About the change

This section includes information about why things need to change and who is affected by the change.

Children’s cancer centres (known as Principal Treatment Centres) are responsible for making sure every child with cancer gets the expert care they need. They are mainly for children aged 15 and under with cancer (they can carry on caring for older children if that is best for individual patients).

NHS England (London and South East regions) ran a 12-week consultation, from 26 September to 18 December 2023, on changes to where very specialist cancer services that lead and coordinate care for children aged one to 15, are based. These changes affect the Principal Treatment Centre for children with cancer living in south London and much of south east England.

The Principal Treatment Centre for south London and much of the south east is currently provided in partnership between The Royal Marsden NHS Foundation Trust and St George’s University Hospitals NHS Foundation Trust.

The teams leading and coordinating specialist care for children with cancer, including chemotherapy, conventional radiotherapy and bone marrow transplants, are based at The Royal Marsden’s site in Sutton. Life-saving intensive care, most children’s cancer surgery, and other specialist services needed by children with cancer are led and coordinated by the teams at St George’s Hospital eight miles away in Tooting. The service currently provided jointly by the Principal Treatment Centre is high-quality and safe.

There are five main reasons why the specialist children’s cancer services at The Royal Marsden need to move to be on the same site as a children’s intensive care unit.

1. The current Principal Treatment Centre does not meet national requirements 

National requirements for Principal Treatment Centres are set by NHS England. They say very specialist cancer treatment services for children – like those at The Royal Marsden – MUST be on the same site as a level 3 children’s intensive care unit and other specialist children’s services. This is non-negotiable. The current Principal Treatment Centre does not and cannot comply.

The national service specification for Principal Treatment Centres was approved by NHS England in 2021 after being developed with patients, parents and professionals.

2. Hospital transfers of very sick children for intensive care) add risks and stress 

Every year, a small number of very sick children with cancer, who need intensive care, are transferred eight miles from the specialist children’s unit at The Royal Marsden’s Sutton site to St George’s children’s intensive care unit at Tooting. This is done safely. But urgent transfers of very sick children to another hospital for level 3 intensive care services that can give life support, even in a special children’s ambulance with an expert team on board, add risks to what is already a very difficult situation. These risks can only ever be managed. Transfers of very sick children also put added stress on patients, parents, and the staff involved.

Patient transfers from shared care units in local hospitals to the specialist children’s cancer centre, including emergency patient transfers, would not be affected by our proposals. By their nature, most shared care units are a long way from the specialist centre. They are all on sites which have beds where children can be closely monitored and given support. Children are only transferred for level 3 care when it is unavoidable.

3. The intensive care team is not currently able to provide face-to-face advice on the care of children on the ward 

Currently, the Principal Treatment Centre’s intensive care specialists are at St George’s Hospital while most specialist care for children with cancer is at The Royal Marsden. Some children every year have to be transferred by ambulance from The Royal Marsden to the cancer ward at St George’s Hospital as a precaution, in case they suddenly get worse and need intensive care. It can be disruptive and stressful for them.

Intensive care specialists can’t work closely with specialist cancer teams to help children stay well enough to avoid intensive care if they are not all on the same site.

4. There is a need to improve children and families’ experience when patients require intensive care and other specialist children’s services 

Some specialist children’s services needed by children with cancer are not on site at The Royal Marsden, because it is a specialist cancer hospital. Staff at The Royal Marsden arrange for children to attend or be safely transferred to other hospitals as needed.

Parents and staff say having to get to know new members of staff at different locations, especially at a time of crisis, can also increase families’ anxiety and distress.

Children’s cancer care is complex. Our proposals would not eliminate the need for children to get specific kinds of expert care at different hospitals. Under our proposals, conventional radiotherapy would also move to University College Hospital. Instead of some (as now), all children who need radiotherapy would go to University College Hospital.

5. Although it offers a wide range of innovative treatments, the current Principal Treatment Centre is excluded from giving a specific type of new treatment, and others expected in the future 

Innovative cancer treatments are bringing new hope for children and families. Some have a greater risk of complications – such as too big a response from a child’s immune system – that could require urgent support from an onsite intensive care team. As a result, they can only be given at children’s cancer centres on the same site as a children’s intensive care unit. This is the case for ground-breaking CAR-T treatment, which uses a child’s own, treated, cells to fight their cancer. Many more of these treatments are expected to become available in the next few years.

The Principal Treatment Centre for south London and much of the south east is currently excluded from giving this type of life-saving treatment. There is a compelling case to move the centre so it has the same opportunity to provide future treatments as other major centres worldwide.

It is a national clinical requirement for very specialist cancer treatment services for children to be on the same site as a children’s intensive care unit and other specialist children’s services.

The current service for children with cancer who live in south London and much of the south east does not and cannot meet this requirement. As a specialist cancer hospital, The Royal Marsden does not have a level 3 children’s intensive care unit (which can give life support) on site. Children’s intensive care units are always on sites used by tens of thousands of children every year because intensive care teams need to see high volumes of very sick children to maintain their specialist skills and expertise. This wouldn’t be possible at The Royal Marsden due to the smaller number of children who need treatment there.

A children’s intensive care unit needs to be on the same site as supporting specialist children’s services. Children’s intensive care units are always on sites used by many thousands of children every year because intensive care teams need to see high volumes of very sick children to maintain their specialist skills and expertise. The Royal Marsden is an outstanding specialist cancer hospital but therefore does not see enough children to meet these requirements to have a children’s intensive care on site.

As the children’s cancer services currently at The Royal Marsden need to move, we have   two options for the proposed future children’s cancer centre – Evelina London Children’s Hospital and St George’s Hospital. We propose that, under both options, all radiotherapy services for the future children’s cancer centre (instead of some, as now) would be provided by University College London Hospitals NHS Foundation Trust (UCLH) in central London.

If Evelina London became the future Principal Treatment Centre, it would have all the specialist children’s cancer services currently at The Royal Marsden (except conventional radiotherapy) and the specialist children’s cancer services currently provided for the Principal Treatment Centre at St George’s alongside its well-established children’s intensive care unit and other specialist children’s services.

If St George’s became the future Principal Treatment Centre, it would have all the specialist children’s cancer services currently at The Royal Marsden (except conventional radiotherapy) alongside its well-established children’s intensive care unit and other specialist children’s services, including the services it already provides for the Principal Treatment Centre.

Under both options, St George’s would continue to provide a children’s shared care cancer unit for local children, and neurosurgery for some children, including those with cancer. We propose that, under both options, all radiotherapy services would be provided by University College Hospital. Children would continue to travel for some specialist cancer services – such as for bone, eye and liver surgery – because of the specific expertise different hospitals have in these areas.

Research for new drugs and treatments would continue at the Institute of Cancer Research in Sutton, working closely with staff at the future Principal Treatment Centre.

Retaining the expertise and knowledge of the staff within the current service is a priority for us. We will work closely with staff as well as patients and their families in the current service, the cancer network, the Institute of Cancer Research, and other Trusts who provide specialist cancer services to ensure that the move to the new site is as smooth as possible.

We hope that most staff who currently work in the Principal Treatment Centre will want to continue to provide care to children with cancer by moving to the future centre. Supporting them to do so is really important and a priority for us.

Our vision for the future centre is that it will build on all the strengths of the existing service and give best quality care, achieving world-class outcomes for children with cancer for decades to come.

About 1,400 children, most aged one to 15, are under the care of the Principal Treatment Centre at any given time. More than 60% of the centre’s patients are from outside London. About 190 children aged one to 15 living in south London and much of the south east are diagnosed with cancer every year.

The options

This section includes information about the two options for the future Principal Treatment Centre, Evelina London Children’s Hospital and St George’s Hospital.

Our process to identify possible ways of providing very specialist cancer treatment services for children which are currently at The Royal Marsden found one solution that met all the criteria. This is that the future service must be based at an existing hospital in south London that provides specialist children’s services and has a children’s intensive care unit.

This led to the two options that are under consideration and that we received feedback about in the consultation. They are for the future Principal Treatment Centre to be at either:

  • Evelina London Children’s Hospital, in Lambeth, south east London, run by Guy’s and St Thomas’ NHS Foundation Trust, with conventional radiotherapy services at University College Hospital

or

  • St George’s Hospital in Tooting, south west London, which is part of St George’s University Hospitals NHS Foundation Trust as well as St George’s, Epsom and St Helier Hospitals and Health Group, with conventional radiotherapy services at University College Hospital.

Under both options, the children’s cancer shared unit would continue to be at St George’s as would neurosurgery. All radiotherapy services would be provided by University College Hospital. Children would continue to travel for some specialist cancer services because of the specific expertise hospitals have in these areas.

We followed a best practice approach to understand the possible solutions for the future centre. Working in partnership with parents, cancer charities, staff, researchers, independent experts, the Trusts and the Programme Board (which oversees our work), we did this by:

  1. agreeing a list of things that will not be affected by the service change (such as the specialist services which will continue to be delivered at specific hospitals, like neurosurgery, which will remain at King’s College Hospital and St George’s Hospital wherever the future Principal Treatment Centre is based), which we have called ‘fixed points’. It is a fixed point that the proposed options must deliver a Principal Treatment Centre on the same site as a paediatric intensive care unit. This is the purpose of the programme. Its success must not depend on changes to other models of care.
  2. agreeing basic things that need to be delivered by any option we put forward, which we have called ‘hurdle criteria’. They include:
    • the need for the service to be based in Greater London so it is accessible for everyone across the catchment area
    • the ability to comply with the NHS England service specification including the provision of a level 3 children’s intensive care unit.
    • the ability to deliver the future centre within two and a half years of final go-ahead
    • the need for the option to be affordable.
  3. drawing up a list of every way the Principal Treatment Centre could be provided in the future
  4. applying the fixed points and hurdle criteria to the initial list of eight possible solutions. If you would like to know more, please see our information on how we identified the options.

This identified that the future service must be based at an existing hospital in south London that provides specialist children’s services and has a children’s intensive care unit. This led to the two options that are under consideration and that we received feedback about in the consultation.

Before the consultation began, both Evelina London and St George’s answered questions themed on key areas which are considered very important for the future Principal Treatment Centre:

  • clinical services – aspects of the services the two hospitals provide that would be important for the future centre
  • patient and carer experience – how the two hospitals would support children with cancer and their families
  • enabling (non-clinical) factors – everything the future centre would need to have to work smoothly. This included looking at impacts on staff
  • research – what the hospitals, and the Trusts that run them, do now for research and what they would offer the future centre.

Their answers were reviewed and scored by four panels, one for each key area. In total, more than 30 experts – independent nurses and doctors from London, the south east and further afield with no involvement in the current or future Principal Treatment Centre, parents, representatives of children’s cancer charities, independent researchers, managers, experts in specific fields including emergency preparedness and human resources, and staff from NHS England London and NHS England South East regions – were part of these panels. Some areas – including travel times – were scored using statistical data, not assessed by the panels. If you would like to know more, please see our information on how the evaluation criteria were developed and how the options were assessed and scored.

In the evaluation by the expert panels, Guy’s and St Thomas’ NHS Foundation Trust’s proposal on behalf of Evelina London Children’s Hospital scored higher than St George’s University Hospitals NHS Foundation Trust’s proposal on behalf of St George’s Hospital (80.5% compared to 75.3%). The biggest differences in scores were for clinical services and research. Evelina London scored higher on three of the four sub-criteria for the clinical services key area and on all three sub-criteria for research. St George’s Hospital scored higher on two of the five sub-criteria for patient and carer experience. Other scores were the same or very similar. If you would like to know more, please see our information on how the options were assessed and scored.

The assessment undertaken before the consultation by panels of experts gave us a better understanding of the strengths of both options. Both options scored highly in the pre-consultation evaluation but Evelina London Children’s Hospital scored higher. On this basis, we made it clear ahead of the consultation that, at that stage in the process, Evelina London was the site we preferred for the future Principal Treatment Centre.

However, the decision on the location of the future centre (including the proposed move of conventional radiotherapy services) has not been made. In taking the decision, leaders from NHS England (London and South East Regions) will look at all the evidence available to them, including feedback from the public consultation, as well as other evidence such as the integrated impact assessment, environmental assessment, evidence from the Trusts and other relevant information.

As we go into this next phase of work, we remain open-minded about both options.

We held a public consultation to involve the public and get their views on the options. This is in order to meet our legal obligations and enable us to make a decision, based on all the relevant information.

Both Evelina London and St George’s Hospital meet all the criteria and want to provide the service. Both scored highly in the evaluation process. We consulted with an open mind on both options which means we are, and remain, open to all feedback and new information that the public have shared through the public consultation. All of this will be considered in preparing to make a final decision.

Making a decision and next steps

This section is about how we will decide on the location of the future Principal Treatment Centre and when we expect the move to happen.

Leaders for NHS England (London and South East regions) will choose the option for the proposed future Principal Treatment Centre that gives them the greatest confidence that it will deliver the best quality care for children with cancer in the future.

In taking this decision, they will look at all the evidence available to them, including feedback from the public consultation. They will consider the need to provide care for children across the entire catchment area (south London and much of the south east).

Feedback received through the consultation is presented in the consultation report (which has been prepared by the independent organisation appointed to analyse it).

When considering the feedback from the consultation, NHS England leaders will not ‘weight’ or ‘score’ it. They will review and consider all the feedback included in the consultation report, as well as other evidence such as the integrated impact assessment, environmental assessment, evidence from the Trusts and other relevant information.

NHS England leaders will consider what impact the feedback has on the existing options assessment, on the basis of which Evelina London became the preferred option. This was based on proposals submitted by both Trusts and was undertaken by panels of experts before the consultation, it considered clinical services, patient and carer experience, key enablers for success (such as staffing), and research.

This will help them to decide which option would offer the best care for children with cancer.

Feedback received through the consultation has been reviewed by an independent organisation appointed for this purpose. They analysed it by theme of what people said, and by group of who said it, such as, parents and carers, children and young people and staff.

They have prepared a consultation report which is published on this website, and has been shared with NHS England leaders who will review and consider all the feedback included in the report.

They will also consider a document called a decision-making business case that we will produce, and which will set out, among other things, how we have taken account of the feedback received.

NHS England (London and South East regions) will consider all information that has been received through the consultation. This will include any information that suggests further evaluation of options may be needed and information that it is important for us to take into account during the implementation stage, regardless of which option is chosen.

There will be no sudden changes to how children and young people receive care. The future Principal Treatment Centre would not be ready until late 2026 at the earliest. The move would be carefully planned with the full involvement of current teams and clear information for parents and families. We recognise, as with any move of service, there would be risks we need to manage, and planning for that is already underway.

Once there is final go-ahead for the future Principal Treatment Centre, we will work closely with staff in the current service, patients and their families, all the Trusts involved, the cancer network, the Institute of Cancer Research, and other partners to ensure that the move to the future site, wherever it is, is as smooth as possible.  All staff involved in the service would have the opportunity to be part of this work. Patients and parents will also be able to help design the new service – the team running the future centre would make sure that people from different groups and communities have the chance to get involved.

As with any change, there will be things we need to focus on managing, however, all the Trusts involved in this consultation are committed to making a success of this for children with cancer, and to working together to achieve it.

The decision about the future location of very specialist cancer treatment services for children living in south London and much of south east England will be discussed at a meeting on Thursday 14 March, which is due to start at 10:30am and will last approximately three hours. It will be held at NHS England’s offices, Wellington House, 133-155 Waterloo Road, London, SE1 8UG. The final agenda will be published in advance.

The decision-making meeting will be held in public. This means that members of the public can observe the meeting. It will be live streamed so as many people as possible can watch the meeting.

To facilitate this for a wide audience, the meeting will be live streamed. A link will be available on this website.

In addition to the live stream, there will be a limited number of spaces available for people to observe in person. To book one of these spaces, please register via an Eventbrite link on this website that will go live from 10am on Wednesday 6 March. In-person attendance will be determined on a first come first served basis.

The meeting will also be recorded and details of how to access the recording will be posted following the meeting.

The agenda will be published on the key information page a week before the meeting. All other meeting papers will be published on the day of the meeting.

Travel and access

This section includes information about travel to the future centre and how travel times for patients and staff contributed to the scores for the two options.

We recognise that parents and families are worried about travelling by public transport with a severely ill or immunosuppressed child. They are also worried about driving into London, with the costs, the congestion, and difficulties parking. To date we have considered this in a number of ways.

To work out the impact of the move on children and families’ travel times, an independent travel analysis looked at journey times. It was based on anonymised addresses for the patients who were admitted to hospital as inpatients in 2019/20. The analysis found both options would be very similar or faster to get to by public transport than the current Principal Treatment Centre at The Royal Marsden and St George’s Hospital for the vast majority of people. By road, for many people going to St George’s and most going to Evelina London, it would be slower.

To understand the impact on travel times of our proposal to move conventional radiotherapy services from The Royal Marsden to University College Hospital, an independent analysis was carried out. It compared travel times to The Royal Marsden and University College Hospital by car and by public transport for all children across the catchment area.

The analysis found University College Hospital would be faster to get to by public transport and slower by road than The Royal Marsden for most children in the catchment area.

An assessment of travel times formed part of our evaluation criteria.  Some concerns about how travel times were assessed and scored were raised with us. In response to this we ran checks which assumed more children came by car and fewer by public transport, to see what effect that had on the scores. It reduced the scores for both options but, even if we assumed all families drove, the overall result stayed the same. If you would like to know more, please see our information on how travel times were assessed and scored for this consultation.

The group advising on our impact assessment has looked at help with travel for children and families. Both Guy’s and St Thomas’ NHS Foundation Trust (which runs Evelina London), and St George’s University Hospitals NHS Foundation Trust (which runs St George’s Hospital) have been involved in this work and are committed to making things as easy as possible for children and families, if they were to become the future children’s cancer centre.

  • If a child has a medical need that prevents them using public transport, they are eligible for patient transport. This would include if they are immunocompromised and have no access to a car. Patients who need to be closely monitored during the journey or are likely to need assistance because of their treatment (such as being sick) may also be eligible. Guy’s and St Thomas’, St George’s and University College London Hospitals have dedicated patient transport teams.
  • Both Guy’s and St Thomas’ and St George’s would offer parking for children and families accessing the future cancer centre if it was at their hospitals. There would be a drop-off zone and dedicated parking outside the children’s cancer centre at St George’s. Through the equality and health inequalities impact assessment work, Guy’s and St Thomas’ on behalf of Evelina London has confirmed that, in addition to an existing drop-off zone, dedicated parking for patients with a weakened immune system, including those visiting the cancer centre, would be available, in St Thomas’ Hospital car park, less than a five-minute walk away from Evelina London.
  • All three organisations are able to reimburse parking and support parents/carers travelling with children to/from hospital to access reimbursement for Ultra Low Emission Zone (ULEZ) charges. Evelina London and University College Hospital would also support with reimbursement for congestion zone charges.
  • As now, families on low income or benefits may be able to reclaim public transport costs under the Healthcare Travel Costs Scheme
  • Evelina London’s volunteers would support families as mobility assistants, especially families with disabilities. There would also be a volunteer driver scheme.
  • St George’s helps families with travel arrangements for appointments and to make the journey home by taxi or patient transport after a hospital stay.

The Royal Marsden, in collaboration with Great Ormond Street Hospital and University College Hospital (which also provide specialist cancer services) has guidance which advises children and families that it is safe to travel on public transport for children with cancer, even with a weakened immune system. The guidance says that for some patients, it might not always be appropriate to be in crowded areas, depending on the treatment they are receiving. It says that clinicians should assess patients on a case-by-case basis. For instance, staff at Great Ormond Street give specific advice to bone marrow transplant patients and advise, if possible, not to travel at peak times. The guidance is reviewed on a regular basis with clinicians across all three hospitals to ensure the best interests of children and their families are considered at all stages of their treatment journey. Although hospital guidance says it is safe, parents and carers have told us they have worries about travel and would prefer to travel by car.

The group advising on the equality assessment has also made recommendations for the future Principal Treatment Centre on how to reduce the impact of this change on families. These include:

  • help for patients and families to plan their journeys to hospital, including easy to understand information in different languages
  • getting their travel costs paid quickly. Help to access other financial support
  • improving non-emergency transport services for patients and their families
  • space for families to stay
  • easy arrangements at the site, including for dedicated parking and drop-off
  • convenient appointment times, more care closer to home, strong communication between different health and social care teams, and online or phone appointments
  • an excellent plan to support patients during the move, with a named care coordinator (such as a specialist cancer nurse) for each child and family.

The team running the future centre will need to act on these recommendations. Everyone involved is committed to doing so.

Staff have told us that travel to work is important. As part of our evaluation criteria, we therefore looked at the change in travel times for staff. The independent analysis was based on the anonymised addresses of actual members of staff at The Royal Marsden (and, for the Evelina option, St George’s) who would qualify to transfer to the future centre, if they wanted to. The options appraisal looked at travel times by public transport. It found both options are very similar or faster to get to by public transport than their current workplace for most staff.

We recognise that the vast majority of staff at The Royal Marsden currently drive, walk or cycle to work and this is unlikely to be possible after the move.

We analysed average travel times for staff who drive to work at The Royal Marsden and found it is 32 minutes. Travel times to work by public transport would increase to 70 minutes to Evelina London or 69 minutes to St George’s.

Staff would be able to claim back extra travel costs caused by the move for up to four years, as part of their protected rights. Whichever hospital was the site of the future Principal Treatment Centre, they would also be entitled to inner London weighting.

Engagement

This section includes information about our engagement with key stakeholders and how we have used their feedback to inform this consultation.

We involved key stakeholders in developing our plans for pre-consultation and consultation. These stakeholders included our Stakeholder Group of parents and local and national charities, NHS Trust and Integrated Care Board communications and engagement colleagues, and Overview and Scrutiny Committees within the service catchment area as well as children and young people themselves.

Pre-consultation period

  • targeted online surveys – tailored to specific groups with specific questions on travel and access for those directly providing or experiencing the current service
  • on the ward surveys – visits to wards at The Royal Marsden, St George’s Hospital and Evelina London to directly engage with children and young people and their families.
  • face to face events and focus groups for staff
  • online on-demand briefing sessions
  • attendance at meetings (by invitation)
  • meetings with Overview and Scrutiny Committees which deemed this change as substantial for their populations – formal meetings open to members of the public
  • meetings with MPs whose constituents may be affected
  • meetings with our Stakeholder Group of parents and local and national charities
  • attending a Teenage and Young Adults Forum at the Royal Marsden Hospital
  • a session with children’s cancer shared care unit staff and patient representatives

In total, we had 739 responses to this phase of engagement, which included 27 engagement sessions, 313 responses to online surveys and seven ward visits.

Consultation period

The 12-week public consultation ran from 26 September to 18 December 2023, activities included:

  • targeted questionnaire (both online and paper copies)
  • onsite visits to The Royal Marsden and children’s cancer shared care units outpatient areas to directly engage with children and young people and their families, and record their views
  • play therapy sessions with children and young people with cancer
  • three online public events to provide more information about our proposals and to seek feedback
  • focus groups for families with/without direct experience of cancer, staff at all three Trusts and wider NHS staff (e.g. staff at other Principal Treatment Centres, staff working in children’s cancer shared care units)
  • attendance at meetings and forums with equalities groups such as families with children with learning disabilities and ethnic minority forums
  • targeted efforts to reach equalities groups and requests to them to spread the word to their members and networks
  • 1:1 interviews as requested
  • meetings with Overview and Scrutiny Committees
  • meetings with MPs whose constituents may be affected
  • paid for social media campaign – to raise awareness of the consultation and encourage people to share feedback.

Staff have been involved throughout this process. Our early engagement took place during 2020-2021.

A small number of staff were involved in two working groups for the programme, shaping the fixed points and hurdle criteria for assessing the potential options, and the evaluation criteria for assessing the two proposals, working alongside other independent experts.

The groups were:

  • a clinical advisory group involving clinicians from St George’s, Evelina London, King’s College Hospital NHS Foundation Trust, and The Royal Marsden. They considered and commented on the fixed points, hurdle criteria and evaluation criteria. Representatives from the children’s cancer and strategic paediatric network for south London and South East region attended the meetings. Both networks supplied written submissions to the chair of the clinical advisory group
  • a group of senior managers and clinicians from the same four Trusts who considered the impacts of the change on staff and what would be needed to deliver it (in terms of capacity and activity).

There was also a workshop with staff from The Royal Marsden, St George’s and Evelina London Children’s Hospital to capture their views on what the future Principal Treatment Centre could deliver. Discussions highlighted concerns about support to staff during the change process.

This led to more in-depth work with staff at The Royal Marsden, which found that staff wanted to:

  • be reassured that the benefits (such as childcare and opportunities for staff learning and development) they currently receive at The Royal Marsden would be maintained or improved upon by the future Principal Treatment Centre, wherever it is
  • to understand the likely difference to their travel times to work for both of the shortlisted options.

Both these points were incorporated into the ‘impact on staff’ element of the evaluation criteria as a result of this feedback.

During the pre-consultation engagement period between mid-April 2023 and the end of August 2023, we held briefing sessions and undertook surveys with staff at Evelina London, St George’s and The Royal Marsden.  At the briefing sessions, we provided an overview of our work to date and gathered feedback from staff.

A summary of their feedback was then shared with them, along with a survey to give staff who were unable to attend the engagement sessions an opportunity to share their thoughts and raise any questions they had.

During the consultation period (26 September to 18 December 2023), all three Trusts shared letters from NHS England with their staff to encourage them to respond to the consultation and share their views. Staff were encouraged to share their feedback via the questionnaire, for instance by being given time during working hours to do this. Feedback sessions were held at each of the Trusts where staff were invited to share their views. Staff were also encouraged to share any feedback via email. During site visits and on demand, there were opportunities for staff to share their feedback on a 1:1 basis.

We will continue to engage with staff as we move through the different stages of this reconfiguration process.

In the run up to consultation, we engaged with the London and South East Clinical Senates, the London Mayor, MPs, Overview and Scrutiny Committees, including Joint Health Overview and Scrutiny Committees for south west London and Surrey, and south east London, Integrated Care Boards for south London and much of the south east, and NHS England assurance experts. All gave us helpful feedback from their different perspectives on different aspects of our work.

The London and South East Clinical Senates are expert groups of senior clinicians who tested our proposals before the consultation and gave us helpful advice. You can read more about this in their report and our response to it.

Experts in NHS England and the London Mayor are helping to make sure our proposals are robust and satisfy the government’s and NHS tests, and the London Mayor’s tests which apply to any impacts on Londoners.

We worked closely with parents and other stakeholders who advised us on our pre-consultation activity and helped to plan our consultation activities. This is covered in our pre-consultation feedback report.

During the consultation period, we sought to be responsive to feedback that we received.  For instance, some parents gave us feedback about the timing of our public events. They suggested offering more flexible timings to work around their caring responsibilities and other commitments. As a result, we arranged smaller focus groups at a range of different times to try to reach as many families as possible.

We also received feedback that some families, due to time constraints and caring responsibilities, wanted more flexible ways to give their feedback. We therefore prepared some targeted communications to remind people that there were several ways that feedback could be shared. This included via email, the easy-read version of the questionnaire and the opportunity for one-to-one telephone calls or virtual meetings. We also visited The Royal Marsden and spoke to families who were attending appointments. We received anecdotal feedback that this was a good approach, one we had previously used during the pre-consultation engagement phase.

This page was last updated on 31 January 2024.