Expert warns over cancer switch

A TOP dental expert today dealt a withering blow to a scheme to move head and neck cancer surgery to Norwich - pointing out that there are no specialist registrars at that hospital.

Rebecca Lefort

A TOP dental expert today dealt a withering blow to a scheme to move head and neck cancer surgery to Norwich - pointing out that there are no specialist registrars at that hospital.

Campaigners working to prevent the move of the specialist surgery from Ipswich to the Norfolk and Norwich Hospital were stunned today after the information was revealed.

Professor Brian Avery, from the Faculty of Dental Surgery at the Royal College of Surgeons, said Ipswich has the necessary staff but moving the service could disrupt the training of specialists needed there for cancer and other treatment, including dealing with crash victims.

He added that with surgeons possibly having to travel from Ipswich to Norwich, should post-operative complications occur it could put patient safety at risk.

It is the latest blow to health chiefs who are trying to justify switching the life-saving surgery to Norwich - and again shows their flawed reasoning for making the changes.

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Earlier this week it was revealed decisions were being made on out-of-date figures.

In yet another twist, Lord Darzi, the government health minister charged with transforming the health service, has said all plans should be based on local need and pointed out that “different places have different needs and local needs are best met by local solutions.”

Proposals to move the cancer surgery from Ipswich to Norwich has been marred by a catalogue of flaws, but health bosses at the Anglia Cancer Network and Suffolk Primary Care Trust still insist it will be the best thing for patient care.

At a public meeting it was revealed there was no published clinical evidence to show specialist centres like the one planned for Norwich are best for patient care.

The Evening Star is campaigning to try to prevent the move of surgery for head and neck cancer patients to the Norfolk and Norwich Hospital, forcing people to travel more than 40 miles while ill, which means family and friends may not be able to visit them.

So far, more than 2,000 people have signed the petition.

The latest disclosures come in a letter from Prof Avery to Audrey Bradford, director of the Anglia Cancer Network (ACN).

The faculty is opposed to the service being moved - mainly because of the impact on patients travelling to and from Norfolk, but also because of the long and demanding day it would create for surgeons, some of whom will also have other work at Ipswich.

Prof Avery said: “Even the best of surgeons will from time to time face post-operative complications which often occur on the first night of surgery.

“It is difficult to comprehend how the surgeons who have spent all day operating could return in the middle of the night when such large distances are involved. This would put patients' safety at risk and this should exclude such surgery being carried out.”

While the aim of the move is to create a specialist centre, Prof Avery points out “at the present time there are no oral and maxillofacial specialist registrars in the Norfolk and Norwich, whereas there are at Ipswich.”

One-site surgery based at Norwich would inevitably disrupt the training of the specialist registrars in Ipswich.

David Dyer, chairman of the Cancer Services Users' Group at Ipswich, said: “It is absolutely crazy - we are learning so much now which contradicts the reasons given for making this move. First there were the incorrect figures, and now this.

“In addition, we understand Essex people would prefer to use Ipswich for head and neck cancer services and yet they are told they cannot cross boundaries in future - yet on the other hand, the health service says it is fine for gynaecological cancer patients to cross the boundary and use Ipswich. It does not make sense.”

A spokesman for Anglia Cancer Network said: “If surgery were to transfer, one of the things which would need further discussion with the East of England Deanery, which allocates training accreditation, is whether training status would go to Norfolk and Norwich together with the specialist registrar training posts.”

Should head and neck services be retained in Ipswich? Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN, or e-mail


Lord Darzi, the government minister charged with transforming the health service, has stressed in his latest report that all decisions must be taken at local level with clinicians and patients being listened to.

He said in his report, NHS Next Stage Review: Leading Local Change': “The right way of doing this is to put local

clinicians in the lead, with the public and relevant independent experts consulted and involved at an early stage, ensuring that changes are based on the strongest clinical evidence and are relevant to their local communities.

“The role of national bodies has to be to support local clinicians with the best evidence.”

Yet despite opposition from head and neck surgeons at Ipswich Hospital cancer charity experts and patients, the ACN is determined to press on and leave patients with a 100-mile round trip for the treatment.

A spokesman for ACN said: “The Department of Health has adopted compliance with the published Improving Outcomes Guidance (IOG) as policy which means that cancer networks must ensure adherence is achieved by agreed specified dates.

“For head and neck services, this is December 2008. The

policy of requiring IOG compliance is to benefit patients ensuring they get the best possible outcomes. Overall, evidence shows that centralising surgery also enables clinicians to improve their knowledge and skills by treating more cases of these specialist cancers.”

However, this flies in the face of Lord Darzi's recommendations which state:

By definition, world-class quality of care is tailored to personal needs and local

circumstances. It cannot be imposed from the top but must be led by local clinicians,

care professionals in local authorities and the third sector responding to local needs.

Universal is not the same as uniform. Different places have different and changing needs - and local needs are best met by local solutions.

A grand plan or national blueprint cannot possibly achieve the world-class quality of care that patients want and NHS staff and partners aspire to deliver.

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