The Children’s Cancer Principal Treatment Centre (which we call the Children’s Cancer Centre) provides very specialist cancer treatment services for children who live in south London and much of south east England. It is going to move to Evelina London Children’s Hospital in Lambeth, with conventional radiotherapy services at University College Hospital in central London.

This is currently expected to happen in autumn 2026.  As detailed planning gets underway, we will share any changes to this timeline.

We (NHS England London and South East regions) hope as many staff as possible from the current service, with all their experience and expertise, will move with the service. A lot of planning will go into making sure the move is as smooth as it possibly can be for children, families and staff.

Currently the Children’s Cancer Centre for children who live in Brighton and Hove, East Sussex, Kent, Medway, south London, and much of Surrey (the catchment area) is split over two sites: The Royal Marsden in Sutton, and St George’s Hospital in Tooting. Every year, a small number of very sick children are transferred from The Royal Marsden to St George’s Hospital for intensive care.

This is done as safely as possible. But urgent transfers of clinically high risk and very sick children to another hospital for intensive care, even in a special children’s ambulance with an expert team on board, add avoidable risks to what is already a very difficult situation.

The national service specification (PDF), which sets the standards and requirements for Children’s Cancer Principal Treatment Centres, says very specialist cancer treatment services – like those at The Royal Marsden – must be on the same site as a children’s intensive care unit, for many reasons.

After the Children’s Cancer Centre transfers to Evelina London Children’s Hospital, it will have all the services that the national service specification says must be on site, including intensive care and children’s cancer surgery. It will also be on the same site as specialist children’s services, such as infectious disease services, heart and kidney care, and gastroenterology, that must be readily available for children with cancer.

This will remove the added risks and stress of avoidable transfers for intensive care.

It will also mean the future Children’s Cancer Centre is able to give innovative cancer treatments, such as CAR-T treatment which, because of the risk of complications, can only be given by children’s cancer centres on the same site as a children’s intensive care team.

Conventional radiotherapy which mainly uses high-energy x-rays is currently provided at The Royal Marsden for children with cancer who live in south London and much of south east England.

For other kinds of very specialist radiotherapy – for example, proton beam therapy and brachytherapy – children already go to University College Hospital in central London.

The radiotherapy service at University College Hospital is one of only two very specialist radiotherapy services in the country that provide proton beam therapy. The other is in Manchester. It would be difficult to sustain the conventional radiotherapy service for children at The Royal Marsden without the staff and facilities of the Children’s Cancer Centre on site. In addition, the number of children requiring conventional radiotherapy in the future is expected to fall as more children have proton beam therapy instead, meaning a high-quality service would be even harder to sustain.

As part of the move of the Children’s Cancer Centre, conventional radiotherapy services will therefore move from The Royal Marsden to University College Hospital. All radiotherapy services for patients of the future centre will be at University College Hospital instead of some, as now.

Bringing radiotherapy services together will enable patients to benefit from staff who are very specialist and highly skilled in these treatments for children, with new opportunities for learning, research and clinical trials.

Patients from Southampton, Oxford and Great Ormond Street Children’s Cancer Principal Treatment Centres also already have their radiotherapy treatment at University College Hospital.

Other services that children with cancer need, including surgery for bone, eye, and liver cancers, and neurosurgery (for cancer-related brain, spine and nervous system problems) are not affected by the move of the Children’s Cancer Centre.

Neither is shared care for cancer which is provided at paediatric oncology shared care units (which we call children’s cancer shared care units) at a number of hospitals in the centre’s catchment area in partnership with the expert teams at the Children’s Cancer Centre. This allows patients to get some of the care they require closer to home.

Laboratory-based research for children with cancer will continue at the Institute of Cancer Research in Sutton, working closely with the clinical research teams at the Children’s Cancer Centre at Evelina London Children’s Hospital.

There will be no sudden changes to children’s cancer care. The Children’s Cancer Centre will continue to be at The Royal Marsden and St George’s Hospital for the time being.

As a result, the majority of children who are currently under the care of the Children’s Cancer Centre will no longer be patients by the time the service moves in 2026 because their treatment will be over or they will have moved onto teenage and young adult services.

Lots of planning work will go into ensuring continuity of high-quality care for patients when services do transfer.

Yes. The teams at The Royal Marsden and St George’s Hospital work very hard to make sure children with cancer get safe, joined-up care.

But, because they are not on the same site, there are underlying risks to the current arrangement that can only ever be managed (not removed).

Moving the services to a site with a children’s intensive care unit that can give life support (and the associated specialist children’s services) will mean no more transfers for intensive care within the Children’s Cancer Centre. This will remove the added risks and stress to children and families these transfers bring.

It will also mean the future Children’s Cancer Centre will be capable of giving innovative cancer treatments, such as CAR-T treatment which, because of the risk of complications, can only be given by children’s cancer centres on the same site as a children’s intensive care team.

Once the Children’s Cancer Centre moves, children with cancer who live in Brighton and Hove, East Sussex, Kent, Medway, south London and much of Surrey, or who attend a children’s cancer shared care unit in those areas, will go to Evelina London Children’s Hospital for very specialist cancer treatment services.

They will go to University College Hospital if they need radiotherapy of any kind.

They will still have other kinds of care – like clinic appointments and hospital stays for pain management and symptoms – at their nearest shared care unit, some of which also provide some types of chemotherapy.

About 1,400 children, most aged one to 15, are under the care of the Children’s Cancer 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.

Currently, about 60 children with cancer living in south London and much of the south east  require radiotherapy every year.

About 40 of them currently have conventional radiotherapy at The Royal Marsden and the others have proton beam or superspecialist radiotherapy at University College Hospital. In coming years, more children are expected to have proton beam/superspecialist radiotherapy, with the others having conventional radiotherapy.

However, because all these services will be on the same site, it will be easy to adjust to this change.

Children with cancer can become seriously ill very quickly.

Once the Children’s Cancer Centre is at Evelina London Children’s Hospital, it will be on the same site as an intensive care unit which can offer life support to the most seriously ill children.

It will also be on the same site as many other specialist services that children with cancer may need – such as intensive care, cancer surgery, eye, heart, kidney, and infectious diseases services, and care for digestive problems.

Children on the cancer ward who need life-saving care will be quickly and safely moved within the same building to the children’s intensive care unit rather than waiting for an ambulance to move them eight miles from The Royal Marsden to St George’s Hospital, as now.

Children on the cancer ward who are becoming seriously ill will be visited by intensive care specialists, to advise on their care. This will help some stay well enough to avoid a stay in the intensive care unit, which can be stressful and frightening.

Whether they are on the ward or the intensive care unit, they will see the same doctors, clinical nurse specialists, teams of play specialists and teachers.

For children who need to be treated by many different specialties, most will be on site.

Specialists in cancer and non-cancer care for children will work together face to face to coordinate care for individual children, share learning, and undertake research.

Children’s Cancer Centre research experts will run clinical trials at Evelina London Children’s Hospital and work closely with researchers at the Institute of Cancer Research in Sutton.

And the future centre will be capable of giving cutting-edge treatments that require intensive care on site, such as CAR-T treatment, like other major centres worldwide.

These changes will:

• build on all the strengths of the existing service – high quality care by expert staff, good access to clinical trials, a family-friendly centre for children and young people, and ground-breaking research working very closely with the Institute of Cancer Research
• deliver the national service specification for Children’s Cancer Centres (PDF) with all the benefits that brings
• create a Children’s Cancer Centre that gives best quality care to achieve world-class outcomes for children with cancer for decades to come.

Travel to Evelina London Children’s Hospital is something parents and carers have raised concerns about.

Evelina London is aware of this and will work with families, especially those who live further away, to offer flexible appointments. Family accommodation is also available.

Patient transport will be offered to every eligible child with cancer coming to Evelina London for treatment.

Evelina London is planning a fleet of vehicles just for the Children’s Cancer Centre to allow for long distance travel. Children using these vehicles will not be expected to share with other patients – the only passengers will be them and a parent/carer.

In addition, the following support will be available.

For driving

To help parents or carers driving their child with cancer to Evelina London Children’s Hospital for care, they will provide:

• at least the same number of parking spaces as at the Oak Centre for Children and Young People at The Royal Marsden (four accessible spaces for Blue Badge holders and four dedicated spaces for Children’s Cancer Centre patients). These are most likely to be on the site of St Thomas’ Hospital where Evelina London Children’s Hospital is located
• a system for managing parking spaces with free, bookable, parking for children with cancer coming for outpatient or day care treatment who regularly attend hospital (more than three times a month for at least three months) or are disabled. Parking will either be free on entry or reimbursed the same day
• free overnight parking for parents whose child with cancer is having inpatient care. This will be between 7.30pm and 8am. Parking will either be free on entry or reimbursed the same day
• hospital volunteers to help families get from the car park to their appointment in the hospital
• drop-off zones outside or near the entrance to the children’s hospital.

Parents or carers will be able to get the congestion and Ultra Low Emissions Zone (ULEZ) charges reimbursed online, which Transport for London says will usually happen on the same day they paid. This TFL ULEZ page has more information.

Evelina London Children’s Hospital will be developing these plans further, including in response to feedback from patients and families. The aim is to improve parking provision for all patients.

Public transport

They are also looking into having shuttle buses to pick up children and parents/carers from nearby Waterloo station and take them to Evelina London Children’s Hospital, to support those who travel by public transport.

Help with costs

Help with travel costs is available from the NHS Healthcare Travel Costs Scheme page for people on specific income-related benefits.

Other recommendations

The group advising on the equality assessment that was carried out for this change of service has made recommendations on how the future Children’s Cancer Centre can reduce the impact on families. These include:

• help for patients and families to plan their journeys to hospital, including easy to understand information in different languages
• help to access financial support (such as the Healthcare Travel Costs Scheme)
• more care closer to home, strong communication between different health and social care teams, and online or phone appointments.

Evelina London Children’s Hospital will act on these recommendations, developing plans over the coming period.  NHS England will oversee this work.

Travel to University College Hospital is something parents and carers have raised concerns about.

University College London Hospitals NHS Foundation Trust (University College London Hospitals) already provides proton beam therapy for children from across the south of England, and conventional radiotherapy for children from Southampton, Great Ormond Street, and Oxford Principal Treatment Centres, so it is used to supporting families travelling from a long way away, including by providing flexible appointments and overnight accommodation for children who need to be there very early.

All children who live more than 60 minutes away from the hospital or outside the M25 will be offered accommodation so they do not have to travel daily for radiotherapy.

University College London Hospitals also provides patient transport for some children if they meet certain criteria. This will be assessed on a case by case basis.

Parents or carers driving their child with cancer to University College Hospital for care will be able to get the congestion and Ultra Low Emissions Zone (ULEZ) charges reimbursed online, which Transport for London says will usually happen on the same day they paid. The TFL ULEZ page has more information.

Both Evelina London Children’s Hospital and University College Hospital are easier and quicker to get to by public transport than The Royal Marsden.

We know parents are worried about travelling by public transport with immunocompromised children. Clinicians will be able to offer guidance to patients on a case-by-case basis. Those who are concerned will be supported with patient transport and parking.

Staff at The Royal Marsden and St George’s Hospital who spend more than half their time on children’s cancer care are in scope for transfer to the future Children’s Cancer Centre under Transfer of Undertakings (Protected Employment) regulations (TUPE).

This works out as about 170 Royal Marsden staff and four from St George’s Hospital.

Retaining as many as possible of the expert staff in the current service is a priority for Evelina London Children’s Hospital and University College London Hospitals.

Members of staff transferring will be eligible to receive support for excess travel costs for up to four years under TUPE regulations. They will also receive inner London high cost area supplement.

Trusts will work closely together and with staff to support them through the transition period and transfer process. Staff transferring will have access to a wide range of developmental, wellbeing, and other benefits provided by their future employers.

The need for this move has been discussed for a long time. There is now a decision about the future location of the service, which has been taken after a rigorous process, including a public consultation and an options appraisal involving clinical advisers, parents, charities, nurses and research staff.

Evelina London Children’s Hospital, The Royal Marsden, St George’s Hospital, University College London Hospitals, King’s College Hospital (which provides most neurosurgery for children with cancer in south London and much of south east England), the Institute of Cancer Research and other partners will work very closely together to develop plans for a safe transfer of services for children with cancer to Evelina London Children’s Hospital.

We will work with Kent and Medway, South East London, South West London, Sussex and Surrey Heartlands Integrated Care Boards to oversee the plans and ensure everything stays on track.

We will also make sure this planning aligns with work to transform children’s cancer shared care units, following publication of the national service specification (PDF) for these units.

Evelina London Children’s Hospital will be offering opportunities for patients, families and staff to get involved in shaping plans for the future. We hope people will take up the opportunity.

Children with cancer, their families and staff gave us lots of very detailed consultation feedback about what they would like to see in the future Children’s Cancer Centre. The Evelina London Children’s Hospital team will use this feedback to help design the centre’s facilities and other aspects of the service.

Looking forward, all staff involved in the service, patients with experience of cancer and families will have the opportunity to be part of this work. The Evelina London Children’s Hospital team will make sure that people from different groups and communities have the chance to get involved.

We will support Evelina London Children’s Hospital and University College London Hospitals to work closely with staff in the current service, patients and their families, all the Trusts involved, the Children’s Cancer Network, the Institute of Cancer Research, and other partners to ensure that the move of service is as smooth as possible.

As with any change, there will be things that need to be closely managed, however, all the Trusts involved are committed to making a success of this for children with cancer, and to working together to achieve it. Updates will be shared with patients and families as the work progresses.

Children’s Cancer Centres (which are formally called Children’s Cancer 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). They undertake the diagnosis and organise the treatment for children with treatment.

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 Children’s Cancer Centre does not meet national requirements 

National requirements for Principal Treatment Centres are set by NHS England and set out on the NHS service specification page. 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 Children’s Cancer Centre does not and cannot meet this mandatory requirement.

Service specifications for specialised services are produced nationally based on clinical evidence and set out the standards and requirements for delivery of these services.

2. Hospital transfers of very sick children for intensive care add clinical risks and stress to what is already a difficult situation

Children being treated for cancer can become very ill, very quickly. 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 as safely as possible. But urgent transfers of clinically high risk and 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 avoidable risks to what is already a very difficult situation. Although these risks are carefully managed, while the current service arrangements continue, the risks continue and can only ever be mitigated. Transfers of very sick children also put added stress on patients, parents, and the staff involved.

Patient transfers from children’s cancer shared care units in local hospitals to the specialist children’s cancer centre, including emergency patient transfers, will continue to be necessary.

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 Children’s Cancer 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.

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

Currently, children have to travel to other hospitals for these services named in the service specification which are not on site at The Royal Marsden: intensive care; emergency surgery and most biopsies and central lines; specialist cardiology; children’s cancer surgery; other surgery for children; infectious diseases; gastroenterology; specialist nephrology; neurosurgery; ophthalmology; and some types of radiotherapy (proton beam and superspecialist). 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 increase families’ anxiety and distress.

Children’s cancer care is complex. Children will continue to get surgery for bone, eye and liver cancer, and neurosurgery, at different hospitals, and conventional radiotherapy will move to University College Hospital. 

5. Although it offers a wide range of innovative treatments, the current Children’s Cancer 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.

At Great Ormond Street Hospital, even with pre-emptive treatment to reduce the reaction, 10 to 20% of children having CAR-T treatment currently need some kind of intensive care. The most recent CAR-T trial treating children with acute myeloid leukaemia requires the CAR-T cells to be administered on the children’s intensive care as a precaution because of how quickly these children can react to the treatment. Many more of these treatments are expected to become available in the next few years.

The Royal Marsden’s children’s service is 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.

NHS England leaders chose Evelina London Children’s Hospital as the future location for the Children’s Cancer Centre for south London and much of south east England because it was the option that gave them greatest confidence it will deliver the best quality care for children with cancer for decades to come.

This followed a robust process since 2021 involving clinical cancer specialists, children with cancer and their parents, NHS staff, local communities and their representatives, a 12-week public consultation, and very careful consideration of all the evidence, including feedback from the public consultation. The decision makers considered the needs of children from across the entire catchment area (south London and much of the south east).

If you would like to know more about what they discussed in taking their decision, you can view a recording of the meeting, or read the minutes (PDF).

To take their decision, NHS England leaders considered feedback from the public consultation as well as other evidence. To find out more, please see the decision-making business case, and our You said, we did report.