Mount Vernon Hospital is a very complex place. The site is owned by The Hillingdon Hospital NHS Trust, which provides elective surgery in the Mount Vernon Treatment Centre. It also provides some of the other acute services on the site, including the Minor Injuries Unit and a number of out-patient services.
However, Mount Vernon Cancer Centre - the biggest Cancer Centre in the south of England - is the responsibility of East & North Herts NHS Trust, and the Northwood & Pinner Unit is the responsibility of Central & North West London Foundation Trust.
Several charities are housed on the site – The Paul Strickland Scanner Centre, The Lynda Jackson Macmillan Centre, The Restoration of Appearance and Function Trust (RAFT). The site also houses commercial interests – Bishopswood Hospital; a private sector dental service; Baxters providing Scanner Centre pharmaceuticals.
There is also the Mountwood GP Surgery, the Michael Sobell Hospice, staff accommodation and Chart Lodge - a patients’ hostel. Some buildings have historic importance and are listed. Some buildings are empty, awaiting demolition. If we had the resources, we could devote a whole website to this remarkable place – as it is, we have only this page for news from anywhere on the site.
On 4th March 2013, Dr Catherine Lemon, Divisional Chair for Cancer Services, East & North Herts NHS Trust was guest speaker at the meeting of The Community Voice - of which we are a member. The notes below summarise her address.
Dr. Lemon has been in post at Mount Vernon since April 2012. She was pleased to report that the Mount Vernon Cancer Centre (MVCC) is thriving. It has 26 consultants and many new developments. Her talk was divided into sections – Radiotherapy / Chemotherapy / Patient Experience / Research / Plans for the Mount Vernon site / The new NHS.
- Radiotherapy: MVCC now has eight standard radiotherapy treatment machines, plus cyberknife.
- It has two new state-of-the-art True Beam Treatment Machines, which use new faster delivery techniques and rapid-arc treatment, with the machine moving around the patient. Treatment which used to take 15 minutes now takes 2 minutes – a big improvement for patients. The machines also offer future opportunities to compensate for movement due to breathing during treatment. As MVCC is one of the few centres with two machines, it is to be featured in a TV programme on 18th March.
- Seven of the treatment machines allow Intensity Modulated Radiotherapy (IMRT) which offers very focused treatment so that tumours receive high dosage of radiotherapy to improve rates of cure but normal tissues are spared, which reduces side effects.
- Image Guided Radiotherapy (IGRT) takes an image of the patient daily and compensates for small changes that arise between treatments on different days, such as the patient’s position or fullness of the bladder.
- The National Radiotherapy Innovation Fund distributed £15m to improve access to IMRT and IGRT. Of this, MVCC received £750,000 this will allow an additional machine to offer IGRT, plus software to help replan patients who may have lost weight during a course of radiotherapy or to compensate for movement during breathing for lung patients, and for planning from remote hospitals.
- Cyberknife treated 109 patients last year. MVCC is collecting evidence of its benefits for particular cancers such as prostate cancer. It is becoming the standard treatment for lung and brain patients.
- During replacement of aging machines MVCC extended its day from 8m to around 8pm. This proved very helpful for some patients and so this pattern of work has now become standard.
- A new storage system for scans is to be installed and MVCC hopes to get a new gamma camera which shows the position of radioactive substances in the patient, useful in iodine treatment and bone scans.
- Chemotherapy: This has seen major changes too. Marie Curie Ward, with 18 patients’ chairs, is now a day-care ward. Electronic prescribing has been introduced and the advice line has been expanded to include advice for all cancer patients and professionals 24 hours a day including weekends.
- Patient experience: There has been much effort to improve the experience of patients within MVCC. There have been various questionnaires and surveys. Patient Information Prescriptions (PIPS) have been introduced. HOPE (Helping Overcome Problems Effectively) has been set up to assist the carers of cancer patients. WiFi is used to help patients access online information. The Lynda Jackson Centre has led the way in providing information for patients and their families.
- Research: MVCC and Royal Marsden Hospital are academic partners. There is a strong emphasis on research and patients are entered into trials when these are available and appropriate.
- NHS changes have replaced cancer networks with Academic Health Science Networks. MVCC is on the edge of two such networks and so is a member of both East of England and Imperial (London).
- Plans for the Mount Vernon site: Joint working between the Hillingdon Hospital Trust and East and North Herts Trust led to formation of the Mount Vernon Programme Board. The vision for the site is being developed under the title “Project 2015”. This aims to improve the facilities on the Mount Vernon site especially the cancer wards and the cancer outpatients department. There is also planned building work to extend the Lynda Jackson Centre.
- The new NHS: Primary Care Trusts and Cancer Networks will be abolished on 1st April 2013, to be replaced by Clinical Commissioning Groups and Academic Health Science Networks. London has developed two Cancer groups. One is the London Cancer Alliance, of which MVCC is a full member, which includes the Royal Marsden Hospital, Charing Cross Hospital and Guys and St Thomas Hospitals – serving most Harrow and Hillingdon patients. The second is called London Cancer, of which MVCC is an Associate Member, which includes Barts Health, The Royal Free Hospital, University College Hospital and West Middlesex Hospital.
- The future holds many challenges including payment by results and national tariffs, for which all treatments will be coded. Clinical Commissioning Groups will commission and pay for many cancer treatments, but Specialist Commissioning Groups will be responsible for radiotherapy commissioning and payment. Strategic Networks will devise standard treatment pathways.
- The vision for MVCC: The aim is to be a state-of-the-art cancer centre, delivering best radiotherapy and chemotherapy, with high levels of patient satisfaction and key partnerships supporting continued development of MVCC within the Mount Vernon site.
Dr Lemon then answered wide ranging questions. She acknowledged that MVCC hopes to expand the lymphoedema services. She also noted that new commissioning patterns will help to address the problems of postcode lottery for cancer services.
Dr Lemon was thanked on behalf of the audience by James Kincaid, Vice Chairman of the Community Voice. This was followed by extensive applause as she left the hall.
Areas that were down on income were being looked at carefully – in particular maternity, and the women and children’s unit, were investigating this issue. The Trust's financial position at the end of December was worse than forecast, following a better than forecast position at the end of November. The cumulative deficit of £189k was due to a combination of low non-clinical income, higher expenditure by paying suppliers earlier, and the impact of Norovirus. However the deficit will be offset by winter pressure funding which was received after submission of the financial report for the end of December. The Trust is expected to achieve its revised forecast trajectory subject to satisfactory negotiations with the PCT/CCGs regarding outstanding contractual risks and transformation funding.
Mount Vernon had responded to earlier concerns about lower income than expected and there was recent improvement.
In answer to a question about Mount Vernon activity, it was felt that although this was being recorded in a satisfactory way, further work in this area was required.
The September meeting of Hillingdon's External Scrutiny Committee (ESC) heard about proposals to move the beds in the Northwood & Pinner Ward at Mount Vernon to the Woodlands Centre in Hillingdon Hospital.
Here are some of the details:
The Northwood and Pinner Unit at Mount Vernon Hospital houses beds that originated in the Northwood & Pinner Community Hospital. When they were moved there the Community Voice was given an undertaking by Hillingdon PCT and Hillingdon Hospital Trust that if the beds could not return to their original site then purpose built accommodation on the Mount Vernon site would be provided at the earliest opportunity – an historic fact not drawn to the attention of the ESC.
That promise has never been acknowledged by the current holders of responsibility within the PCT and hospital. Current financial constraints make implementation of the promise within the foreseeable future increasingly unlikely.
Against that background the ESC received a written report which·outlines the proposal to move the beds to the Woodlands Centre on the Hillingdon Hospital site. That Centre is part of the Central & North West London NHS FT, the trust responsible for Hillingdon Community Health which provides all community NHS services in Hillingdon, including the Northwood & Pinner Unit.
The case for moving the Unit to the proposed site are compelling. The existing beds are in two ten bed open wards, plus two single rooms for isolation purposes, with no day room or outdoor facilities, which despite every effort is not ideal for patients. Currently there is an opportunity to move to the proposed site, which would offer single and double bedded rooms, plus day room facilities and an enclosed garden, on a site adjacent to both the dementia and mental health facilities provided by CNWL and the acute clinical facilities available from Hillingdon Hospital. Clearly there would be advantages for patients but the down-side would be loss of historic continuity and longer journeys for visitors of patients from the north of the Borough, which are quoted as 60% of the recent intake
Speaking informally before the AGM with Wendy Scarr, Assistant Project Director, she explained that replacement of the cancer wards and outpatient facilities at the Mount Vernon Cancer Centre is being addressed as “Project 2015”, currently at an early stage of planning. Constructive discussions are underway with the site landlord, The Hillingdon Hospitals Trust, to explore options, as her Trust is reluctant to embark on a costly building programme without long-term security.
In further informal discussions, Nick Carver, Chief Executive, acknowledged the dire state of the Cancer Centre wards and outpatients department, and gave his assurances that replacement is a Trust priority. Speaking also with the Cancer Centre’s clinical lead, Dr Catherine Lemon, she was optimistic that Project 2015 would bring big improvements to the patient accommodation.
I was surprised to see on the programme that Rosemary Lucey, Head of the Lynda Jackson Macmillan Centre at Mount Vernon, was listed to give a report, so I was pleased to have a few words with her before the event started. She explained that because the Lynda Jackson Centre is jointly funded by Macmillan and East & North Herts Trust, she is regarded as a member of that Trust’s staff.
In his address, the new Chairman, Ian Morfett, formerly a non-Executive Director of the Trust, referred to the imminent launch of “Project 2015” and the commitment of his Trust to invest in the Mount Vernon Cancer Centre. He noted that the Trust has a total budget of £340m and that it has over 800 beds.
The issue of the Trust’s mortality figures was addressed in some detail. Within national statistics, deaths at Michael Sobell House at Mount Vernon are combined with deaths at the Lister and QEII Hospitals, leading to the Trust’s published mortality rates being above average – which gives a misleading impression about safety within the Trust. The anomaly of the Trust being responsible for a hospice is shared with only three other NHS trusts. Questions were asked about whether concern about mortality figures leads to patients being discharged from the Trust’s hospitals or from Michael Sobell House in order to reduce the number of deaths recorded within the Trust. Assurances were given that not only is that contrary to the Trust’s policy, but also that national policy requires inclusion within hospital mortality statistics any deaths that occur at home soon after discharge from NHS care.
Rosemary Lucey gave an excellent report. She noted that the Lynda Jackson Centre is an integral part of the Mount Vernon Cancer Centre and it has won many awards. It collaborates widely on behalf of patients and engages in research projects, but it specialises in face to face patient support. Last year it had 26,807 interactions with patients, involving over a hundred staff, only 30 of whom are paid. Volunteers are specially selected and trained – as many are turned away as they use! A wide range of support services are provided – pre-chemotherapy and pre-radiotherapy consultations, an information point in the Cancer Centre, Welfare Benefits advice, a psychological counselling service, various complementary services (not to cure cancer but to help patients to cope), patient education courses, and support groups. The Centre was first of its kind and next year it will celebrate its 20th anniversary.
- Free 20 minute drop off points
- Free parking for disabled Blue Badge holders in either designated disabled parking spaces or if these are not available in general parking spaces
- Weekly parking permits for £12
- Monthly parking permits for £25 • Parking for cancer patients at £1 a day
- Patients who have arrived for their outpatient appointment to find it has been cancelled are entitled to free exit
The hospital’s Parking Offices are situated at:
Security Room at Hillingdon Hospital
Main reception at Mount Vernon Hospital
Leadership at Mount Vernon Cancer Centre: When Dr Peter Ostler retired in May 2012, Dr Catherine Lemon became Divisional Chair for Cancer Services, East & North Herts NHS Trust, which includes leadership of the Mount Vernon Cancer Centre, Dr Ostler is now focused exclusively on his consultant activities within the Cancer Centre.
In an interview in August 2012, Dr Lemon outlined the many changes that have recently affected Mount Vernon Cancer Centre.
New equipment: A new CT simulator for radiotherapy planning has been installed, also two new linear accelerators, which are opposite Ward 10. These true-beam machines will allow improved daily adjustments for patients undertaking radiotherapy treatment.
The department was under pressure whilst awaiting new equipment, but staff co-operation allowed 8am to 8pm use of the existing equipment, so that patients could be provided with the services that they needed.
One old linear accelerator will be taken out in December, reducing the complement from nine to eight but, with some adjustments to working routines, eight modern machines will meet all the Cancer Centre’s needs. In the New Year, after the linac has gone, the nuclear medicine department, currently sited at the opposite end of the heritage building, may possibly move to be nearer the cancer centre, which would make nuclear medicine more easily accessible and allow better integration with other departments – this would also facilitate the siting of a new gamma camera, used for diagnostic purposes.
Academic partnership with the Royal Marsden Hospital: The partnership is proving very fruitful in shared expertise and services. A joint evening for staff is taking place in September, to mark the first year of the partnership.
Changes to London’s Cancer Services: The five former networks are being replaced by two new cancer groups. South, West and North West London, including our own area, form the London Cancer Alliance. Initially Mount Vernon Cancer Centre was excluded from these developments but that is now rectified. Mount Vernon now has a seat on the Board, fully justified by the number of patients that the Mount Vernon Cancer Centre serves - approximately 450,000 patients from the 1.9m London Cancer Alliance population .
Within the London Integrated Cancer System, surgery is being centralised, to provide more experienced clinical teams. Pathways are being developed for each tumour type, a process in which Mount Vernon is actively involved. In future commissioners will pay for complete care pathways, rather than for component parts.
Academic Health Science Networks: The aim is to bring together universities, commerce and NHS bodies, to further co-operation in research, with the expectation that all NHS bodies will eventually join an AHSN. Initially each NHS Trust was able to join only one AHSN, but this has been relaxed, allowing Lister services from East & North Herts. Trust to join the Cambridge AHSN whilst the Mount Vernon Cancer Centre joins the Imperial AHSN. For Mount Vernon this strengthens its existing research linkages.
Vision for improvement of the Mount Vernon Cancer Centre: East & North Herts NHS Trust is committed to updating the Cancer Centre facilities and is developing its 2015 Strategy to rebuild at Mount Vernon. It is in discussions with its landlord, The Hillingdon Hospitals NHS FT. The need is clear. Both the inpatient wards and the radiotherapy outpatients’ department are inadequate. Chemotherapy needs in the years ahead are more difficult to predict as more chemotherapy may be administered at local hospitals or in patients’ homes, so flexibility is essential. The vision is being developed and after presentation to the Trust Board in September 2012 this will pass to planners and architects, with costings in due course. Chemotherapy changes have already allowed Marie Curie Ward to change its role, providing extended day services, as late as 7pm, so that patients do not need to stay overnight – 18 reclining chairs at around £1000 each are already bringing benefits for its patients!
Guest speaker agreement: Dr Lemon has agreed to be guest speaker at the meeting of The Community Voice - of which Ruislip Residents' Association is a member - on 7th March 2013, by which time there should be more exciting news for her to convey.
As part of the update programme, one linear accelerator has been replaced, but two more have been taken out for replacements to be fitted in August, so the Radiotherapy Department is under pressure and its is working 8am- 8pm Monday to Friday. Another linac will be replaced in December – there will then be seven modern linear accelerators on site.
Mount Vernon Cancer Centre now has a seat on the London Cancer Alliance, which will allow it to have input to that Alliance, which previously was missing
New parking arrangements and charges:
Fines for parking transgressions are being levied - £35 if paid within 14 days or £50 if not then paid. 12 hour tickets are being extended to 14 hours to accommodate staff working 12 hour shifts. There have been some complaints from people who previously parked on grass outside proper parking spaces.
New publicity posters about parking charges:
A3 laminated posters are to be displayed in both hospitals, noting the new tariffs but also showing the concessions for frequent attenders, wheither as visitors or as patients.
Problems have arisen with these newly installed machines but the manufacturers are expected to resolve the difficulties early in February.
Buses serving Mount Vernon:
Negotiations are ongoing and a resolution is expected soon to allow buses to come further onto the Treatment Centre site.
Staff car sharing events:
Events are being held to introduce staff to other staff members who might possibly be able to share travel arrangements. These events will take place on 9th February and 13th March at Hillingdon Hospital and on 23rd February and 15th March at Mount Vernon.