Funding problems for use of cyberknife at Mount Vernon Cancer Centre
Dear Mr Stevens,Exclusion of Mount Vernon Cancer Centre from the commission process that relates to
the treatment of patients with brain metastases with stereotactic radiotherapy.
You may recall from earlier correspondence that The Community Voice is an umbrella organisation concerned exclusively with good NHS services. We are totally independent and represent many thousands of local people in NW London and SW Hertfordshire through our membership - residents associations, community groups and branches of all three major political parties, as well as individual members. If you wish to know more about us, please see our website, address below.Our members are aghast that Mount Vernon Cancer Centre (MVCC) is not among the 17 centres from whom NHS England will from 1st September commission stereotactic radiotherapy for the treatment of brain metastasis. We understand that a trivial omission in the application of the East & North Herts. Hospitals NHS Trust led to MVCC not even being considered for inclusion in this group, despite NHS England being made aware of the highly unfortunate error. In our view this omission should be rectified and MVCC should be added to the list of accredited centres.
We understand that around a third of the MVCC income to run the equipment dedicated to the delivery of stereotactic radiotherapy (Cyberknife) will be lost if the current directive is implemented. That is obviously a matter of considerable concern, particularly when all NHS services are under such great current financial pressure. We are not able to assess whether the loss of income would threaten the viability of MVCC maintaining this equipment, but obviously under-used equipment is always at risk.
However we also have a number of other concerns. Firstly, we are concerned for cancer patients who develop brain metastasis that do not require surgery, which we understand applies to many patients. Their established pathways at MVCC will be disrupted if they are obliged to attend other hospitals, undermining the confidence built up over time with familiar MVCC clinicians and subjecting them to unnecessary travelling, all of which will exacerbate the stress inherent in their illness.
We are unclear why brain metastases have been included in a commissioning package which is really meant to consolidate the management of a group of unusual neurological conditions with stereotactic radiotherapy. We do support that these rare conditions are managed in a small number of specialist centres.However, we believe that brain metastases should be looked at separately. Brain metastases are common and we understand that they are best managed by the oncologist that specialises in the specific disease causing the brain metastases, eg breast oncologist if breast cancer, renal oncologist if renal cancer, etc. Clearly all patients must have access to neurosurgery if needed and for some patients this will be essential, but the decision on which treatment should be offered should be made by the site specific oncologist. MVCC has been treating such patients for 6 years, with good neurosurgical links when appropriate, and we feel strongly that this should be contracted to continue.
Secondly, we are conscious that MVCC was the first cancer centre to install dedicated stereotactic equipment (Cyberknife) in the UK, due to the great generosity of a private donor. Similar generosity will be dealt a serious blow if it is known that NHS England obliges donated equipment at MVCC to lie idle rather than being used effectively. The impact on other potential donors could do the NHS considerable harm.
Thirdly, there is a sense of disbelief that having tutored and mentored many of the 17 centres that will continue to be commissioned, MVCC is itself debarred from this commissioning, for a service that it is fully able to provide.We hope that what we see as common sense will prevail and that this extremely damaging decision will be reviewed so that MVCC can continue to provide the excellent service for which it is rightly well known.
We ask for your intervention in this very worrying issue.Yours sincerely,
Joan Davis, Chairman The Community Voice
Copied to: Nick Carver CEO, East & North Herts. Hospitals NHS Trust, Bob Blackman MP, David Gauke MP, Dominic Grieve QC MP, Richard Harrington MP, Nick Hurd MP, Boris Johnson MP, Gareth Thomas MP Caroline Morison, Chief Operating Officer, Hillingdon CCG