We explained why we think these changes would benefit patients. Here are a few scenarios showing what the proposals would mean for future patients.
Advantages of having a larger care team
Now:
Lydia has a low-grade lymphoma and none of the usual treatments are working. Her care team at Aintree University Hospital think she may be suitable for a clinical trial. The trial isn’t available at Aintree so they need to refer her to the blood cancer service at Clatterbridge Cancer Centre – Liverpool. This takes a few days and then she has to be assessed by a consultant at Clatterbridge to see if she’s suitable for the trial.
Under the proposals:
Lydia could be considered for the trial right from the start of her care. She would still be cared for by the same people at Aintree but, if her treatment wasn’t working, she would be able to access the clinical trial straight away. She wouldn’t need a referral and the consultant leading the clinical trial would already have been involved in her care. As a result, she could join the clinical trial more quickly. Her care could be carefully planned from her diagnosis to maximise access to novel treatment only available through trials.
Advantages when people need urgent cancer care
Now:
Bridget is feeling very unwell after chemotherapy. She calls NHS 111 who advise her to go to A&E. She spends a few hours being assessed by the A&E team. They decide to admit her to hospital. She spends 24 hours on an acute medical admissions unit, along with patients with other conditions including pneumonia and heart disease. The next day, she is seen by an acute oncology nurse who knows how to deal with her side-effects.
Under the proposals:
Bridget can access 24/7 support from a specialist cancer nurse via The Clatterbridge Cancer Centre’s hotline. She phones them when she feels unwell. The nurse assesses her over the phone to check whether she is well enough to manage her side-effects at home. The nurse advises Bridget to come to the Clinical Decisions Unit at Clatterbridge Cancer Centre – Liverpool, which specialises in urgent cancer care. She is immediately assessed by a specialist cancer team who know how to deal with her side-effects. She has rapid access to any specialist cancer care she needs.
Advantages for specialist treatments
Now:
Tony needs CAR T-cell therapy, a very specialist treatment that helps the immune system to recognise and attack some cancer cells. This treatment is not currently available in Cheshire and Merseyside so Tony has to go to Manchester to receive it.
Under the proposals:
Creating one blood cancer service by bringing the teams from Aintree and Clatterbridge together would mean it was big enough to provide treatments like CAR T-cell therapy that can only be provided in centres with a large enough number of patients and clinicians. Patients could be treated in Liverpool instead of having to go to Manchester.
Advantages for inpatients who need complex care
Now:
Salim has acute lymphoblastic leukaemia (ALL), a type of blood cancer. He needs to stay in hospital for very intensive chemotherapy. He also receives other drugs that help kill the cancer cells in his blood. This treatment makes Salim extremely vulnerable to infection, and he needs rapid access to experts if he suddenly becomes unwell. Although the care he receives in Aintree University Hospital is very good, the care team is quite small.
Under the proposals:
Although it’s further from his home, Salim is admitted to the specialist Clatterbridge Cancer Centre – Liverpool where he has his own air-filtered room, instead of being on a shared ward. This reduces his risk of picking up an infection. He also has rapid access to a team that specialises in ALL and knows exactly how to care for him if his condition suddenly worsens. Being in a specialist cancer hospital means he also gets all the wraparound care he needs, including clinical therapies and psychological support. Salim can get plenty of rest, undisturbed by other patients, and his family can visit him any time (once pandemic visiting restrictions ease). The ward also has a shared social space where he can chat to other patients when he likes.
Advantages for teenagers & young adults with blood cancer
Now:
Andrezj, 19, was diagnosed with lymphoma after going to A&E with breathing difficulties. As he is under 25, the team at Aintree University Hospital need to refer him to the specialist Teenage & Young Adult service at Clatterbridge Cancer Centre – Liverpool so he can get full access to clinical care and wraparound support specifically designed for young people with cancer. This service isn’t available at Aintree.
Under the proposals:
As services at Aintree and Clatterbridge are now provided by the same team. Andrezj doesn’t need to be referred to Clatterbridge. In future, the specialist Teenage & Young Adult service could also run an outreach clinic at Aintree University Hospital so Andrezj could have his treatment there while also benefiting from wraparound care and peer support that the service provides, including the ability to chat to other young people with cancer.
Advantages for staffing levels
Now:
Aintree has four consultants. One of them specialises in myeloma. If she gets ill and is unable to work, there is nobody who can cover her clinics or provide specialist myeloma care. If she left, the service would have no myeloma specialist until a new consultant had been recruited.
Under the proposals:
The new service would have 16 consultants, including a team specialising in myeloma. If one consultant gets sick or leaves, there are other myeloma experts who can cover their clinics. It will also be easier to recruit a replacement as doctors generally prefer to work in larger services where they can learn from and support each other.
Protecting patients from infection
Clatterbridge Cancer Centre – Liverpool has been specially designed to reduce the risk of infection, with single en-suite rooms, isolation facilities and air filtration systems that remove harmful particles from the air.
This is particularly important because people with blood cancer are among those most at risk from infections. Many blood cancers affect the immune system. Treatments such as chemotherapy and stem cell transplant – also called bone marrow transplant – also affect the immune system.
Blood cancer patients may find it hard to fight infections that are relatively harmless to most people so it’s extremely important that hospital facilities are designed to reduce any possible risk.
Every inpatient has their own spacious en-suite room, with a nurse call, smart TV and entertainment system, and comfortable pulldown furniture so relatives can stay overnight after the COVID-19 pandemic.
As a dedicated cancer hospital, everything is focused around the needs of people with cancer. There are no patients being treated for other health conditions.