cardiff Council, and has not received planning approval for the application for the discharge of condition 17 – a CEMP for the whole site must be completed before any clearance works begin.
Why is the hospital in charge of notifying the community about clearance? Why are the community the last to know about these significant, destructive developments? And how can clearance begin when planning application 21/01954/MJR, which seeks to give approval to their Construction Environmental Management plan, has not been accepted by the planning department?
We ask that the public, MS’s, MP’s, Councillors, and all community members come together to resist this clearance work, which will kick off years of environmental destruction, traffic chaos, and overspending on a cancer centre which will only increase the risk of harm to seriously ill patients.
The full announcement is forwarded below.
Senior Cancer Medics Launch Website to Highlight Serious Concerns over Velindre Plans
The website, called Co-locate Velindre, is a healthcare professional action-group fighting for the best cancer care in South East Wales. Its members are appalled that a new cancer centre for the region is actually planned to be ‘stand-alone’.
Leaked Damning Letter Ignored by Welsh Gov.
A letter has emerged that has been brought to the attention of the STNM campaign.
It was written in November 2020 and sent to the Wales Cancer Research Centre. The Labour Welsh Government has been aware of this letter since that time. Despite this damning appraisal of Velindre’s plans, Health Minister Vaughan Gething signed off the business plan 5 months later, in March 2021, sentencing the people of South East Wales and future generations to substandard cancer care. How can this be allowed to happen?
This letter speaks volumes and should shock each and everyone of us into action. We must stop this madness now and hold the Labour Welsh Government accountable for its actions.
With work due to start mid September, this damning letter, and the damning letter signed by 163 Welsh clinicians, show that regardless of the LONG TERM impact on our cancer treatment, the Government does not care. They don’t care that we’ll be receiving substandard care. And Julie Morgan MS Vaughan Gething MS for Cardiff South and Penarth Julie James Eluned Morgan do not give a toss about the impact this project will have – increasing asthmas and air pollution causing cancers in primary school children, whilst simultaneously throwing a wrench in the future of cancer care in Wales.
Cardiff North Community Newsletter
Quote: Robert Swan OBE, Polar Explorer and Environmental Leader
“The greatest threat to our planet is the belief that someone else will save it.”
Our Community Newsletter, recently posted through doors in Whitchurch and the surrounding area, gives a stark warning about some of the very serious issues we’ve raised over the last 18 months regarding the proposed development of the Northern Meadows. Though these issues are extremely serious, they have been completely ignored by those who claim to act on our behalf, our local politicians, local council, the Welsh Government themselves and even the managers of Velindre Hospital. All have ignored the issues raised by the local community here in North Cardiff, but also the 163+ senior Clinicians from within the Welsh NHS who have expressed very serious concerns about the safety and future viability of a stand-alone cancer centre.
Please read and take on board the points raised here and help our campaign if you can by getting involved and also by donating to the Just Giving fundraiser for the legal challenge being undertaken by local resident Catherine Lewis.
Here’s a link to the planning application that will allow the destruction of the meadows to begin.
Please follow the link here, have a look at what others have written, then put in your own words why the planning application should be rejected. Any questions just ask us at email@example.com
Silent Auction August 2021
**SILENT AUCTION UPDATE** – – All of our items have now reached or exceeded the minimum amount (with the exception of the leaf blower) Some items will be available to view on the meadow next Saturday at ‘Fox and Bunny’s Wedding’ at 2pm, more details of this event to follow. The good news is that you can still do a silent bid on anything that takes your fancy! How does it work you may ask? Well we have set a “base price’ on the items and all you have to do is message one of the team before hand with how much you would like to bid, or you can make a bid on Saturday (we will have mini ballot style box) You can message the page directly to make a bid or email us at firstname.lastname@example.org Anything you are unsure please feel to ask questions. We really hope to see you on the day but please feel free to get your bids on NOW…….GO GO GO!!!!!! All bids made will be treated in confidence.
To make a bid email us at email@example.com
Or make contact through Facebook or Messenger
Speech by Laura – one of the 163
If you are reading this then we already agree on one point – the most important point – that patients with cancer should receive the very best, most easily accessible, appropriate and up to date care that it is possible to deliver. It is reasonable to assume that this is exactly what those of us engaged in this matter wish for. Sadly, people don’t feel able to speak openly about their true views on many things these days but in relation to this specific matter, there is a large group of clinicians who do not feel able to speak up against the Velindre plans through fear of implications for their employment and personal lives. It is deeply saddening to witness because the only reason any of us are here is to do our best for others.
When the initial plans for the new site were conceived over a decade ago, they were probably appropriate for what was able to be provided at the time. Thankfully, science, medicine and technology have exceeded our expectations and huge steps have been made in all areas. Treatment options and prognoses have radically improved in recent years and this is a fact we should be immensely proud of. As an intensive care doctor and anaesthetist, the nature of cancer patients I care for has dramatically changed over the course of my career. I have a particular interest in anaesthesia and critical care for patients with malignancy. It is something that makes up a significant proportion of our workload and this is increasing as more can be offered to more people. We have increased knowledge about how the conduct of our care impacts on the disease process. This will continue to evolve and I look forward to seeing how things continue to progress and inspire me as the years go by.
Collectively, we can offer the best al- round care providing we accept that cancer treatment rarely requires ‘just’ treatment from an oncologist. In order to support the patient through their disease, access to other services is likely to be needed – specialist surgical services, radiology, general medicine, intensive care and more. When we work cohesively within a system, when we communicate well and when people can transition seamlessly between points of care, the patient experience will inevitably be superior. The current plans for the Velindre site do not offer this. The team at the VCC will be equipped to offer outstanding oncology care but not to deal with all of the potentially life-threatening complications of treatment – the sepsis with multi organ failure and severe toxicity from immunotherapy to name only two examples. Patients will need to be transferred to other sites, removing them from the principal location of their cancer management. At this stage, care can become disjointed and stressful. Communication breaks down, appointments are missed, hospital transport is unreliable and patients suffer both physically and emotionally. A scan in one hospital, an oncology appointment in another, an ENT follow up in another, a planned procedure in another………Is this necessary? Is this helpful? Is this the best way to deliver the best care?
Undoubtedly, the new location of the VCC will offer a beautiful backdrop and the holistic implications of this cannot be underestimated. But is this enough? Can senior NHS managers genuinely say with their hands on their hearts that they can guarantee that individualised emergency care will be delivered as rapidly and as appropriately as it would be on a co-location site? That they cannot foresee any situation whereby there will be avoidable delays in patients receiving the exact level of care that they need? Can they say without a doubt that the care patients receive in an emergency will not be inferior to what they would receive on a site with acute care provision? Can we promise that retrieval and transfers of all sick patients will happen in a timely fashion? It doesn’t happen for any other patients so why would different things apply here? The NHS in Wales is crippled with underfunding, we don’t have enough doctors and nurses, let alone paramedics. How can we make the maths work when it doesn’t already do so? We should not be promising things to patients that we cannot realistically provide. We need to advocate for them and their needs. This is why I am writing this. We can do so much more for the people who trust us to care for them when we work as a team and provide shared care on one site. There will be fewer avoidable gaps in communication, treatment delays, time wasted by patients and families whilst they travel and wait. Stand-alone cancer care is no longer realistic and we should welcome the modernisation of shared care on a shared site.
Here is a pdf copy of the above statement:-
Cancer Care England v Wales
We have assembled a table, with the help and approval of senior clinicians from within the Welsh NHS, that compares the cancer treatments and facilities available in the New Clatterbridge Cancer Hospital opened 2020 in Liverpool versus those in the proposed New Velindre Cancer Centre planned for there Northern Meadows. Why are we being told this is World Leading Cancer Care when it very clearly isn’t!
Scrubs at the Senedd
SCRUBS @ THE SENEDD this sat 12.
Let’s show support to the 163 clinicians who have been silenced.
If you have scrubs, great, if not, just come along as you are.
Letter from 163 Clinicians to Welsh Gov
Mr Vaughan Gething MS
Minister for Health and Social Services
Dear Mr. Gething,
14th January, 2021
As a large group of clinicians who are specialists in the diagnosis, treatment and care of cancer patients in South-East Wales, we recognise the pressing need to address the ageing facilities of the Velindre Cancer Centre (VCC) in north Cardiff. We therefore welcome the independent advice from the Nuffield Trust on the proposed model for non-surgical tertiary oncology services in South East Wales.
We agree with the report that the approach to cancer service planning cannot be the responsibility of a single organisation that is only delivering part of the cancer pathway, as has been the case with Velindre University NHS Trust’s Transforming Cancer Services (TCS) programme.
We agree that co-location with an acute hospital would provide safer acute in-patient care, improve support from other specialties, create a better base for research and be in line with best practice elsewhere. A clear implication from the report is that the best long-term future for Velindre’s acute oncology services, beds for acutely unwell patients and clinical research is on an acute hospital site, alongside other surgical, haematological and paediatric oncology colleagues, as well as vital medical, surgical and intensive care services.
Whilst the report is highly professional and well balanced, it is limited by the short time- scale for its publication and by its questionable terms of reference. We are troubled that, in consequence, it seems too ready to accept as inevitable the construction of the ‘stand-alone’ new building proposed by the TCS programme. The Nuffield Trust seems to endorse a medium-term, ‘split-site’ solution, similar to the Ambulatory Hub model outlined in the Mount Vernon report (2019). In this model, high-volume, low-risk cancer services would be delivered at Northern Meadows, whilst acute oncology, most in- patient services and research would be on an acute hospital site.
We strongly doubt this will deliver the best service for patients, and whether it is the best use of public funds. Ambulatory units can deliver the important goal of care close to patients’ homes. However, we question the logic and huge expense of constructing an ambulatory unit within 3.5 miles of a projected new cancer centre on an acute hospital site. This seems particularly misguided, as the report envisages the viability of the ambulatory unit will be limited by the life-expectancy of new radiotherapy machines, whilst Mutual Investment Model payments from public funds would extend far beyond this period. Furthermore, there would be logistical and financial benefits from integrating plans for the new cancer centre with the re-development of University Hospital Wales (UHW) – a factor that was not a realistic possibility, at the inception of TCS.
The Nuffield Trust states that a full options appraisal of possible clinical models was beyond the remit of its report. We see in this as a missed opportunity which should be rectified. Evidence and expert opinion contained within the report make it clear that patient safety, multi-disciplinary care, training, and continuation of world-class clinical research would all be significantly compromised by failure to co-locate most, if not all, cancer services with an acute hospital. Furthermore, we believe that a stand-alone model is already out-of-date, is out of step with international standards of excellence and lacks future-proofing.
It is not clear why the report concludes that it will take too long to pursue an alternative, co-located ‘full replacement’ model. This conclusion is insufficiently supported by evidence and is open to challenge. The recent, rapidly-constructed Lakeside Wing project at the UHW site, built within months of the start of the COVID-19 pandemic, illustrates what can be achieved in a short time, within limited space and when there is a pressing clinical need, as is clearly the case for the VCC’s ageing facilities.
The report does not consider alternatives beyond a 10-15 year interim solution. We share the view that we have a once-in-a-half-century opportunity to integrate much- needed building projects for both VCC and UHW, along with other essential evolution of cancer care in the region’s Health Boards.
Patients and the public need to be reassured that a new location and a new model of care will not compromise Velindre’s long-established and well-deserved reputation for high-quality cancer treatment and care, and for exceptional patient satisfaction. We are therefore concerned that the report did not regard the current proposals as any more than a “reasonable” way forward. This is clearly not an endorsement of the current planned direction, an approach that has already consumed considerable time and money. We therefore call on Welsh Government to assume direct responsibility for addressing deficiencies in leadership and planning pointed out in the Nuffield report. There must be a formal review, including an updated, full options appraisal and re- assessment of some of the prior assumptions made by TCS which are insufficiently challenged in the report. This can be done at pace.
We are convinced that there is an opportunity to integrate existing plans for the VCC new-build with those for a reconfigured UHW. We believe that this would be a logical extension of many of the findings of the Nuffield Trust report and that this can be achieved more rapidly than the 10-15 year time-scale suggested in the report. It would also provide valuable flexibility in the greatly-altered landscape following the COVID-19 pandemic and Brexit. Above all, it would represent a more ambitious, genuinely transformative vision for delivering improved cancer survival outcomes for patients, and better value-for-money for the public than the TCS model considered within the limited scope of the Nuffield Trust report.
We would welcome a meeting with you to discuss our views further and to explore potential solutions together.
The undersigned (in alphabetical order, by surname): (Names removed to protect privacy)
The letter sent to the health Minister, Mr Vaughan Gething, was signed by 163 senior clinicians. The vast majority of these are Consultants within their field of practice.
A number of the signatories are Professors.
The specialities represented include the following: Anaesthetics/Pain management.
ENT surgery (Ear Nose and Throat) Gastroenterology
Gastrointestinal Surgery (Upper and Lower GI) General Medicine
Head and Neck Surgery
Public health Radiology/Interventional radiology Respiratory/Chest Physicians Rheumatology
All of the above will deal with the care of patients who have a diagnosis of cancer. For some it represents the main part of their clinical work.
There is NO field within health care that does not have a part to play in the screening, diagnosis, treatment, care of, recovery or palliation of patients with cancer.
The 163 signatories are a cross section of health care in South East Wales.
These people are the experts!
They understand the immensely complex and overlapping needs of these patients! Please listen to the experts.
Contact Details for Senedd Members Etc.
Link to all members of Senedd:-
Click on his/her picture and you should get contact details.
Link to Ministers:-
Link to Commissioners:-
Link to contact details:-
Our messages in response to the decision to grant funding for the new Velindre.
Firstly we want to thank all our supporters, you’re amazing, and we wouldn’t have got this far without you.
As recent protests and vigils have shown we can come together and firmly show our resilience, love for the world and our communities. Together we are unstoppable.
Let’s do this.
In the short term – let’s make any move on the meadows a crushing political blow with our open objection to this. Up and down the country in this last week alone communities have been out to stop the destruction of our world.
Our history, our heritage, our health, our homes and our future are all tied in to this space.
So keep fighting with us. You can donate to our just giving, you can support us by helping with research or social media monitoring, or you can join a protest. We will resist, we won’t simply allow this destruction to be wrought on our community and our environment.
Our press release:
“We are angry at Vaughan Gething’s decision to give the go-ahead to the new Velindre Cancer Centre on the Northern Meadows for a number of reasons. The concerns of 163 senior clinicians have been ignored and the community, Coryton primary school, Ty Coryton Special school, and assisted living accommodation within the area have been sentenced to four years of heavy construction. This will cause immeasurable damage to the people living nearby.
Gething states, the development will be sustainable. But cutting down over 100 mature, and nearly 1000 semi-mature trees is not sustainable, nor does it care for our future generations. With numerous protected species living on and around the meadows, we despair at the impact this will have on biodiversity in Cardiff. It makes a mockery of the declaration of a climate emergency, the Environment Act, and the Wellbeing of Future Generations Act. And it laughs in the face of the children who live here, who are already subject to dangerous and illegal levels of air pollution.
Transforming Cancer Services has repeatedly lied to the Welsh Government and the public, failing to produce the Barrett report, failing to constructively engage their staff and clinicians. Choosing a medical model that will simply have ‘many’ of the benefits of co-location is simply not good enough. Actually co-locating on an acute hospital site and having ‘all’ the benefits of co-location is what the patients of South East Wales deserve. Without this SE Wales will continue to have the worst cancer outcomes in Europe. We deserve better.
The Senedd Petitions Committee has this week chosen to carry the petition to the next Senedd post-election, as it has not received the information requested from Velindre. Velindre has failed in its statutory obligation to answer a number of FOI requests and this is being examined by the Information Ombudsman. Despite all of this, Vaughan Gething has chosen to grant this decision in order to fulfil a defunct manifesto commitment.
This is not the right model of cancer care for the future and it is not the right location. We will not accept this decision and now more than ever see the requirement for a full independent inquiry. We will continue to fight this decision, which disregards the needs of future generations, of the local community, of biodiversity, and our commitment to the climate. Hypocritically, the Ministers statement asks us to work with them. Yet he has treated us with total disregard throughout the decision making process. We will make it clear for him – we refuse to give up our open space, our health, our biodiversity, for a project which will not provide the best cancer care the people of South East Wales require.”
A Real Solution for Velindre, Politicians, the Community, and the Meadows.
Dear Mr Richards and Mr Gething
I know you have received much correspondence about the Northern Meadows in Whitchurch but please take the time to read my email as I am suggesting workable solutions.
Mr Gething: Please do not approve any business case which involves the destruction of the meadows.
Mr Richards: I implore you and your Board to withdraw the offer made for the land swap with Velindre NHS Trust and rethink application 20/00357/MJR on the Whitchurch Hospital site.
I have suggestions of how all this could move this forward – to benefit cancer patients, communities and future generations, and with public support. Please, let’s work together and let’s look at the bigger picture.
The new VCC
Following Nuffield’s advice, co-location is required in the long term to secure patient safety, positive outcomes, and world-class training and research. With this in mind, there is no justification to building to the extent originally planned and destroying the Northern Meadows.
Immediately, Velindre could be extended upwards or outwards, and the Grange@Whitchurch used in the interim until full co-location on an acute site is possible (within the Heath Hospital refurbishment plans, possibly), to take the pressure off the current building (after all, £6million of NHS money has been spent on the Grange site). Focus also needs to be on building the satellite centre in Abergavenny as soon as possible.
The Northern Meadows
Through a Community Asset Transfer or collaboration between CAVUHB and the community, leave the meadows as they are. They are vital to biodiversity and to the mental and physical health of thousands of people.
In the short term, through 3rd sector funding and fundraising we would:
- Improve the paths, making them accessible to buggies, wheelchair users and those unsteady underfoot.
- Create nature trails.
- Display information boards.
- Create environmentally sensitive walkways from Velindre, City Hospice and Whitchurch Hospital.
Through 3rd sector funding in the longer term
- Connect with all sorts of organisations (eg. Mind, McMillan, Age Concern, City Hospice, local GP and social services, young parents groups, nurseries, schools, youth provisions and many, many more) and provide nature-based workshops and experiences to support wellbeing, rehabilitation, physical & mental health. There are so, so many opportunities to support people, introduce them to nature and its healing benefits.
- Create a cultural visitors attraction – Highlight the area’s history – The Cory Family; Lady Cory Field; the Old Cardiff Railway; the Glamorganshire Canal; Melin Griffith Tin Works; Renowned naturalist and conservationist Ronald Lockley; The Hollybush and its connection to the Welsh language; Whitchurch Hospital etc.
- Create a volunteer network to preserve and enhance the area. (Working with Cardiff Council and Forest Farm Nature Reserve).
- Create a core-staff team to manage these projects (potentially providing jobs for the local community.)
- Young people could volunteer as part of their Welsh Baccalaureate, Duke of Edinburgh etc. and undertake work experience placements. And those at risk of exclusion or disengagement from school could also undertake placements.
- Those on community sentences and on ROLT (Release on temporary licence) could undertake placements, supporting their rehabilitation, resettlement into society – providing new skills, work experience and improving self-esteem.
- And many, many more ideas of how this space could benefit the community moving forwards.
Whitchurch Hospital (WH) Chapel
Refurbished to become a community resource centre. It could hold a café, play sessions for children, all sorts of arts and crafts workshops, youth provision, after school clubs (working closely with the sports clubs in the area and children can engage in nature activities.)
The Military Medicine Museum and Britannia Park – Whitchurch Hospital
Across the city, decisions are being made that are distressing communities and putting mental and physical health at risk. The people of Butetown and the Bay are hugely distressed with the proposal to site the above museum on Britannia Park, resulting in the loss of precious and rare green space in the area and a children’s playground.
If it is 100% decided that Cardiff should have this museum (many oppose not only its location but subject matter) then it should come to Whitchurch Hospital. WH was used during both world wars. The elm trees on the common were planted as a gift to the community from American soldiers. Houses on Park Road were used to accommodate recovering soldiers. The gardens and meadows were used for rehabilitation of patients.
The architecture of Whitchurch Hospital is significant and is studied on university architecture courses. There is a vast history there. Let’s honour it and learn it all.
I know that CAVUHB wrote in support of this museum and that there is to be a project attached to support veterans. What better place than in Whitchurch where there is already precedence set for the rehabilitation of service people? With access to the meadows, the nature reserve and the support and opportunities I am proposing here, it would be really complementary and could be hugely beneficial to many.
It could also take an honest look at the advancement of medicine in relation to colonialism; health inequalities among lower income and BAME communities and hopefully show what we have learned and continue to learn and the steps being taken to improve things for the future.
Income generating schemes
- Friends of the Northern Meadows memberships
- Fundraising through all sorts of community events
- Children’s nature-based children’s parties
- Purchase a tree/flower planting for honouring a birth, other significant life events or in memorandum
- Name plaques (such as the Millennium Walkway or Penarth Pier)
- Long term – working with the Council and Forest Farm – development of the cottages at Forest Farm and then used for school trips, team building weekends.
- Corporate Away days.
- Formal, informal and non-formal opportunities
- Nursery, school and college visits
- I have made an initial approach to Pencoed College about running accredited courses at the Northern Meadows, WH Chapel and Forest Farm and will be exploring this further. Young people and older people alike could undertake courses on environmental studies, horticulture, animal and nature studies. We could train the next generation in industries that will work to secure healthier and green futures for us all.
- Apprenticeships for all aspects – building and refurbishment of the chapel, gardening to restore the historic gardens, customer service, hospitality in the community café.
- The list goes on but here are just some examples of opportunities and a full community consultation would provide many more. There are a wealth of skills and experiences within our community. I myself am a youth and community worker, and teacher (predominantly with young people at risk of exclusion and young offenders). We have people who are medical, teachers, academics, social workers, child-minders, artists, graphic designers, engineers, sports coaches, ecologists, solicitors, those working in hospitality, retail and many, many more. All these people can bring their ideas and experiences to enhance this project.
The community is exhausted. We are being made ill by the stress and distress. We have been subjected to months of abuse and vitriol online and have been bombarded by developers with tactically timed applications and amendments through the planning system, hoping to confuse and overpower us.
We cannot lose this crucial green space. Our children cannot endure being exposed to the levels of pollution this development will involve. Communities increased risks of flooding cannot be allowed to happen, not only in Whitchurch, but Llandaf North, Gabalfa, and along the whole Taff corridor into town.
These thing make people ill. These things have a massive detrimental effect on wellbeing, physical and mental health.
Please work with us to create something amazing. Something we can all be proud of. Something that will benefit us all and future generations. Work with the community to try and achieve positive change rather than against it or without it’s input.
Please do not go ahead with something that will divide and devastate our communities. That will be extortionately expensive, burdening future generations, causing irreparable damage to the environment and provide second rate, out-dated cancer care for the whole of South East Wales.
There is no need to choose between updated cancer care and the Northern Meadows. We can have both.
I respectfully request an acknowledgement and reply from you both and request to speak with you further on this matter urgently.
Please make the right choice for us all.
-, on behalf of the Save the Northern Meadows group
Cardiff ‘New’ People’s Paper
LEAKED: Clinical Letter to Ministers
We have received the contents of a letter sent by clinicians to Welsh Ministers, Senedd Members, and Councillors in South East Wales. This highlights the major concerns regarding a stand alone Cancer Centre. Yet Members largely chose to ignore these at the Plenary debate on Wednesday 3rd of March, despite having it sitting in their inbox. Instead, they used platitudes regarding their constituents, failing to acknowledge the evidence that this cancer centre will not be fit for purpose, or even try to hold the Executive team who have wasted public money and time to account.
We are publishing the letter as we feel Members are violating their duty to act in the public interest, and secure the best, safest cancer care for their constituents. Read the shocking issues with the model below.
Dear Members of the Senedd,
I apologise for writing to you uninvited, but I believe that the information contained in this email is of paramount importance, and as such it must be shared widely with all stakeholders and interested parties.
At the latest meeting of the petitions committee it was recommended that a submission calling for an independent clinical review of the proposed new Velindre Cancer Centre (VCC) be put forward for open debate in the Senedd.
Open debate requires those engaged to have access to all the information.
This email was originally sent to the Health Minister as there was significant concern that the decision making process regarding the siting of the New Velindre Cancer Centre may have been adversely affected by misinformation and as such it is now fatally flawed.
I am sending to you today an updated version with inclusion of two additional documents (Appendices Nineteen and Twenty).
The following observations are not made lightly, and each one is referenced with supporting evidence.
- The Non existent Barrett Report.
- Misrepresentation of the number of patients transferred urgently.
- Misrepresentation of the role of EMRTS (Emergency Medical Retrieval and Transfer Service).
- Falsely stating EMRTS had attended a patient who sadly died.
- Misrepresenting the time taken for ambulance transfer for escalation of care.
- Misrepresentation/Suppression of the Level of concern within Velindre NHS trust.
- Failure to fully and meaningfully engage stakeholder Health Boards in the planning process.
- A recent letter signed by 163 Senior clinicians, expressing concern at the current plans for a stand alone new Velindre Cancer Centre.
The above points are explained in detail below, with 20 appended documents to confirm the veracity of each point raised.
I. The Barrett report:
In the document produced by the Velindre NHS Trust “Why not build a new Velindre Cancer Centre on another hospital site?” (Appendix One) the following statement is made:
“The clinical lead in an external review of the project, carried out in 2017, was Dr Jane Barrett OBE, an eminent UK clinical oncologist and past President of the Royal College of Radiologists.”
This statement is clearly refuted in an email from Dr Barrett herself (Appendix Two), wherein it is stated:
“You are correct that I was involved in the review into the siting of satellite centres in South Wales. However it was not a review into the redevelopment of Velindre.”
The existence of an independent clinical review of the proposed stand alone model has frequently been alluded to by the Velindre NHS trust, when the reality is that no such report was ever written by Dr Barrett.
To date NO external clinical review of the project has been undertaken. The Nuffield Trust did not undertake a clinical review, as clearly stated on page 10 of their report (Appendix Seven)
“First, this is not and has never claimed to be a wholescale independent review of the project. The scope of this report is tightly defined and relates specifically to the clinical management of the planned network model for non-surgical tertiary cancer services and new cancer centre.”
2. Misrepresentation of Patient numbers transferred for urgent escalation of care unavailable at the current Velindre site:
The concern here is that the current figures as quoted by the Velindre NHS trust are incorrect, misleading and falsely reassuring to the general public. More worrying is the intention to replicate this current model of care at the proposed New Velindre Cancer Centre on the Northern Meadows.
In the same document “Why not build a new Velindre Cancer Centre on another hospital site?” (Appendix One) the following statement is made:
“fewer than thirty patients a year on average need an unplanned emergency transfer.”
A Freedom of Information enquiry was submitted to WAST (Welsh Ambulance Service Trust) (Appendix Three) and in their response they have provided the raw data on ambulance transfers (Appendix Four).
What this clearly shows is that on average around 100 patients are transferred each year using the 999 Ambulance system. These are urgent transfers for escalation of care that is not available at the Velindre Hospital.
The same request was made of Velindre NHS trust in respect of acute patient transfers, and their response is included as Appendix Five.
In the response by Velindre NHS Trust , the following statement is made:
“Due to the nature of these clinical pathways, and the number of clinical systems, the organisation does not hold one overall system that collates all patient interventions and transfers”
“In our duty to advise and assist we can confirm patients are transferred to other acute hospitals for a range of interventions and the details are accessible by clinical staff in the individual patient record.”
Essentially the Velindre NHS trust have no idea how many patients are transferred each year, nor indeed why they are transferred. To be certain of the exact figure, every set of patient notes held by the Velindre Hospital would have to be scrutinised.
The previous statement “Fewer than 30 patients a year” could, for all we know, be a random number chosen to offer a false sense of security to the public.
A detailed analysis of the responses to both FOI enquiries submitted to WAST and Velindre NHS Trust is included as Appendix 6. It must also be noted that this misrepresentation continued as recently as November 2020, with the publication of a letter in the South Wales Echo, from the Chair of Velindre NHS Trust (Appendix sixteen).
Whilst this letter suggests that most transfers were non urgent, the Nuffield Trust report 2020 (Appendix Seven) states on page 32:
“In addition to the 999 calls detailed above, there were a very small number of other non-urgent transfers”
3. Misrepresentation of the role of EMRTS (Emergency Medical Retrieval and Transfer Service):
In the same document “Why not build a new Velindre Cancer Centre on another hospital site?” (Appendix One) the following statement is made:
“have access to the Emergency Medical Retrieval and Transfer Service (EMRTs) who can assess and transfer these unwell patients to the University Hospital of Wales (UHW)”
A similar statement is made in the document “Transforming Cancer Services In South East Wales – Clinical Service Model – January 2016 (Appendix Eighteen) wherein it is stated on page 11:
“Patients rapidly deteriorating will have access to Emergency Medical Retrieval and Transfer Services, who will come to Velindre Cancer Centre, stabilise the patient and arrange transfer to the most appropriate Local Health Board”
To the general public, the belief that the helicopter doctors are on hand is hugely reassuring.
In the last five years EMRTS have attended twice, and they did not attend at all in 2019. This is stated on page 32 of the Nuffield Trust Report 2020 (Appendix Seven).
The statement as made by the Velindre NHS trust is falsely reassuring and misleading.
Whilst EMRTS are available to any critically unwell patient, the practicalities of their attending a hospital site over 50 miles from their helicopter base in Llanelli, yet 3 miles from UHW, translates to the reality of having attended only twice in five years.
4. Misrepresentation of the role of EMRTS in attending the fatal collapse at Velindre NHS Trust:
More concerning is the fact that Velindre NHS Trust have stated in the response to two separate Freedom of information requests, that EMRTS attended in 2019 to treat the patient who collapsed and died.
This patient had suffered an anaphylactic reaction to chemotherapy.
The public would have been reassured to believe that the specialist helicopter doctors attended this resuscitation.
Velindre NHS Trust stated that EMRTS did attend. (Page 4, Appendix 5).
They did not: (Appendix 8, Appendix 9).
Perhaps of equal concern is the statement made by the Velindre NHS trust regarding this unexpected death. (Appendix Five)
“The case was not reported as a serious incident as it did not meet the threshold for reporting.”
5. Misrepresentation of the transfer times for patients requiring urgent escalation of care:
In the same document “Why not build a new Velindre Cancer Centre on another hospital site?” (Appendix One) the following statement is made:
“UHW is less than three miles away and can be reached within minutes.”
As previously stated, the Velindre NHS trust do not collect and collate this data, and as such the statement is presumably a guess based on geographical proximity. The statement as it reads is very reassuring, the reality, less so.
A freedom of information request was submitted to the Welsh Ambulance Service Trust (WAST) requesting information on transfer times.
The response (Appendix Ten) and the raw data provided in the form of an Excel Spreadsheet (Appendix Eleven) is Analysed and summarised in Appendix 12 .
a) The average wait for an ambulance was:
AMBER ONE calls = 59 minutes 59 seconds
RED calls = 8 minutes 18 seconds
b) The Longest wait for an Ambulance was
AMBER ONE Call = 3 hours 27 minutes 52 seconds
RED Call = 24 minutes
c) Average wait for handover at hospital
AMBER ONE calls = 44 minutes 54 seconds
RED Calls = 30 minutes 28 seconds
d) The longest wait for Handover at Hospital
AMBER ONE Call = 4 Hours 12 minutes 25 seconds
RED Call = 51 minutes 21 Seconds
e) Average Transfer Time for RED calls to UHW = 6 minutes 36 seconds
Average transfer Time for AMBER ONE calls to UHW = 8 Minutes and 10 seconds.
The suggestion that UHW (University Hospital of Wales) can be reached in minutes, belies the stark truth.
Reassuring the public that UHW can be reached in minutes is a disingenuous representation of the actual time these transfers take.
These patients are already ill, they deteriorate, and then on average for AMBER ONE CALLS have to wait nearly two hours until admitted to UHW.
This fact is also discussed in the Nuffield report (Page 31 – 32).
6. Misrepresentation/Suppression of the level of concern within the Velindre NHS Trust:
In the same document “Why not build a new Velindre Cancer Centre on another hospital site?” (Appendix One) the following statement is made:
“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.
A letter was written to this effect on 24 July 2020, but appeared to progress no further than the Chief executive (Appendix Thirteen), and it was not until external help and reassurance was provided by the British Medical Association, that the letter was sent to the Health Minister and other members of the Health, Social Care and Sports committee.
I requested, under the Freedom of Information act, a copy of the letter written by the British Medical association to the Velindre NHS trust. After 57 working days (The expectation is that a response will be provided within 20 working days) The Velindre NHS Trust wrote to me advising that they would not release the letters as requested.
They stated that it was in the public interest to withhold this information.
I have now obtained a copy of the letter from the BMA to the Velindre NHS Trust, which is attached as Appendix Nineteen. The letter itself confirms the belief that there was suppression of internal dissent, including the line:
“members are still not prepared to speak up because of fear of reprisals”
7. Failure to fully engage the other stakeholder Local Health Boards in the planning process:
This is discussed in 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]
On Page 18 of the Nuffield Trust report (Appendix Seven) the following points are made with reference to the Transforming cancer care 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.
The detailed components of some of this have not been developed. This planning process culminated in the approval in 2017–18 by all LHBs of an outline business case for a new VCC to be built on the Northern Meadows,
It beggars belief that despite the fact that “The detailed components of some of this have not been developed” approval was gained for the outline business plan.
This may in part be explained by comments from the Chief Medical Officer, 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.”
At 09:50:21 the following statement is made, again by Dr Atherton:
“ Talking to Tom Crosby, in particular, he spent a huge amount of time travelling around all the health boards, talking with all interested parties from a clinical perspective, up to the decision by the health boards in 2018 to proceed with the development of the new Velindre cancer centre. Of course, since then, time has moved on, and, with the benefit of hindsight, I think it would have been better if that clinical engagement perhaps had continued. It probably paused because a decision had been made; it was assumed that everybody was comfortable”
It is quite clear that the engagement process has been incomplete and flawed.
Assuming everyone was comfortable is not the same as unanimous support, and surely not the ringing endorsement to signal the green light for a £200 million project.
It is known that the cancer lead from Cardiff and Vale expressed significant concerns as far back as 2017, regarding the proposal to build a stand alone model.
It is also clear that when engaging with other Health boards, there was no discussion around the findings of the Beatson enquiry into the West of Scotland Cancer Centre, despite this having been undertaken in 2015 (Appendix 14).
More recently there have been further significant examples of Velindre NHS trust failing to engage with other Health Boards in respect of the care of acutely unwell patients.
Velindre NHS trust have undertaken a pilot project to significantly restrict the number and type of patient admitted to their beds.
This is outlined on page 33 of the Nuffield report:
“During the course of our work, the Trust proposed a new set of admission criteria that would further reduce the risks associated with sick patients out of hours”
One must ask why now?
TCS have been in place for 6 years, and have spent £20 Million, yet at no point prior to this did they consider reviewing the admissions criteria for the current hospital. Understanding which patients require what treatment would obviously impact on plans for the New Cancer Centre.
If you do not know what is needed in the present time, how can you plan for the future?
This new admissions protocol has been commenced in the middle of a significantly escalating pandemic, without consulting the other Health Boards who will now have to admit those patients deemed unsuitable for Velindre.
The date for implementation of phase one of this new admission protocol was set at 14/12/2020, (Appendix Fifteen) without discussions having taken place with other Health Boards who may be significantly impacted.
The Nuffield Report essentially states that NO patients should be admitted to Velindre. On page 45 of the report:
“The new model should not admit who are at risk of major escalation, to inpatient beds on the VCC.
These patients should be sent to district general hospital sites if admission is required, to avoid a later transfer”
In reality, this encompasses all patients. If you have cancer, and require admission to hospital, there is inherent in this the risk of deterioration.
Trying to predict which patients will deteriorate and those who will not is unsafe.
8. Letter signed by 163 Senior Clinicians.
This letter is attached as appendix Twenty. The letter questions the wisdom of building a stand alone cancer centre and draws on the Nuffield Trust Advice document to highlight specific issues.
The names of all signatories have been removed as anonymity was in many cases requested. This reflects the significant issues raised above in the letter from the BMA.
The names, role within cancer care and the seniority of all signatories are known to the Health Minister, who can confirm the legitimacy of this letter.
It is clear that TCS and the Velindre NHS Trust have been lacking a level of precision that one might expect from a statutory body, when outlining the facts and figure they have used to reassure the public and politicians regarding the safety of the proposed New Velindre Cancer centre on the Northern Meadows.
The reasons for the persistent inexactitude need to be determined before this project is allowed to proceed any further.
Despite the manner in which the Nuffield Trust engagement was announced (this being at 08:59 on the day the WAG Petitions committee were due to consider a petition calling for an independent clinical review) and the very rigid terms of reference, the Nuffield Trust report makes clear that co-location at UHW would be the option that best serves the needs of the next generation of cancer patients.
There exists the opportunity to use the new Covid-19 Surge unit as a base for co-location, with this unit providing ample space for inpatient beds and research on the UHW campus.
There is no need for a conference centre, and the belief that such a facility might generate significant income now appears questionable, as the Covid-19 pandemic has significantly changed the whole landscape of clinical conferences.
What is left can now be safely and expeditiously built on the current Velindre/Grange site if immediate and full co-location proves challenging.
Spending up to £30 million on access roads to the northern meadows, to build a much smaller unit which may only be used for 10 years may be considered fiscally inappropriate.
One final question which must be asked is why there has been no progress on the satellite radiotherapy unit at Abergavenny.
This unit has the agreement of all invested parties. The report was published in 2017 (Appendix Seventeen) yet 3 years later a business plan has yet to be submitted.
This delay needs to be explored and explained.
As politicians, doctors, nurses and clinicians, our service to the public is but transient.
It is incumbent on us to do the right thing, for the right reasons at the right time.
We owe this to the future generations.