An NHS trust predicts it will save around £700,000 a year by moving inpatient haematology care from an Orpington hospital to Camberwell but claims money is not the “primary driver” of the proposal.
King’s College Hospital NHS Foundation Trust says by absorbing the blood cancer specialism into its offering at Denmark Hill it will improve treatment for patients.
The trust announced in September that it was reviewing the inpatient cancer care it currently offers at the 12-bed Chartwell ward at Princess Royal University Hospital (PRUH).
Bromley residents were quick to react, launching a petition to keep the care in Orpington. The petition has gained nearly 27,000 signatures.
Representatives of the King’s College trust were present at a special meeting of Bromley Council’s Health Scrutiny Sub-Committee yesterday (November 26) to explain the proposal and address concerns of current Chartwell patients and the public. The trust was keen to clarify that the proposal was driven by improving patient care and was not a cost-cutting exercise.
The trust’s Deputy Chief Executive Julie Lowe said: “Our primary responsibility is to offer Bromley residents the best possible care for their clinical condition that we can. What we are saying is that as treatment, particularly for haematological cancers, has moved on through time, the best care and the best chance for the best possible outcome for them is probably not for them to be cared for at the Chartwell Unit but for them to receive inpatient care at Denmark Hill.”
The trust explained that its haematological facilities at King’s in Camberwell were far more advanced than what is offered at the PRUH. Chartwell patients do already get access to these facilities and will be transferred to Denmark Hill if needed, but the trust said this new proposal would provide patients with a “more immediate and direct” access to specialist treatment.
The trust also stressed during the committee meeting that its proposal would only be affecting a small number of Bromley patients. Within a King’s report it states that the specific inpatient care at the PRUH only treats around 144 patients a year, however its representatives did acknowledge the “serious impact” it would have on those individuals. Ms Lowe suggested it was “good news” that the number of patients requiring the service in Bromley was so low.
In terms of finance, Ms Lowe said the trust’s proposed change would save it around £700,000 a year against its budget of nearly £2billion.
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King’s also said specialist haematology nurses working in the Chartwell Unit were not seeing enough patients to maintain their professional competency.
A key point of contention raised by Chartwell patients is that if they have to undergo inpatient care for an extended amount of time, they will now have to do this at the Camberwell hospital making it more difficult for their families and loved ones in Bromley to visit them.
Matthew Venner lives in Chislehurst and has stage four Non-Hodgkin Lymphoma. He says his two children will not be able to visit him if he has to get treatment at Denmark Hill because it is so far away.
Dr Roopen Arya, the Clinical Director for Haematological Medicine at King’s, said: “I’m beginning to empathise more and more with the plight of those families and those patients, but ultimately it is about giving patients the best care possible, and the best support.
“It’s a trade off, and I have huge sympathy for the geography and transport issue, but we are trying to do our best for our patients.”
Another concern that has been raised by Mr Venner and others is the fear that severely immuno-compromised patients may suffer if they have to be transferred from the PRUH to Denmark Hill. King’s Chief of Division, Dr Carmel Curtis, said the trust would “do everything in its power” to keep patients at the PRUH, and would only transfer them if necessary.
Dr Curtis assured the committee that transferring vulnerable patients between hospitals, particularly within London, was common practice and many safeguards were in place—such as single patient minibus journeys—to protect those who are vulnerable and that would not change.
Councillors on the committee were critical of a perceived lack of engagement carried out by the trust. Cllr Thomas Turrell said even getting the trust to turn up to a meeting was “an absolute nightmare” and claimed Bromley Council had to resort to legal means to make it happen.
Ms Lowe refuted the notion that legal means had to be used. She explained there had been a “breakdown in communication” between King’s and the council but that was because the trust wanted to find a date where both Dr Curtis and Dr Arya could find time away from their busy schedules as consultants, to be present at the meeting and give the committee their “full attention”.
The trust’s Deputy Chief Executive did acknowledge that its failure to engage more with the community was “very poor” and it pledged to carry out more engagement going forward. She also said the negative reaction from the public took the trust “by surprise” as they believed the proposal would only affect a small minority of patients.
The committee asked for the NHS trust to come back to its next meeting in January with a more detailed report and more data backing its proposals. The trust said it would be presenting a more thorough business case next year, but it would be “essentially the same proposal”.
Mr Venner was not pleased with what King’s presented at the meeting, feeling that Bromley haematology patients were “belittled”. He told the LDRS afterwards: “Apparently, there are too few of us (and the Chartwell ward is too small a unit) for the executives to have provided thorough facts and figures to support their proposal. Only the outline of their ideas was deemed sufficient.
“The human cost does not matter to these executives. Quotas and centralisation are their priorities. Bromley borough is about to lose cancer beds, and patients are going to lose vital local healthcare provisions. The patients and their families are going to suffer the consequences.
“I feel belittled and unheard. I’m angry and scared of what’s to come, whilst battling Stage 4 cancer. I want the executives to know this.”
