February 2, 2023 8.55 am This story is over 23 months old

Overnight hospital cancer treatment will no longer be delivered in Grimsby

Patients will have to travel to Hull instead

Overnight hospital cancer treatment will soon no longer be delivered in Amethyst Ward at the Diana, Princess of Wales Hospital, Grimsby, with patients instead sent to Castle Hill Hospital, Hull.

Haematology services, the diagnosis and treatment of blood and bone marrow diseases, are described as “vulnerable” across the Humber region and all cancer treatment services face “significant pressure”. The plan, as heard by North and North East Lincolnshire Council health panels, is for separately haematology and oncology services to be merged across the Humber as one. Hull University Teaching Hospital Trust (HUTH) will be the lead provider for both.

National staff shortages had already prompted considerable linkage between HUTH and Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) to run both services. Most ways in which patients for in each service are seen to will remain the same following changes already made in recent years.

With staffing levels still sub-optimal and demand increasing, the Humber merger plan for each is aimed to be brought in in 2023/24.

Directing his remarks in terms of cancer care, NLAG’s chief executive Dr Peter Reading said: “For most patients nothing relating to their care will change. This is the firming up of measures brought in almost two years ago to ensure that patients get the right care from the right expert clinician to meet their needs.

“As cancer treatments have been developed and improved, this becomes an increasingly specialist role, which tends to be done on a regional basis. This is common across the NHS.

“All complex oncological care is already done at Castle Hill Hospital, including inpatient care and radiotherapy. For patients on the south bank most ongoing treatment, including follow-up appointments and chemotherapy will be done either at the Diana, Princess of Wales Hospital, Grimsby, using specialist nurses, or through virtual appointments, with no need to travel.

“Patients needing inpatient care for their cancer will now receive this in the Queen’s Centre at Castle Hill Hospital where they will benefit from the facilities of a dedicated cancer hospital which has 24/7 support from specialist cancer doctors and nurses.”

Cancer care involving overnight stays in hospital will no longer happen in northern Lincolnshire. Such patients with cancer or treatment complications will be sent instead to Castle Hill Hospital. The Amethyst ward at Diana, Princess of Wales Hospital will remain and there will be no impact on staff as a result of the change. HUTH will be ultimately responsible for all oncology, treatment of tumours, activity and relevant financial reporting. The same type of arrangement will also apply to haematology.

The oncology merger was already on the cards, but delayed by the pandemic and essential building work on Queen’s Centre inpatient accommodation in Hull.

Key challenges are identified as needing to be sorted before the mergers to avoid transfer of care delays. These include single IT systems so clinicians have access to the right information at the right time and ensuring support services for patients across the Humber are at the same standards.

Under service level agreements, HUTH already provides the the cancer care for Northern Lincolnshire patients. Outpatient consultations, not requiring overnight stay in hospital, are done at Diana, Princess of Wales Hospital, from Monday to Friday. Each weekday covers a different tumour site, such as the breast.

Non-complex chemotherapy is provided at Grimsby, Scunthorpe General Hospital, and there is an outsourced chemo infusion service run by Lloyds Pharmacy in Scunthorpe. In January, patients who live on the North and North East Lincolnshire border and get chemo at the Diana, Princess of Wales Hospital, have the opportunity to go to the Lloyds pharmacy if it is closer to them.

The principle of care closer to home is the aim of future service arrangements, though factors like demand levels will challenge this. Both haematology and cancer care services in the Humber are facing a number of pressures.

There is a “severe shortage” of therapeutic radiographers and radiotherapy physicists in HUTH, forcing prioritisation based on clinical need. This has caused “considerable delays in treatment initiation” and national targets for this missed.

Chemo day treatment units in NLAG and HUTH are under “extreme pressure due to a combination of increased demand and staffing”. They may have to manage the rate at which new treatments are started. There is reduced capacity of commercial providers to produce off the shelf ready to be given chemotherapy.

This has meant a greater need for chemotherapy treatments to be made by NHS pharmacy aseptic units. A situation aggravated by a national shortage of pharmacists and pharmacy technicians.

All three of these areas are highlighted as “extremely fragile” in the service merger reports to councils. This is as well as sub-optimal medical staff levels, despite some progress in recruitment.

A specific challenge for the haematology merger is the recruitment and retention of consultant haematologists. Since 2017, NLAG and HUTH have worked together to ensure haematology services were delivered across the Humber.

NLAG made the approach for support due to its service being “seriously undermined” by the departure of one its two permanent consultant haematologists. But the Hull hospitals Trust had limited capacity to offer support, so they partnered up.

Effectively, most haematology services have already been rolled into HUTH. All new patients are referred into there and all overnight haematology care is at the Queen’s Centre at Castle Hill Hospital. As are all face-to-face check-ups, including acute assessments. It has also been agreed that the budget and management of three vacant consultant haematology posts switch from NLAG to HUTH.

People admitted with medical problems not a direct consequence of their haematology or oncology health conditions are treated still in northern Lincolnshire. Despite the challenges such as single IT systems, making both services Humber-wide level in 2023/24 is described as achievable.