To receive an update on the proposed expansion of radiotherapy services.

The Committee considered an update on the proposed expansion of local radiotherapy services by the 3 Counties Cancer Network (3CCN). 

In March 2008 the Committee had affirmed its support for the Hereford County Hospital option for extra radiotherapy services provided on a satellite basis and asked the Three Counties Cancer Network to consult on this preferred option, taking account of the National Cancer Strategy recommendation that no patient should have to travel more than 45 minutes for cancer treatment and supporting the development of a treatment facility at Worcester as the next subsequent phase of development after that recommended at Hereford.

A letter from the 3CCN dated 4 June 2008 had been circulated to Members.  This enclosed a pre-consultation paper inviting comment on the proposed decision making and consultation processes.

Mr Antony Walsh, Service Improvement Lead at the 3CCN, gave a presentation.  This described radiotherapy, reminded the Committee of the current provision in the 3CCN and the options for expansion.  Decisions to date were that a linked service would be managed by the Oncology Centre at Cheltenham and would utilise the same clinicians (and some other specialists); it would comprise 2 linacs to provide cover (although a single linac might be an interim solution); the 3CCN Board could not make a decision which impacted on other Networks and patients would not be made to travel to improve the cost effectiveness of an option.

Factors to be considered included cost effectiveness, although it was noted that each PCT had agreed to underwrite its preferred option; clinical and radiation safety; and access – noting national guidance that a maximum journey time of 45 minutes should be seen as best practice. Some patients (c. 20-30%) would still need to travel to the Centre for more specialised treatment (including some of the sickest patients). Recruitment to radiotherapy posts had been difficult.

Nine criteria had been weighted by the Network Board, PCTs and patients and carers.  The top three were: patient access, patient safety and cost effectiveness.

He outlined the next steps which envisaged the 3CCN identifying a preferred option in July for consultation in July, with a final decision in December 2008

In the course of discussion the following principal points were made:

·         The Committee reaffirmed its support for the proposed extra provision to be located at Hereford County Hospital as set out in its decision of  5 March 2008.

·         Herefordshire PCT’s view that there was a need for a radiotherapy service to be provided locally was also reaffirmed.  It was added that the PCT had made financial provision for the Service to be provided.  It was noted that the Gloucestershire PCT was neutral on the proposal given that it would benefit from increased local capacity whichever option was chosen.  The Chief Executives of the Trusts therefore had to decide whether provision was to be at Hereford or at Worcester.

·         In response to a further question on funding it was reiterated that the PCT had made provision for revenue funding.  Further consideration would be given to precisely how the capital funding requirement to be met, if it were agreed the service would be sited in Hereford.

·         It was noted that the enhanced provision had been under consideration since 2005 and implementation was now planned to take place in two years time.  Mr Walsh commented on the developments during this period in the thinking about the proposal, including clinical issues.  Members expressed unhappiness at the delay in reaching a decision noting in particular the weight of public expectation.

RESOLVED:

That    (a)        the Committee’s resolution of 5 March 2008 be reaffirmed; and

            (b)       that a response by the Chairman to the 3CCN Consultation document be authorised following consultation with Members of the Committee.