An independent clinical review of gastric (stomach) and oesophageal cancer services across
Devon and Cornwall, carried out by two of the UK's leading cancer surgeons, is published today
(Mon).

The review, commissioned by the Peninsula Cancer Network on behalf of the four local primary
care trusts, recommends that Derriford Hospital in Plymouth become the specialist centre for
surgery by January 2010.

Prof Mike Richards, the national cancer 'tsar', said the move would see "real gains" for local
patients within a year.

The review was requested in the light of national guidance that calls for specialist treatment of rare
cancers to be carried out at centres of excellence. These centres offer the best survival and cure
rates for the relatively-small numbers of patients involved.

Specialist centres are already in place across most of the country, bringing together specialist
surgical teams that deal day in, day out with people who have rare cancers, and have the
necessary equipment and support services.

All aspects of care apart from surgery should continue to be provided as locally as possible to
patients. This covers initial out-patient appointments, diagnosis, radiotherapy, chemotherapy and
follow-up checks.

The review looked at the three hospital trusts in the Peninsula that currently provide gastric and
oesophageal cancer surgery. All three have endorsed the objective review process, which is based
on the national guidance, and accept the findings.

They are:

• Plymouth Hospitals NHS Trust (covering Derriford), which operated on 40 patients for
  oesophageal/stomach cancer in 2008
• Royal Cornwall Hospitals NHS Trust, which operated on 15 patients for
  oesophageal/stomach cancer in 2008
• Royal Devon and Exeter NHS Foundation Trust, which operated on 28 patients for
  oesophageal/stomach cancer in 2008

The review was carried out by two of the top specialists in upper GI cancer surgery in the UK:

• Prof Mike Griffin, Professor of Gastrointestinal Surgery and Consultant Surgeon at the
  Royal Victoria Infirmary, Newcastle, and a past President of the Association of Upper GI
  Surgeons of Great Britain and Ireland
• Mr Bill Allum, Consultant in GI Surgery at the Royal Marsden NHS Foundation Trust, and
  National Clinical Lead for upper GI cancer for the Cancer Services Collaborative
  'Improvement Partnership'

 

They spent time with all three trusts to look at the ability of each to act as the centre of excellence
and provide the best-possible service for patients. They looked at issues such as death rates, the
ability to offer 24-hour specialist cover, and the range of operations offered.
The review concludes that "Derriford Hospital represents the best opportunity" for a dedicated
gastric/oesophageal cancer service for the 1.7m people across Devon, Cornwall and the Isles of
Scilly.

Prof Griffin and Mr Allum also recommend that the service currently provided at Royal Cornwall
Hospital NHS Trust be moved to Derriford "as soon as is practicable" and that the Royal Devon
and Exeter Hospital service be moved so the Derriford centre is operational by January 2010.
The four local primary care trusts (PCTs) will be discussing the review recommendations, along
with plans for engaging patients and the public, with Overview and Scrutiny Committees over the
coming weeks.

In support of this, market research specialists MORI will be staging in-depth discussions on issues
such as travel, parking and accommodation that are raised by the possible centralisation of
specialist cancer surgery, so any change would work as well as possible for all patients and their
families across Devon, Cornwall and the Isles of Scilly.
Local public events may also be run by the PCTs to look at the issues, feeding into a major
meeting at the end of March for the whole of Devon, Cornwall and the Isles of Scilly.
In addition, MORI will surveying 1,000 people across the whole area to find out the views of the
wider public.

Dr Simon Rule, Clinical Director of the Peninsula Cancer Network, which is leading the work on
local cancer services, said: "It's well known from evidence across the world and specifically within
the UK that centralising the surgical management of patients with gastric and oesophageal cancers
significantly improves survival rates. This has happened around the country following national
guidance, with mortality halving as a result.

"Two of the leading upper GI surgeons in the country have reviewed the three sites currently
undertaking such surgery in the Peninsula, with the endorsement of all the clinical teams involved.
The report clearly states that the site where this treatment should be based is Derriford.

"The result of any move would be an overall improvement in outcome for patients from across
Devon, Cornwall and the Isles of Scilly with the concentration of surgical expertise on one site.
Whilst the report recommends that surgical treatment of these patients should be at Derriford, the
vast majority of the care would take place locally to minimise the inconvenience of travelling.
"With this in mind, what we'd like to do now is find out from people across the area their views on
these proposals. We're very aware that issues such as travel, parking and accommodation will
loom large for some people, though of course Derriford is reasonably central for the Peninsula."

Prof Mike Richards, National Clinical Director for Cancer, said: "Patients across most of the country
are now seeing real gains from having their operations at specialist centres. Put simply, they're
more likely to live longer. It's good to know that the same benefits could be available within a year
to people in Devon, Cornwall and the Isles of Scilly."

Please click here to read a copy of the full review|