London hospital drops chemotherapy due to nursing shortage

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By Denis Campbell Health policy editor

Patients at King George hospital will have to go elsewhere as NHS trust centralises care

One of the biggest NHS trusts is to stop providing chemotherapy at one of its hospitals because it has too few specialist cancer nurses to staff the unit.

The Cedar Centre at King George hospital in Ilford, east London, will cease provision from 12 November because four of its nurses have quit and two others have gone on maternity leave.

It is thought to be the first time the NHS’s widespread staffing problems have led to a specialist cancer unit no longer being able to offer a vital service such as chemotherapy.

More than 500 patients a year received their cancer treatment there, and in future patients will have to go to Queen’s hospital in nearby Romford instead.

Macmillan Cancer Support said the move was “hugely concerning” and a stark example of the “extreme workforce pressure” at NHS cancer services, which are facing rising demand while recruitment and retention of nurses gets harder.

Moira Fraser-Pearce, Macmillan’s director of policy, said: “It is hugely concerning if a hospital is not able to recruit enough cancer nurse specialists to feel it can safely provide patients with the treatment they need.”

Tom Sandford, the Royal College of Nursing’s England director, said: “The loss of the chemotherapy service at the Cedar Centre is a serious blow to patient care at a time when the government’s referral target for urgent cancer treatment has not been met for five years.

“The fact a specialist unit such as this has been forced to close its doors to people needing chemotherapy is the starkest evidence yet that the nurse staffing crisis is jeopardising safe patient care, with almost 42,000 nurse vacancies in England alone.”

Barking, Havering and Redbridge University hospitals NHS trust, which runs both hospitals, said it had been planning to centralise chemotherapy services in Romford, and had accelerated the move when it found it could not replace the four nurses who are leaving. The departures will reduce the number of cancer nurses working across both hospital sites delivering chemotherapy from 19 to 15.

The absence of two nurses on maternity leave will mean 13 will be working at Queen’s, which already has almost 2,000 cancer patients a year.

Chris Bown, the trust’s interim chief executive, said: “Chemotherapy nurses are a specialist group and hard to recruit to.

“Centralising our chemotherapy service at Queen’s hospital is part of our ongoing plans to improve the care and experience of our cancer patients. We’ve brought forward these plans due to staff shortages.”

In January, it emerged that medical chiefs at Churchill hospital in Oxford were considering starting to ration access to chemotherapy for both existing and newly referred cancer patients because it had too few nurses to deliver treatment.

The Cedar Centre has been providing chemotherapy two days a week to what the trust says are patients requiring “less complex treatments” than those who go to Queen’s hospital.

Bown said the centralisation was good for patients because the radiotherapy centre, medical experts in cancer and the pharmacy team were all based at Queens’s.

The Cedar Centre will now be developed as a “living with cancer and beyond health and wellbeing hub, providing a range of support to help patients and their families from their diagnosis through to post-treatment”, Bown said.

Macmillan and Cancer Research UK have warned in recent years about the growing difficulties NHS cancer services are having in recruiting and retaining staff, which has led to patients facing delays in diagnostic testing and treatment.

Macmillan has voiced concern about the number of vacancies for nurses who specialise in treating certain forms of cancer. Sandford said the removal last year of funding for tuition fees and living costs for student nurses was contributing to a worrying outlook.

“Retention rates are also a huge problem as the pressure caused by understaffed workplaces pushes more and more people away from the job they love,” he said.

Shortages of cancer nurses are common, even though more are being employed in the NHS in England. The latest figures from NHS Digital show the total number of nurses and health visitors in England specialising in cancer support rose from 2,869 in June 2016 to 3,096 in June this year.

The number of hospital and community-based doctors working in cancer support fell by 23% over the same two-year period, from 141 to 108.

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