Campaign to keep local child cancer services local

The Royal Marsden Hospital

Wandsworth Council is leading a campaign against the NHS decision to move children’s cancer services from two South London hospitals into Central London and the new Labour Government will be asked to step in. NHS England announced its decision to move the children’s cancer centre based jointly at St George’s Hospital, Tooting, and The Royal Marsden, Sutton, to Evelina London Children’s Hospital, Lambeth, in March.

Wandsworth has now confirmed it will refer the decision to new Health Secretary Wes Streeting in a bid for him to intervene. The council is particularly concerned about the prospect of parents having to travel via public transport into Central London with immunosuppressed kids to reach the Evelina.

The authority said Richmond, Kingston, Merton, Sutton and Surrey councils are set to join the cross-party campaign, as children in their boroughs currently receive care at the existing children’s cancer centre. Richmond approved plans to challenge the decision in May.

Opposition to the plans began to grow after the NHS launched a consultation on two options for the future location of the centre last year – either moving it entirely to St George’s or to the Evelina. The centre has provided specialist children’s cancer services to those aged 15 and under living in South London, Kent, most of Surrey, Brighton and Hove, Medway and East Sussex for 25 years.

The NHS said it has to move the centre as a new national service specification in 2021 outlined very specialist children’s cancer treatment services must be on the same site as a paediatric intensive care unit and other specialist children’s services. The Royal Marsden does not have a paediatric intensive care unit, meaning a small number of children with cancer requiring intensive care are transferred safely by ambulance to St George’s every year.

Labour Wandsworth Council leader Simon Hogg urged Mr Streeting to work with local authorities challenging the decision to find ways to keep services at St George’s. He said: “We have opposed these plans to move specialist children’s cancer care from St George’s from the start. Our serious concerns remain – getting to Evelina hospital through Central London traffic will be challenging at the best of times. Travelling by public transport is not an option for vulnerable children who are on immunosuppressant medication. So there has to be a better solution to these plans.”

Local MPs have also publicly opposed the plans. Tooting MP Dr Rosena Allin-Khan described the decision to move services from St George’s as ‘deeply disappointing’ when it was announced in March, and signed a letter to previous Health Secretary Victoria Atkins asking her to review it. The letter was also signed by Putney MP Fleur Anderson, Mitcham and Morden MP Siobhain McDonagh, Richmond Park MP Sarah Olney and Twickenham MP Munira Wilson.

Services are not expected to move until 2026 at the earliest. An NHS London spokesperson said: “Evelina London has been chosen as the future location for the children’s cancer centre following a rigorous process, including involving clinical advisers, parents, charities, nurses and research staff. The future centre will stand ready to give cutting-edge treatments that require intensive care on site, like other major centres worldwide.

“Service reconfiguration is rarely easy and we recognise that during consultation, parents and families raised a number of concerns about the change in location, including about travelling further into London, and what that will mean for them. Our focus now is on detailed implementation planning which takes all of these concerns into account to support families and staff.”

An Evelina spokesperson added: “We are fully committed to working with patients, their families, staff from the current service, and other partners to design the new service with children, young people and staff at its heart. This will ensure continuity of care during the transition period and a plan for the safe transfer of the service.”

A St George’s spokesperson said: “We understand the concerns being raised by our communities who want to keep specialist children’s cancer care at St George’s. We are working with NHS England and our partners and will continue to provide outstanding care to children and their families throughout this process.”

Charlotte Lillywhite – reporter.

Image credit Jean Barrow Licence

Teen suicide risk underestimated by CAMHs

An “underestimation” of suicide risk and significant mental health ‘failings’ contributed to the death of a vulnerable teenager, a Senior Coroner has found.

Locket Williams, described by their family as “a lovely person with a huge character”, was just 15 years old when they tragically killed themselves in September 2021.

Senior Coroner Richard Travers concluded that there were a number of key failures by Surrey and Borders Partnership (SABP) NHS Foundation Trust’s Children and Adolescent Mental Health Services (CAMHS) which contributed to the death of the vulnerable teenager, who goes by they/them pronouns. The three-week inquest concluded Friday 31 May.

Locket’s older sister, Emily, said: “Hearing the coroner recognize what we have believed for three long years—that failures by CAMHS contributed to Locket’s death and ultimately meant Locket lost all hope—is heartbreaking.

“We’re thankful for the Coroner’s respect for Locket’s identity, which was so important to them, and we sincerely hope this process will help prevent more tragic deaths like Locket’s in the future.”

Described by their family as “vibrant” with a “massive heart”, Locket “brought colour to everything they participated in” their family said.

They had a long history of mental health difficulties, resulting in self-harming behaviours and three previous suicide attempts throughout within seven months of 2021. 

Evidence heard at the inquest highlighted “illogical conclusions” that Locket was deemed “low risk” by clinicians, despite their ongoing suicidal ideation and three suicide attempts in close succession, the family’s lawyers said. 

Coroner Travers found that Locket’s high risk of suicide was “underestimated” by clinicians, as there was an “insufficient account” of Locket’s long-running risk, which meant Locket did not receive the treatment they needed. 

Commenting on the Coroner’s findings, the family’s solicitor, Elle Gauld from Simpson Millar’s public law team, said: “Given Locket’s three suicide attempts and deteriorating mental health, CAMHS’ approach repeatedly defied logic and palpable evidence of suicidality, bypassing the patient’s express wishes and placing an unrealistic burden on a family already in crisis. Treatment was not commenced in a timely manner”

Long waiting lists for Cognitive Behavioural Therapy (CBT) and a shortage of therapists meant that, although clinicians all agreed CBT was necessary, Locket remained at home. Without access to the required support and treatment, their mental health continued to deteriorate, the lawyers for the family said. 

Coroner Travers said there was a ‘failure’ to assess the likelihood Locket could be kept safe while waiting eight months for Cognitive Behavioural Therapy (‘CBT’), a treatment she was ready and willing to engage in. 

Failures in communication between social services and CAMHS were also identified, leading to crucial information being missed in Locket’s assessment and care. CAMHS failed to attend Core Groups meetings held by social services to protect Locket, as a vulnerable child. 

Locket was passed from service to service, with no continuous care from the same clinicians or who was responsible for Locket’s care, lawyers said. 

Speaking of the family’s loss, Locket’s mother, Hazel Williams, said: “We hope the lessons learned from their death highlight the urgent need for change and prevent future tragedies. We are grateful for the thoroughness of this inquest and the potential for positive changes in managing mental health services for young people.”

SABP has 56 days to respond to the senior coroner’s findings. Coroner Tavers has asked the NHS Trust to report whether there is now a system in place to ensure that young people referred to CAMHS are seen and treated promptly, and that clinicians are acting in accordance with the Trust’s guidelines.

A Surrey and Borders Partnership NHS Foundation Trust spokesperson said: “We are extremely saddened by the tragic death of Locket Williams and our deepest sympathies go to their family and friends. 

“We are carefully reflecting on the Coroner’s findings and the questions we have been asked and will respond within the given timeframe.”

Image: Locket. (Credit: Simpson Millar law firm) Coroners Court in background – Google

First steps for mental health

The National Health Service (NHS) has introduced “First Steps to Support,” a new service which is designed to help residents aged 18 and over manage their mental health. This comprehensive facility is accessible via telephone, text, and email, offering early intervention and guidance through a single conversation with a dedicated wellbeing advisor.

Whether you’re feeling stressed, irritable, or down, facing financial worries or sleep issues, caring for others with little to no time for yourself – “First Steps to Support” will help you delve and face these issues. They seek to help you improve your mental wellbeing by providing support not only for individuals but also for their friends and family members. The welcoming staff aims to understand what’s
troubling you and attempts to explore ways to guide you to the right resources, in order to ease your burdens and help you enjoy life again.

Residents will receive tailored guidance on self-help strategies and have early access to talking therapies. In addition, the service offers referrals to various support services that tackle wider determinants of wellbeing, including financial difficulties, housing issues, employment concerns, isolation, and bereavement. The overarching objective is to enhance long-term wellbeing by connecting residents with local community organisations and support hubs, ensuring sustained assistance and

Service Availability:

Residents can reach out to the “First Steps to Support” service through the following
contact methods:
 Telephone: 0333 332 4753
 SMS: 07860 026657
 Email: dohel.firststeps.surrey@nhs.net

The wellbeing advisors can be contacted during the following hours:
 Monday: 8am to 3pm
 Tuesday: 9am to 4pm
 Wednesday: 10am to 5pm
 Thursday: 9am to 7pm
 Friday: 10am to 2pm

Further Information
For more information, the NHS encourages residents to visit the “First Steps to
Support” webpage on healthysurrey.org.uk

Council unaware it was Mental Health Awareness Week?

Robert Geleit Mayor of Epsom 2023-2024 at The Derby

Former Epsom and Ewell Mayor Rob Geleit (Labour Court) has accused the Council of removing references to his schizophrenia from his final speech. Cllr Geleit argues that the action reflects prejudice against mental health issues and constitutes improper censorship. The occasion was the Annual Mayor making meeting of the Full Council on Tuesday 14th May. Notably this was during Mental Health Awareness Week

In an interview with the Epsom and Ewell Times, Mr Geleit revealed that he had planned to end his speech by saying, “It has been an honour and privilege to serve as The Worshipful The Mayor Cllr Rob Geleit for the past year. Schizophrenia or no schizophrenia. If you are all up for it, perhaps we could vote me in for another year?”

However, this section was removed. Mr Geleit stated that he was informed of the change by Mr Piero Ionta, Head of Legal and Monitoring Officer, prior to the meeting.

Mr Geleit added that he had already mentioned his schizophrenia in his acceptance speech when he was made Mayor. He stated he believes that while the visibility of mental health issues has improved, chronic mental health problems remain a taboo subject.

He was not particularly surprised by this, as he has become accustomed to such situations. However, he is now working with his leadership team to file a formal complaint against the conduct of a council officer. He hopes the complaint will result in an apology and assurances that such incidents will not happen again.

In response to these allegations, a council spokesperson stated, “In the course of preparing for council meetings where the Mayor will make a speech, it is the normal course of business for officers and the Mayor to discuss speech content, and for officers to offer any advice and guidance, which is what happened on this occasion. Officers do not decide on any changes to the speech, they purely advise, and it is the Mayor’s ultimate decision on whether to act on the advice. Officers do not recognise the conversation had in this instance as being reflective of the allegation that has been made.”

The council also further emphasised its commitment to mental health issues: “The council is aware that poor mental health is a big challenge for many of our residents. As a result, the council has made mental health the top priority in our work with our NHS colleagues in the Epsom and Ewell Neighbourhood Board. We also have a cohort of trained Mental Health First Aiders within the council to assist and support our own staff and councillors.”

Councillor Chris Ames (Labour Court) expressed strong disapproval of the incident, stating, “The removal of the reference to schizophrenia was a shocking and wholly outdated expression of the type of stigma and prejudice that many of us have worked to move on from. It was also totally outrageous censorship of an elected official who has served the Borough with dignity and distinction during his year as Mayor.”

Despite these challenges, Mr Geleit remains confident and hopeful about the future. He revealed that he will continue to contest for the West Ewell Division of Surrey County Council and that his experience as Mayor has inspired new ambitions to join Parliament.

Image – Cllr. Robert Geleit at the Derby when Mayor of Epsom and Ewell.

Gold star at the end of the Rainbow

Rainbow leisure centre Epsom

Better’s Rainbow Leisure Centre in Epsom has maintained its ‘Excellent’ status from QUEST – the Quality Scheme for Sport and Leisure. This follows a mystery visit from the organisation in April plus a planned audit in May.

Rainbow’s facilities include two pools – full-size and teaching – a sports hall, 100+ station gym, soft play area, spa and a senior activity room.

The centre has approximately 70 members of staff (full and part-time) and around 3,000 members who are mainly families or adults over the age of 66.

QUEST’s report commented on the centre’s excellent, well-maintained facilities and its extremely warm, friendly and welcoming staff. Emily Simmons, General Manager, comments, “I am immensely proud of the centre and our team. Achieving QUEST Excellent status is no easy task and staff consistently work hard to maintain the high standards they set themselves.

“QUEST is a fantastic tool for evaluating best practice and customer service levels. It sets the standard for leisure centre management and sports development, taking into account programming, facilities, management policies and procedures, staff training and development, and environmental impact. This award means both customers and staff are getting the highest level of service, care and support.”

Better’s Head of Service in the area Steve Hannen adds, “A huge well done! It’s a great achievement for Rainbow to maintain Excellent status. This is not an easy thing to do and the entire centre team should be proud.”

Rainbow Leisure Centre is managed by charitable social enterprise GLL under the ‘Better’ brand. Supporting the wellbeing of local communities is an important part of the organisation’s ethos.

GLL press

Bed pressures rushing doctors

Epsom hospital

Pressure to free up hospital beds can “rush” clinicians to make under-informed decisions and discharge plans, a coroner has found. 

A man who tragically died from hypothermia and chronic alcoholism in Epsom General Hospital prompted a coroner to raise concerns that demands on beds can put patient safety at risk.

A local man was admitted to hospital three times from October 22 to December 5, 2022. Each time, the underlying cause of his condition was not diagnosed and he was soon after found to be medically fit for discharge. He died on December 12 2022, after being found profoundly hypothermic the previous day. 

Coroner Caroline Topping found: “Pressure on staff to vacate hospital bed spaces led to inadequate discharge planning and more than minimally contributed to the death.”

It was accepted by the Epsom and St Helier NHS Trust that pressure to vacate hospital bed spaces contributed to the inadequacy of discharge planning. The coroner ruled the need to free up a bed space led to the patient’s rushed release on December 5, 2022 without an adequate care plan being in place.

Nationally, the NHS faces significant pressures to use beds as efficiently as possible. The Trust said it will never willingly compromise a person’s safety by discharging them sooner than it should.

Clinicians and staff discharged the patient without knowing what underlay his deterioration and how his ability to self-care was impacted.

His expressed wish to go home alone was “erroneously” relied on to justify an “unsafe” discharge on the basis he had capacity to make a decision, according to the coroner’s prevention of future death report.

An  inquest on March 12 2024, heard how the man was suffering from alcohol related brain damage, impacting his mobility and fluctuating confusion. Malnourished, as a result of his chronic alcohol use, his health had declined and he lost a significant amount of weight over the summer. 

Continuing to “abuse alcohol”, he was self neglecting and his ability to live alone was reduced. He developed hypothermia in an inadequately heated flat and had not been eating properly.

Contrary to NHS policy, the man was not identified as a vulnerable patient. Any adult unable to take care of themselves (e.g. alcohol as a risk factor) is defined as a vulnerable adult. 

The coroner found there was a lack of information sharing and investigation in relation to the discharge planning for the patient. 

Reportedly unaware of the discharge planning policy, staff made decisions in a vacuum. There was no understanding of the mans’s recent history of frequent admissions, his diagnosis or sufficient investigation of his home circumstances.

The man’s family was not involved in the discharge planning. Concerns were raised by the family on a number of occasions about his ability to look after himself. No heed was paid to these worries and the man was discharged on December 5 to live at his own flat  without an adequate care plan in place. He died a week later.

The coroner’s report states the Trust has already put in place a number of improvements around effective information sharing and recognition of safeguarding issues, including self-neglect.

However, she “remained concerned” that the hospital’s discharge policy remains under review, including how families are involved, meaning it has not been possible to access how effective it is.

The coroner wrote to St George’s Epsom and St Helier Hospital Group and NHS England to raise her concerns, which also included pressure to vacate beds leading to rushed under informed decision making and ability to prepare ‘properly considered’ discharge plans, urging them to take action to reduce the risk of future deaths.

A Trust spokesperson said: “We are deeply sorry that we didn’t give [the man] the care that he and his family were entitled to expect, and our heartfelt apology and condolences go out to [his] family.

 “We took immediate steps to review our discharge process, adding in additional checks, greater contact with families of vulnerable patients and we have also improved safeguarding training for our staff.”

Epsom and St Helier Hospital added they will respond fully to the coroner’s concerns within the set timeframe, by June 12, 2024. 

Rated as ‘good’ in an inspection in 2019, the Care Quality Commission (CQC) said it has received the coroner’s report on the hospital. The CQC said, as always, it will utilise the information during its forthcoming engagement meetings with the Trust. 

Tarbuck’s luck comes to Epsom

Easter Espinosa, Charlotte Druce, Bess Harding, Jimmy Tarbuck, Deji Akiboye

Comedian Jimmy Tarbuck popped into Epsom General Hospital recently – and made a serious bit of  business great fun.

He was in the Urology Department to present a “new toy”, a £10,975 TULA Laser Machine on behalf of Epsom Medical Equipment Fund (EMEF).

Surgeons love new toys and this one saves lives.  The comic heard from Consultant, Deji Akiboye how this new treatment for bladder cancer helps treat cancers without the need for sedation or anaesthetic.  Patients come in and have their condition treated, pain free and walk out of hospital in less than one hour.  The tiny laser goes through a flexible telescope inserted into the bladder.

The consultant added:  “We use this laser to fry abnormal areas in the bladder which are cancerous.  Traditionally this involved a full anaesthetic and a stay in hospital, sometimes with a catheter.

“With this treatment, it means we can do away with all those things and treat people far more quickly, painlessly and let them get back to normal living faster.  It is fast, efficient and effective – plus it’s also great fun to use for us surgeons who love new toys.”

Charlotte Druce, General Manager, Surgery & Endoscopy Surgery Directorate, Epsom and St. Helier University Hospitals NHS Trust thanked EMEF organiser, Bess Harding for helping to make this particular dream come true.

Bess added: “With the support of the local community, we raised the money for the TULA which is an important part of the treatment”.

Find our more and donate to EMEF.

Image: Easter Espinosa, Charlotte Druce, Bess Harding, Jimmy Tarbuck, Deji Akiboye

Meat-free Mondays coming to all Surrey schools?

Three children with school dinners

Meat-free and plant-based options could be mandated across Surrey schools every Monday according to new council guidance. Only some Surrey schools currently participate in a form of ‘meat-free Monday’ so the new food strategy would expand its remit.

The new policy forms part of the so-called Surrey Healthy Schools initiative. The initiatives aims to address food insecurity, reduce climate impact of the local food system and support the local population to keep a healthy weight by improving the accessibility and affordability of nutritious food.

Speaking at a Surrey County Council (SCC) meeting on April 29, Officer Marisa Heath said: “I don’t think meat-free Mondays is too much to ask for one day a week. We’re still giving six days a week for people to make other choices so I don’t think it is draconian or heavy handed.”

Council officers said the preferred menu would prioritise fruit, vegetables and legumes- rather than processed, plant-based meat alternatives. Only schools signed up to the Surrey Healthy Schools will be part of the initiative, including all SCC public schools and some private schools.

Framing the programme as being to “educate and not dictate”, Cllr Mark Nuti (Conservative/ Chertsey) said the policy is empowering individuals and families to make informed and healthy food choices.

The committee discussed the importance of sustainable and locally sourced farming, as well as cutting meat to decrease carbon emissions and environmental resources. It was noted that ‘plant-based’ food was not always “nutritional”, but that children needed fibre from fruit and vegetables.

The new strategy aims to increase children’s nutrition and combat obesity, as well as increasing sustainability and environmentally conscious eating. Around 1,210 of 9,355 Year 6 pupils measured in Surrey were classed as obese or severely obese in 2022-23, NHS figures show.

Healthy food, such as fruit and vegetables, are often out of reach for many parents on low incomes who prioritise affordability over nutrition. The amount of vegetables being purchased in the UK has fallen to its lowest level in 50 years, according to The Food Foundation.

“Levelling up is not just about buildings, it’s about people,” Officer Marisa said. “It’s about their wellbeing, mental and physical, and allowing them to reach their [potential].”

Councillors argued the strategy must be adaptable to children who may suffer with eating disorders, have neurodiversity requirements or medical issues, and not be able to eat (or do not want to eat) plant-based food.

In a heated debate, concerns were raised about the policy going ‘too far’. Cllr Trefor Hogg (Conservative/ Camberley East) said an extension to adults and elderly people with dementia could mean “being confronted with things they just can’t cope with”.

He added: “My particular concern of those who are in any form of social care have had their liberties and freedom restricted to some degree. It’s very very important that they have a full choice. This is particularly important where there are neurodiverse and mental health issues as well. I think we should be very explicit on the subject. I would be very concerned about the adults and the elderly being confronted with things they just can’t cope with.”

Meeting documents stated the eating environment should be inclusive and social as restricting to plant based only options may make some feel excluded.

Image: Creator: Chris Radburn | Credit: Pa Photos, NTB scanpix License details

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Animal health benefits human health

Pigs in a pen

Ensuring animals are treated well throughout their lives and using sustainable farming practices are at the heart of an ambitious partnership to control the spread of infectious diseases and improve animal welfare. The University of Surrey’s School of Biosciences and School of Veterinary Medicine have joined the European Partnership on Animal Health and Welfare. The University is set to receive over £2 million from the Horizon Europe Research and Innovation Programme.

Along with helping to prevent and control diseases in terrestrial and aquatic animals, the partnership will also encourage the careful use of medicines and develop methods to maintain high welfare standards. The partnership involves 90 members from 24 countries, and the initiative’s total funding is €360 million.

Professor Roberto La Ragione, the Surrey Principal Investigator and Head of the School of Biosciences at the University of Surrey, said:

“With the rising numbers of diseases in animals that are spreading to humans, the scientific community is waking up to the fact that animal health and welfare are inextricably linked to our own.

“I’m proud that our University is joining colleagues from across the country and Europe, so that we can not only share and tackle these issues at a large scale, but also find sustainable solutions that improve the wellbeing of the animals that we share this planet with.”

The European Partnership on Animal Health and Welfare aims to support a food system that is fair, healthy, and environmentally friendly. Its goals align with the European Green Deal and the related Farm to Fork strategy, which focuses on sustainable food production.

Professor Kamalan Jeevaratnam, Head of the School of Veterinary Medicine at the University of Surrey, said:

“Our University has a long-standing commitment to the One Health, One Medicine ethos, and we are excited to share our expertise and learn from our partners. This collaboration underscores the UK’s significant role in advancing the wellbeing of humans, animals, and our natural environment for a better future.”

Nathalie Vanderheijden of the University of Ghent, coordinator of the EUP AH&W, sums up the partnership as follows:

“Our partnership is a new, open initiative, bringing together EC funding, national/regional funders and research-performing organisations to concentrate efforts on developments with high societal, economic and policy impact. Belgium, with its current presidency of the European Council for six months, appreciates the potential of unity in driving change!”

Speaking of the Partnership EFSA’s, Chief Scientist Carlos Das Neves said:

“We are pleased to announce that EFSA will be a full partner of the European Partnership Animal Health & Welfare. This is the first time that we will be a beneficiary in a research partnership under Horizon Europe, which will enable a smoother transition from research to regulatory science. We are prepared and committed to bring our expertise to the table, together with the best experts in Europe, for the benefit of animal health and welfare.”

The European Partnership on Animal Health and Welfare started on the 1st of January 2024 and held its kick-off meeting on the 26th and 27th of February 2024 in Brussels. All partners signed the Grant Agreement on the 29th of March 2024.

Image: Marie Anna Lee