North London Cancer Network

The NLCN is the last network in London to undergo Peer Review of services for haematological malignancies. At the time of writing the process is nearly complete and formal written feedback to individual Trusts and the Network as a whole is awaited.

The process has taken a large amount of time but has helped identify weak points in services across the Network as well as strengths. It is likely that a reconfiguration of MDTs will need to take place to adhere to the Improving Outcomes Guidance. Level 2 Units

An external assessment of the configuration of Level 2 units across the Network was undertaken in 2005/2006. Currently there are four units undertaking Level 2 work: UCLH, RFH, BCFH, and NMUH. The external assessors led by Professor Charles Craddock from Queen Elizabeth, Birmingham, were in favour of centralising services to UCLH and RFH. Professor Craddock commented that there was a significant advantage to patients in this Network of having two world-rated centres on their doorstep with the opportunity of very sophisticated discussion and decision making immediately at local MDTs. BCFH and the Whittington have accepted this as a rational way forward but anxiety remains at NMUH and PAH. The Director of Services has recognised these anxieties in the context of an overwhelming recommendation from the external assessor, and has postponed the final decision until the end of 2007 while further examination of the services and their future at NMUH is carried out. Meanwhile the Director has recommended that younger suitable patients for intensive therapy are immediately transferred to the Centre and that NMUH refers all cases requiring complex treatment for immediate discussion at MDT on diagnosis at either of the two teaching hospitals.