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Head and neck services review

review of head and neck cancer services has been underway since November 2009 and covers Bristol, North Somerset, South Gloucestershire, Bath & North East Somerset, Somerset and Wiltshire PCT areas. The aim of the review is to improve outcomes for patients with head and neck cancers through the delivery of excellent services by identifying the best service model and location for these services. The scope of the review was expanded to cover ENT and OMF services for patients treated in the Bristol hospitals based on feedback from clinicians. For patients receiving ENT and OMF services outside of Bristol, services are not expected to change.

A service model has been developed jointly by clinicians from all the trusts in Bristol and Bath providing these services and endorsed by patients, PCTs , acute trusts and Local Involvement Networks (LINks). The model outlines a hub, satellite and spoke approach. This proposes the centralisation of complex surgical care in a Bristol hub with other services where possible being provided closer to home. The satellites will provide some diagnostics and routine surgery and the spokes will provide rehabilitation and follow up.

There were two potential options for the location of the Bristol hub: within the new Southmead Hospital ( part of North Bristol NHS Trust ) and within the BRI (part of University Hospitals Bristol NHS Foundation Trust).

An advisory panel was chaired by Professor Patrick Bradley, who has recently retired as Consultant Otolaryngologist / Head and Neck Oncologic Surgeon from Nottingham University Hospitals NHS Trust and has been involved in the Peer Review process. The panel met to assess stakeholder views and consider current activity data to make a recommendation to the Project Board on the preferred site for the Bristol hub. The panel was asked to assess the important clinical adjacencies from presentations from key stakeholders, including all the clinical disciplines involved in the treatment of patients with head and neck cancers, patient representatives, Local Involvement Networks (LINks) and Trust managers. They came to the conclusion that UHB should be recommended as the site for the centralised hub because it could best provide:-

• Clinicians’ aspirations for a Head and Neck Service and Institute which maximises integrated working and adjacencies
• Likely developments in cancer treatment in the medium term e.g. Oncological interventions
• The location that offered best opportunity for coordinated service provision for patients

The Project Board ratified the Panel’s recommendation and this is now being subjected to a process of due diligence. This process is designed to test that UHB can deliver the agreed clinical model within the resources available and meet the required performance targets.

If you would like to know more about the Review, we would be happy to come along to one of your Locality Board meetings. Please let Emma Phillips know if this is the case. Emma can be contacted at emma.phillips@bristol.nhs.uk or on 0117 984 1629.