Up to 5,000 beds facing axe in NHS cancer shake-up

11 May 2008

The Sunday Times, Sarah-Kate Templeton, 11 May 2008

The government plans to close up to 5,000 beds on cancer wards in a reorganisation of the way patients are treated, according to a report by experts in the disease.

Government figures show the National Health Service aims to save up to £500m a year from an “inpatient management programme” that it describes as preventing unnecessary hospital admissions and reducing the length of time patients spend in hospital.

Cancer doctors and health economists say the changes could make better use of money for cancer treatment but accuse the government of hiding the extent of the bed closures from the public.

The report by Nick Bosanquet, professor of health policy at Imperial College School of Medicine, London, and Professor Karol Sikora, medical director of CancerPartnersUK, a private cancer treatment company, comes as a shake-up of NHS hospitals, led by Lord Darzi, the health minister, is expected to include widespread closures of maternity hospitals and accident and emergency units.

Bosanquet and Sikora have analysed figures published by the government as part of its Cancer Reform Strategy in December. They reveal the efficiency savings the NHS will need to make in order to pay for better radiotherapy and screening programmes.

“My worry,” said Sikora, “is that the only way the Cancer Reform Strategy adds up financially is by massive bed closures to produce the funding for the huge deficits in both radiotherapy and cancer drugs.

“Up to 5,000 beds will need to disappear in England to make the spreadsheet balance. How else will the money be saved? Interestingly, the financials are not in the strategy document but hidden in an obscure corner of the Department of Health website.”

The government said cancer services must change so that patients can receive chemotherapy and radiotherapy during day trips to local clinics without going to hospital. It is also centralising specialist cancer care in larger hospitals where there is the expertise to get the best results.

The government has been forced to review NHS cancer treatment after studies showed that, despite spending comparable amounts on the disease as other European countries, Britain still has some of the worst survival rates.

Bosanquet, who was chairman of the Cancer Reform Strategy value for money group, said cutting beds could make better use of NHS funds but added the government should be more open about its plans.

“The Department of Health has put forward aspirations that must inevitably be to lower bed use in cancer services by around 5,000,” he said. “To save £500m, which is urgently needed to build up these community centres, they will need to reduce bed use in cancer services and the best estimate is that it would be by about 5,000 beds. I would urge the Department of Health to be a lot more open about it.”

Sikora maintained that while cancer patients can receive chemotherapy and radiotherapy during daytime visits to local cancer clinics some patients will be so sick they will need to stay in hospital. He said these patients did not need high-tech beds in large hospitals, which cost about £400 a day, but could be cared for by nurses in cottage hospitals.

The Department of Health denied beds on cancer wards will be closed. A spokeswoman said: “We are not planning to close beds, rather we are identifying efficiency gains by using new models of care and streamlining existing inpatient care.”