Open Letter by Dr Ashley Roberts

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I am both a Whitchurch resident and a Consultant Interventional Radiologist at Cardiff and Vale University Health Board, and over 90% of my professional work as a doctor is related to cancer. The views I express are my own, but do reflect those of other colleagues in healthcare. All of the documents cited are publicly available for verification.

The environmental arguments against destroying the Northern Meadows are clear. I don’t need to reiterate these. The main reason for writing is regarding good modern cancer care of the population in the 21st Century.

Cardiff and Vale UHB

Cardiff and Vale University Health Board is responsible for the health and well-being of the whole population. Indeed, this is set out in the aims of the health board -Shaping our future wellbeing strategy 2015-2025. 

“Caring for People; Keeping People Well is why we exist as a UHB, with a vision that a person’s chance of leading a healthy life is the same wherever they live and whoever they are.”

There is little doubt taking away the Northern Meadows as they currently are from the local population would be hugely detrimental to physical and mental well-being.

The proposed model for Transforming Cancer Services in South East Wales

Developing a stand-alone Cancer centre is an archaic model, and I will go on to explain why.

Cancer treatment has become more and more complex, and cancer patients undergoing treatment have increasingly complex issues. If they become severely unwell now, they are transferred to UHW in an ambulance. Sometimes they require ITU treatment. Other new cancer service developments are using a different, better model with specialties on the same site, such as surgery, cardiology, interventional radiology, gastroenterology, respiratory medicine, intensive care and others. In other words, modern cancer services are physically linked to larger acute hospitals.

No ambulances required!

Two examples:

  1. Clatterbridge Cancer Centre

https://www.clatterbridgecc.nhs.uk/about-centre/mission-aims-and-values

Abstracted rom the above website:

·  Our plans for Transforming Cancer Care

We are expanding and improving cancer care even further with the development of a new 11-floor specialist cancer hospital in the heart of Liverpool. The new cancer hospital is due to open in 2020 and will provide highly-specialist cancer care for people with blood cancers and solid tumours. Although the Liverpool hospital will become our main base, we will also continue providing services at our current site in Wirral and our satellite radiotherapy centre on the Aintree site.

Being located in central Liverpool alongside the University of Liverpool and Royal Liverpool University Hospital will significantly improve care for people with cancer:

·  Our main base will be closer to the majority of the population we serve, which stretches from Southport down to Wirral and across to Widnes / Warrington. People who live closer to Wirral / Aintree will still be able to access care locally as we’re keeping our current sites

·  Unlike now, we will be co-located with a major acute teaching hospital providing rapid access to intensive care and other key medical and surgical specialties when patients need them. At the moment these patients have to be transferred by emergency ambulance to other hospitals

·  We will be at the heart of a thriving research and healthcare campus with the University of Liverpool, NHS and other key research partners, enabling even more ground breaking cancer research and clinical trials

The document below outlines clearly the forward-thinking direction of travel on a single-side of A4 in 2020:

https://www.transformingcancercaremc.nhs.uk/services/services-from-2020

  1. Mount Vernon Cancer Centre Review

There are many pieces of evidence in the website below, which illustrates why the proposed new Velindre model is outdated.

https://www.england.nhs.uk/east-of-england/nhs-england-and-nhs-improvement-east-of-englands-work/mount-vernon-cancer-centre-review/

In the Independent Clinical Panel Report below is just one example from Page 7, where “any proposed model of care must address:

https://www.england.nhs.uk/east-of-england/wp-content/uploads/sites/47/2019/08/Independent-Clinical-Panel-Report.pdf

“The need for onsite surgical and comprehensive medical acute support services to quickly and safely manage treatment related toxicities / complications, acute illness linked to patient comorbidities and frailty as well as disease related sequelae”

In other words, an independent body considers this to be an essential requirement.

Why have Velindre selected an archaic model?

Only they can answer this, but it MUST be scrutinised. 

I completely understand why the clinical and managerial leaders at Velindre wish to remain large fish in a small pond, as they are at the moment. I also understand why they would not want this status quo to be disrupted, and that they want the new hospital to be built as soon as possible. 

It appears they continue to disregard other options, although no doubt there have been reviews and option appraisals in the past. The world has changed, including the effect of COVID-19 and the importance of outdoor spaces for communities. 

Velindre is an outstanding “brand” and much loved by the people of Cardiff. It is possible they may have taken the opportunity to exploit this “brand” so their decisions go without external scrutiny. 

The new model for cancer care will be outdated before it is even built.

There are therefore important questions to ask.

Questions to consider

Has there been an independent clinical review of the proposed model for Velindre for the 21st century? 

If there has been, when was it? 

Who conducted it? 

Was it truly independent?

Has there been any proper engagement with C and V UHB regarding the proposed redevelopment of UHW, and integration of cancer services on that site?

Has this been revisited as an option since the COVID-19 pandemic?

The clinical and managerial leaders may suggest a further cycle of review and updating will not achieve anything, and they may even be fearful nothing at all might happen. I understand this fear, as Velindre does need updating.  My colleagues at Velindre would need reassurances from politicians that a 21st cancer centre will be delivered.

However, we should not spend millions of pounds of tax payers money doing the wrong thing, and destroying an important natural space which we would never have back, however outstanding the architecture is.

Those who oppose the new development and destruction of the Northern Meadows have been branded as anti “cancer services” but this is not true.  The application must be called in and the proposed model of care reviewed.

Dr Ashley Roberts