New £725m Velindre Cancer Centre “obsolete because of treatment changes” say campaigners

Martin Shipton

Campaigners who oppose plans to build a £725m cancer centre in Cardiff claim that changes in the way treatment will be delivered to patients make the new building obsolete.

The changes are revealed in a report published by Velindre University NHS Trust.

A long campaign has been fought against the plan to build New Velindre in the city’s Whitchurch district on both environmental and clinical grounds. Local residents oppose the decision to build the new centre on a well-loved green space known as the Northern Meadows. At the same time, it is argued that instead of developing a stand-alone centre, it would be preferable to co-locate it with an existing general hospital.

Report

The campaign group Colocate Velindre, which includes doctors, has analysed a recent report from the NHS Trust that details future plans for the delivery of treatment to patients.

A spokesperson for Colocate Velindre said: “This recent data from Velindre itself provides definitive evidence that the current cancer centre already has sufficient capacity to keep pace with future demand. The reason is a planned increase in cancer treatments given locally across south east Wales. Chemotherapy given at Velindre will reduce to under half the total amount given in south east Wales, and additional radiotherapy capacity will be provided at Nevill Hall Hospital in Abergavenny.

“These recent figures especially raise the question of whether the timehas come to plan a mainstream ‘centre of excellence’, co-located with a general hospital and more easily funded. This would still allow for significant, prudent improvements to the current Velindre site.”

The spokesperson pointed out that Velindre’s own report confirms that by 2025 the amount of chemotherapy treatment given at Velindre Cancer Centre will reduce to 45% of the total given in south east Wales. Chemotherapy given at Prince Charles Hospital in Merthyr Tydfil and Nevill Hall Hospital in Abergavenny will increase. Also Royal Gwent Hospital, Royal Glamorgan Hospital and Princess of Wales Hospital in Bridgend are being considered as sites where more chemotherapy can be given closer to where patients live.

“To model future demand for cancer treatments Velindre Trust has used the forecasts by the Welsh Information Cancer Surveillance Unit and Cancer Research UK of a 2% annual increase in the incidence of cancer. A further increase was added for Covid-19 recovery.

“Capacity for chemotherapy treatment is expressed in the number of chemotherapy chairs required. Using the above forecast demand, Velindre’s report shows 14.1 chemotherapy chairs will be needed in 2026, when New Velindre is planned to open and 15.5 chairs by 2031. However the current Velindre Cancer Centre already has 19 chemotherapy chairs), which is more than is forecasted to be needed at New Velindre. This calls into question the need for a New Velindre for chemotherapy treatment. Even using the worst-case scenario of a 5% forecast increase in demand when 19 chairs would be required, the current Velindre Cancer Centre still has enough capacity to meet demand. It is clear that new ways of delivering chemotherapy closer to patients’ homes, welcomed by Velindre, have rendered obsolete the need for a new, larger, centralised building for this form of cancer treatment.

“The other main cancer treatment given at Velindre is radiotherapy. The new Radiotherapy Satellite Centre at Nevill Hall Hospital, due to open in 2025, will provide 20% of the radiotherapy treatment given in south east Wales. This will reduce the radiotherapy given at Velindre from 100% of the total to 80%. The plan is for the new Velindre to have eight radiotherapy machines, the same number of radiotherapy machines as the current Velindre Cancer Centre. Building a new stand-alone Velindre is therefore difficult to justify for the same number of radiotherapy machines.”

Concerns

Whether or not new Velindre should have inpatient beds was questioned by the Nuffield Trust in a review published in 2020. The review said: “Velindre Cancer Centre is of the view that inpatient provision will still be required at the Velindre Cancer Centre site. But the key question is whether this is a robust approach for the future.”

The Colocate Velindre spokesperson suggested that this “unexpectedly blunt” reassessment of Velindre’s future sprang from its managers’ rejection of colocation.

“Velindre Trust had highlighted how the New Velindre would be a centre for research,” said the spokesperson.  “However, the new Cardiff Cancer Research Hub together with the new Complex Specialist Oncology Service are now going to be built at the University Hospital of Wales (UHW) as these services ‘must be colocated’. The development of the Acute Oncology Service will also now take place at UHW and other hospitals in south east Wales, rather than the new Velindre.

“The above initiatives are all widely welcomed. However, they raise the important question for Velindre Trust and the Welsh Government of why build a stand-alone new Velindre Cancer Centre now, when the plan is to move treatments out of Velindre to local hospitals.

“In the new Velindre Full Business Case of March 2023 the key reason given by Velindre Trust for needing a new building as a matter of urgency is the lack of space in the current Velindre Cancer Centre. As this reason is vanishing, there are now compelling arguments for the Welsh Government to pause its decision on the funding merits of a stand-alone New Velindre.

“Ministers should listen to the 200 cancer care specialists who are recommending a colocated New Velindre, which would be in line with national and international best practice. Given the excellence of new cancer services being developed at UHW together with the planning of UHW2, this would be the site of choice for many.

“Health Minister Eluned Morgan has recently warned that all health organisations in Wales are facing very real financial challenges. We therefore hope the Health Minister will realise there are better ways to spend £725 million. Indeed, the typical cost for an entire new general hospital is that shown currently for the replacement for Monklands Hospital near Glasgow. It is £700m, hence approximately the same as the funding of New Velindre’s predominantly day-patient cancer unit alone.

“What is more, Velindre Trust has just announced in its January 2024 Board papers that costs have exceeded the Capital Expenditure limit, and there is now a ‘risk to the financial sustainability of the New Velindre project’.

“We would like to see more investment in our NHS Wales excellent cancer care staff, before a new building with so many question marks hanging over it. This is especially the case at Velindre where a universally admired staff could be lifted by a more buoyant recruitment and retention campaign alongside the proposed research centre of excellence at UHW.”

Members of the Trust board are likely to consider the Full Business Case for New Velindre within days.

A spokesperson for the Velindre NHS Trust said: “The new Velindre Cancer Centre is vital in safeguarding crucial cancer treatment and care for the 1.5 million people of south Wales for future generations.  As stated on multiple occasions, the opportunity to co-locate the new Velindre Cancer Centre on an acute hospital has been considered and is not feasible.

“The clinical model underpinning the development of the new centre and the future shape of non-surgical cancer services in south east Wales was considered by the Nuffield Trust in 2020. The model reflects the need to consider care closer to home where possible and appropriate, and the urgent need for a new Velindre Cancer Centre, as concluded by the Nuffield report. The new Velindre Cancer Centre is an integral part of this model and our new cancer centre has been correctly sized to reflect this.

“It is well documented that the current cancer centre is making it increasingly difficult to maintain the high standard of care for which Velindre is known. It limits our ability to support improved outcomes and quality of life for our patients today and in future.”