Agenda item

12:00

In light of the recent focus in the press on cancer services at the Churchill Hospital, a report was requested from Health representatives (JHO8) on the provision of services at the Hospital and any actions taken to ensure the resilience of these services.

The role of HOSC in monitoring the provision of Cancer Care at the Churchill going forwards will be discussed.

In light of the recent focus in the press on cancer services at the Churchill Hospital, a report was requested from Health representatives on the provision of services at the Hospital and any actions taken to ensure the resilience of these services. This was attached at JHO8 for consideration.

The Chairman welcomed the following representatives from the OUH to the meeting:

Dr Andy Peniket – Clinical Lead for Haematology

Matt Akid – Head of Communications

John Drew – Director of Improvement & Culture

Matt Akid began by welcoming the approach made by the Committee to establish the facts behind the headlines, expressing his belief that communication was very important to the Service. He explained that the headlines had centred on one part of the patient pathway which was chemotherapy treatments given at day treatment units at the Churchill Hospital and at the Brodie Centre at the Horton Hospital. Almost 100 patients a day received treatment at these centres combined, which was a 10-12% annual increase in patients receiving chemotherapy. People were living longer in Oxfordshire compared to other areas and therefore more treatment was being given in comparison with other areas. The specific challenge was not one of resources, rather it was one of provision of nursing staff to manage the service and how to maintain standards in patient care.

He added that the challenges faced by the Trust in relation to the recruitment and retention of staff were substantial.  More money had been put into this area but there were still problems in recruiting. Despite this the number of complaints had fallen and standards of care had continued to be very good.

He outlined the innovative work being undertaken to increase the capacity of chemotherapy services which included:

-       Improved training to aid staff retention;

-       Weekly interviews for staff using social media for recruitment campaigns;

-       Working hard at the standards of service to attract staff.

Dr Peniket highlighted the efforts taken by the oncology consultants in seeking constructive comments and ideas about alternative ways of giving palliative care in a bid to maintain services; given the premise that how one responded to cancer care was not an exact science. Matt Akid added that in this instance the email in question which asked for comments and ideas was leaked and the Times newspaper had led with a headline ‘hospital cuts to cancer care due to lack of staff’. A statement had then been issued to the Times stating that this headline was untrue, no decision had been yet been made and explaining that the aim of the email was not to cut services, that no changes to treatment had been made and the Trust’s priority was to its patients. He agreed that whilst the issue needed to be aired, the impact of the headline was damaging and upsetting to patients. The Trust’s clinical head of service, Dr Hobbs, had spoken to the media reassuring patients and the public of this, stating that the area of challenge was in nurse recruitment. The situation was then discussed with patients and staff who were given a more balanced and accurate picture of the situation.

The Chairman thanked the representatives for their very informative explanation of the situation. Issues and comments raised by members of the Committee, and responses received, were as follows:

-       When asked if anything could have been done to prevent the newspaper headline, Matt Akid responded that the NHS was always very high on the media’s agenda and therefore there was no surprise at the provenance of the story. However, the Trust always liked to handle things in a better way if it could. Furthermore, debate/discussion in public was not unhelpful and it was believed that issues such as these should be talked about in the public domain;

-       Dr Peniket confirmed that whilst it might be sensible for chemotherapy to be administered at home, in line with practice in some other countries, the delivery of chemotherapy in the home environment was strongly regulated in this country;

-       With regard to a question about whether the Trust would consider engaging with the district councils about the offer of housing packages and other incentives in a bid to provide more staff to the Trust’s hospitals, Dr Peniket stated that should an opportunity arise, the Trust would consider this to be very helpful. Some local Cherwell District Councillors urged the Trust to take this action, stating that Cherwell District Council had won an award for finding innovative ways in relation to housing;

-       In response to a question, Dr Peniket stated that the Trust was thinking about ways of making better use of staff and it had plans to upskill, and give a greater role to support and care workers, whilst always keeping safety in mind. The Trust was also offering incentives for staff to work additional shifts. In connection with this initiative, a member asked if home-helps and local pharmacists could be trained to administer the drugs. Dr Peniket responded that this point was well made and there was further work to be done in this area, adding that there were many new agents coming onto the market which were less toxic, for example, immunity and modulatory drugs;

-       A member asked if more training would be given to staff when treating or caring for patients with mental health issues; also whether more assistance from relatives who often had a greater knowledge and understanding of the patient could be accessed.  Dr Peniket and John Drew accepted this as an interesting observation and indeed a training issue, stating that the Trust only appointed psychiatric assistance to support patients who had solid tumours. They accepted that staff could be better aware of acting on this knowledge and the Trust was already working on staff training to accord with the area of illness. They also added that training was not a hospital-wide speciality as the training status for major specialists was becoming harder and harder. This in turn became a difficulty for smaller units. The Trust however was trying to do its best. The Horton Hospital, for example, now had a trainee registrar which in turn enabled nurses to train there.

The Chairman, when thanking Mr Akid, Dr Peniket and Mr Drew for their attendance asked them to come back to the Committee when they were further down the line with their innovations as outlined above. They accepted, stating that they would be happy to do this, welcoming the opportunity to maintain a dialogue with the Committee. They also offered to organise a visit for members to visit the chemotherapy units at the Churchill Hospital.