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Changes to services at Imperial College Healthcare NHS Trust
July 2011
Imperial College Healthcare Trust is constantly improving its services. In the last year the trust has opened a major trauma centre at St Mary's, a hyper acute stroke unit at Charing Cross and a Heart Assessment Centre at Hammersmith Hospital.
In 2011 the Trust aims to provide better care for more patients in improved surroundings. To ensure we meet the needs of patients we are working with local GPs, Primary Care Trusts, patient groups and key stakeholders to improve the following services:

Vascular surgery
Vascular surgery is changing. In 2010, there was a London-wide review to improve quality and ensure everyone with arterial disease has access to the best and latest treatment. The review engaged patients, doctors and nurses; as a result, arterial surgery will now be provided in fewer, more highly equipped London hospitals. This will ensure the concentration of patients and staff needed to provide all modern treatment options.
Imperial College Healthcare NHS Trust intends to be the best vascular surgical unit in Europe within the next five years; a worthy yet realistic aim given the surgical skills and research expertise in the Trust. 

The Trust wishes to merge the arterial surgery services currently at Charing Cross and St Mary’s hospitals into one service that will guarantee we are providing all the latest technologies and treating high enough numbers of patients to ensure we provide the best care possible – in line with London-wide recommendations. St Mary’s is proposed as the site for the new centre, which will also support patients in the recently opened major trauma centre, as emergency arterial surgery is a core life-saving treatment.
This change will improve the treatment for around 400 patients a year – fewer than 200 of these will need to be treated in a different hospital. Outpatient consultations, diagnostic tests and varicose vein treatment will continue to be provided in both hospitals. The Trust is engaging with local stakeholders to ensure the new service will have a positive impact on the patient experience as well as clinical outcomes. 

Read the arterial surgery business case

Cancer services
The Trust has recently reviewed how it provides cancer services across its three main sites – St Mary’s, Charing Cross and Hammersmith Hospital.

The Trust will continue to provide cancer surgery, outpatient appointments, daycase chemotherapy and radiotherapy services as it does now.

Following discussions with the North West London Cancer Network, we have decided to care for all chemotherapy inpatients together at Charing Cross Hospital. Organising our services in this way will result in a better experience for our patients. Charing Cross Hospital will have a 52-bed dedicated cancer ward, run by a team of cancer specialists. The Maggie’s Cancer Care centre is also on this site and provides a range of support services for people affected by the disease.  

We are creating a dedicated young persons cancer facility at Charing Cross and investing in an improved daycase chemotherapy suite at Hammersmith Hospital.

Orthopaedic surgery
The Trust is proposing to separate urgent and planned orthopaedic surgery currently based at Charing Cross Hospital and St Mary’s Hospital.

Whilst the Trust currently provides a good service, change is necessary to:

  • cope with demand – the population is growing, getting older and heavier
  • improve services for patients. Separation of planned and urgent care is recommended by the Royal College of Surgeons as it reduces infection rates; improves care and outcomes; reduces cancellations and delays; facilitates training, research and single-sex accommodation; and patients like it
  • make better use of taxpayers’ money – running two, relatively small, identical  services on two sites is not an efficient way of working

Separating urgent and planned orthopaedic surgery would mean:

  • clinical teams would improve their skills and there would be more opportunities for researchers to develop new treatments
  • patients would  receive better quality, faster care in an improved environment, with less chance of their operation being cancelled
  • the service could be provided more efficiently

The changes could affect around 1,600 patients requiring planned care and fewer than 500 patients requiring urgent specialist surgery.

As part of the proposed changes we have prepared plans to safely and quickly transfer patients when necessary. This would be for a small number of patients.

The Trust is currently seeking stakeholders’ views on how best to provide services, and discussing the proposals with Primary Care Trusts and local GP leaders.

Read the orthopaedic surgery business case