Independent advice to Velindre NHS University Trust


Published: 06/10/2020

Project status: Current

What is this project?

The Nuffield Trust has been commissioned by Velindre University NHS Trust to provide independent advice on the clinical model underpinning its planned changes to Velindre’s cancer services contained in its Transforming Cancer Services programme.

The planned model includes delivering more care within patients’ homes; development of a number of Velindre@ facilities on Local Health Board sites across South East Wales, providing chemotherapy, outpatient and support services; a radiotherapy satellite centre in Nevill Hall Hospital, Abergavenny; and the redevelopment of the Velindre Cancer Centre on a new site at Northern Meadows in North Cardiff.   

This piece of work will assess the proposals for the planned changes to non-surgical tertiary cancer services across South East Wales and clinical concerns raised about plans to build the new Velindre Cancer Centre on the proposed site.  

What is within the scope of this work?

This project will seek to provide advice to Velindre on the following questions:

  1. What are the benefits of the planned regionally integrated network clinical model for non- surgical tertiary cancer services?
  2. What are the risks inherent in the planned regionally integrated network clinical model, including the location of the main non-surgical tertiary cancer centre on the Northern Meadows?
  3. Are the strategies proposed to manage these risks satisfactory and what else might be considered with regard to:
    1. additional opportunities to strengthen planned arrangements
    2. prioritising/accelerating any specific areas of planned work
  4. What are the risks and benefits of the planned regionally integrated network clinical model with regard to research, development and innovation?
    1. How does the network model support high quality research and development and promote innovation?
    2. How might any risks be mitigated?
  5. How could the benefits/opportunities be further optimised with learning from other health care systems? Are there any broader development opportunities related to cancer/related healthcare that could be considered to maximise the opportunity?

What is not within the scope of this work?

This project is about providing independent advice to Velindre but it is not a wholescale independent review of the project. The scope of this piece of advice is tightly defined and relates specifically to the clinical management of the planned regionally integrated network model for non-surgical tertiary cancer services and the location of the new Cancer Centre at Northern Meadows.

It does not seek to offer a definitive verdict on any broader plans to reconfigure cancer services in South East Wales and will offer no view on other important issues such as environmental concerns, inequalities impact or financial or cost considerations.

Who is carrying out this work?

The work will be carried out by a small team from the Nuffield Trust and assessed by a panel of clinical experts. The Nuffield Trust team will be led by Chief Executive Nigel Edwards and the project work will be delivered by Hilary Wilderspin, with input from Dr Louella Vaughan.

Nigel Edwards is Chief Executive of the Nuffield Trust.  His career has been spent in health service management and health policy, focusing particularly on innovation and change in the delivery of health services in the UK and internationally. Nigel’s work and interests are wide ranging, from the development and implementation of new models of service delivery at the front line to wider health care policy in the UK and internationally. 

Hilary Wilderspin is a Senior Associate at the Nuffield Trust. She is an experienced health service manager who has worked at all organisational tiers of the NHS and in the private sector. Hilary’s core skills are in strategy and business case development, option appraisal, project management and problem solving. She has led strategy review and development work across a broad range of subjects, including cardiac, cancer, neonatal and community services, and waiting list/time management.

Hilary worked in the acute provider sector for the first 10 years of her career both managing direct clinical services and undertaking service reconfiguration and business case development work and has an excellent understanding of the components and dependencies of a wide range of clinical services. Since 2000 Hilary has enjoyed a successful career as both a freelance and retained consultant working with clients such as the London Cancer Alliance, the Integrated Cancer Centre, South East London (Guy’s and St Thomas’ and Kings College Hospitals), South East London Cancer Network, the Department of Health, South Central SHA and the Government Office, East of England.

Louella Vaughan is an Acute Physician and clinical academic who has extensive experience in research in networked care and care in remote locations. Louella works at the Royal London Hospital and for the Northwest London CLAHRC. She is the Research Group Lead and a Council Member of the Society for Acute Medicine, is a member of the NICE Clinical Guideline Development Group on Sepsis, an External Clinical Advisor for the Ombudsman and has sat on a number of Working Parties of the Royal College of Physicians, including the Future Hospital Commission.

How will the project be carried out?

This work will be carried out in three phases:

Phase 1 

Information gathering:  reviewing existing literature and evidence from healthcare systems around the world, together with clinical/operational information.

Phase 2

Engagement: The Nuffield Trust team will interview clinicians and healthcare professionals within the Velindre Trust and with partner organisations, as well as patient representatives to gather further views and evidence on the model.

Phase 3

Analysis and findings: The information and evidence gathered will be examined and analysed by a panel of eminent cancer experts, drawing out the key findings and any recommendations for Velindre University NHS Trust and the wider regional system.

The final output will be a report detailing the Nuffield Trust’s advice to Velindre University NHS Trust, taking into account the views of the expert panel. This will be published as an independent Nuffield Trust paper, to be hosted on the Nuffield Trust website. We expect to publish this work in November 2020.

Who is being interviewed and how have they been selected?

The project will involve interviews with staff across the Velindre University NHS Trust, professional representative groups, local health boards and patient representatives. The Nuffield Trust has specifically requested to be given access to a cross-section of interviewees, including those who have concerns about the proposal. Velindre University NHS Trust is providing the administrative and logistical setup for these interviews.

Interviewees will be listed in the final report, though we will ensure that comments are not attributed to individuals.

Who is on the expert panel and how has it been selected?

The expert panel will be made up of eminent cancer experts from across the UK who are volunteering their time to critically assess the Nuffield Trust’s work. Their involvement with the project will begin at phase 3 and they will be named in the final report. 

The panel has been engaged by the Nuffield Trust on the basis of their expertise and knowledge of cancer care. Velindre and partners have supported the Nuffield Trust in identifying some of the panel members.