Neglected NHS cancer hospital is unfit for purposeNachelle Geronimo
Neglected NHS cancer hospital is unfit for purpose, says report.
Mount Vernon so dilapidated and short-staffed that it cannot provide basic elements of treatment.
Entrance of Mount Vernon hospital, Middlesex. Photograph: Medicimage/REX/Shutterstock.
An NHS cancer hospital has such crumbling buildings, out-of-date equipment and staffing problems that patients’ safety and quality of care are at risk, a bombshell report for health service bosses has warned.
Patients at the Mount Vernon Cancer Centre who are acutely unwell or dying are receiving substandard care because it lacks the medical expertise and facilities needed to manage them properly, and its services need to be moved, an inquiry has found.
Mount Vernon in Hillingdon, north-west London, is one of the NHS’s specialist cancer hospitals, along with London’s Royal Marsden and the Christie in Manchester.
The impending loss of most or all of Mount Vernon’s services will be of concern to Boris Johnson, as his Uxbridge and South Ruislip constituency is nearby. Voters in the seat are among the 2 million people in London, Hertfordshire, Bedfordshire and Berkshire for whom Mount Vernon is their nearest specialist cancer centre.
However, despite its decrepit physical infrastructure, it is not one of the six hospitals the prime minister this week said would be rebuilt over the next five years with a £2.7bn injection of NHS capital funding.
The 117-year-old London hospital is so dilapidated and short of doctors and nurses that it cannot provide modern cancer care or even basic elements of treatment such as consultants undertaking daily ward rounds, new inpatients being reviewed within 14 hours of arrival and rapid access to diagnostic testing and their results.
The group of experts who undertook the urgent review on behalf of NHS bosses have concluded that Mount Vernon has been neglected for so long that it can no longer operate safely as an important regional centre of cancer care, is unviable and as a result, its services need to be moved and rebuilt from scratch elsewhere.
“Maintaining safety of patients cannot be guaranteed in the near future. Status quo is not an option. There is a need for urgent action. Current estate is not fit for purpose, particularly ward buildings for acutely unwell and end of life inpatients,” the report says.
Leaking roofs have forced Mount Vernon’s management to move some services from one part of the hospital to another, the 34-page report reveals. The wards containing its 37 inpatient beds – where people are treated for complications of cancer or recover from radiotherapy or chemotherapy or are in their last days – are in “very poor” condition. And its lack of an intensive care or high dependency unit and operating theatres means that “large numbers” of patients have to be transferred from Mount Vernon to other hospitals because it is unable to look after the very sick.
“Much of the existing estate used by MVCC is dilapidated and not fit for purpose,” the report says. An “urgent backlog maintenance of existing clinical facilities” needs to be tackled.
Its lack of staff has become “critical” and means that some patients are not getting helped by a nurse who specialises in their form of cancer. Shortages are being exacerbated by an exodus of experienced doctors and nurses.
The report found: “Staff losses are impacting upon the service. There are additional clinical risks such as the backlog of patient letters and notes as a result of inadequate administrative support.
“Recruitment and retention of expert staff is an increasing problem and is becoming critical.” In addition, personnel “are, in the main, demoralised and frustrated” over the hospital’s uncertain future.
It is thought to be the first time in the NHS’s 71-year history that a major facility specialising in the country’s second biggest killer disease has been deemed to pose a risk to patients and been declared unfit for purpose.
Cancer charities said the hospital’s shortcomings were “deeply worrying” and reflect the serious workforce shortages and reliance on old equipment that are increasingly common in NHS cancer services after almost a decade of austerity funding of the health service.
“Time after time we’ve heard about staff shortages causing crises in NHS cancer services, and this is yet more evidence of the unbearable pressure on the system,” said Matt Case, Cancer Research UK’s policy manager.
“Recent government commitments to investing in NHS buildings and equipment are a welcome first step, but must be met by significant investment in cancer staff, or stories like this will continue to emerge and cancer patients will not receive the care that they deserve.”
Prof Nick Slevin, a consultant clinical oncologist at the Christie hospital, led the clinical advisory panel of experts which undertook the urgent review in May at the request of NHS England’s east of England region.
Slevin states in the report that it was undertaken because “acute support services have been progressively depleted on the site over many years such that there is current and increasing concern regarding patient safety”.
He adds: “Services continue to be provided within very poor quality accommodation with much equipment reaching the end of its life without a replacement plan.” For example, one linear accelerator (linacs) machine used to deliver radiotherapy has been temporarily upgraded so the hospital can continue using it because it cannot afford to buy a new one.
Other problems highlighted by the panel’s report include:
- Information technology and electronic patient record systems are so poor that they constitute “a clinical risk”.
- Staff provide excellent care in difficult circumstances but are struggling due to “excess workload”.
- Doctors cannot access the results of CT and MRI scans out of hours.
- Delays of up to six weeks in typing up letters detailing patients’ latest condition mean that nurses staffing Mount Vernon’s 24-hour telephone chemotherapy advice line may inadvertently give wrong advice.
The experts have recommended that Mount Vernon is either replaced in full beside an acute hospital or that that happens but some radiotherapy and chemotherapy services remain on the existing site.
With Mount Vernon’s days numbered, three major London NHS trusts – the Marsden, University College London Hospitals and Imperial College Healthcare – as well as Addenbrooke’s hospital in Cambridge – are interested in its replacement being built on their site. Whichever gets it will take over running it from East and North Hertfordshire trust.
Gwyneth Tyler, Macmillan Cancer Support’s head of services for south and east England, said: “The findings from the recent review into the Mount Vernon Cancer centre are deeply worrying. People living with cancer deserve access to the best possible care from the moment they are diagnosed and cancer centres cannot provide this without capital investment in their infrastructure and workforce.”
An NHS spokesperson said: “The review of Mount Vernon Cancer Centre is ongoing to ensure the service is able to respond to the significant advances in cancer treatment over recent decades. This includes identifying a specialist cancer provider to run the centre.”
Creative Commons Disclosure
About The Mandatory Training Group
The Mandatory Training Group is the leading UK provider of accredited healthcare and social care statutory and mandatory training courses, programs and qualifications.
Click on the links below to find out more about our increasing range of leadership and management training courses and programs.
- Mandatory Training for Health and Social Care Workers
- CQC Mandatory Training Courses for Healthcare Professionals – Online Training Course
- Employee Recruitment Training – Online Training Course – CPD Accredited
- Clinical Governance – Level 3 – Online Training Course – CPD Accredited
Contact our Support Team on 02476100090 or via Email for more courses relating to the Care Quality Commission (CQC) and other regulatory compliance requirements.