NHS Cancer Programme team and COVID-19 updates

AMMF’s CEO, Helen Morement is attending the weekly virtual COVID-19 briefing meetings with the NHS Cancer Programme team …

Today’s meeting (07.04.2020) was chaired by David Fitzgerald (Programme Director, NHS Cancer Programme), Peter Johnson (National Clinical Director for Cancer, NHS England and NHS Improvement), and Cally Palmer (National Cancer Director for NHS England and NHS Improvement).

Top left, Peter Johnson. bottom left, David Fitzgerald, and bottom right, Cally Palmer – and AMMF’s question …

Amongst this morning’s discussion topics were the expected surge in incidence and mortality, the anxiety created through lack of information, and that treatments may be cancelled because of the high risk of infection

The new COVID-19-free hubs were discussed at length.  Many of these hubs are independent hospitals, and this is seen as a way to ensure cancer services continue in a safer environment.  Surgical guidance is expected soon, and doctors/consultants have already received detailed information to help them in their decision making, which should always be in discussion with their patients, in continuing/starting treatment vs the risks involved.

AMMF is very concerned about the situation many cholangiocarcinoma patients are finding themselves in, and Helen took the opportunity to explain this to the panel:  

Q: Helen Morement – AMMF – The Cholangiocarcinoma Charity:
Re: surgery for cholangiocarcinoma (the only potentially curative treatment), the main issue is staff – anaesthetists, surgeons, theatre, CNS’s are all being re-deployed at short notice to ramp up invasive/non-invasive ventilator capacity as well as supporting the medical inpatients (ratio of ITU to ward COVID patients 1:3).

Even with COVID free hubs, it seems workforce, patient and staff screening remains a major issue. It seems undertaking major resections that potentially require level 1 or 2 beds are now unlikely, with dire consequences.

In addition, radiology services are providing only basic emergency cover (so there’s restriction to procedures like PVE that may be required prior to a major liver resection).

Chemotherapy is being restricted because of risk, clinical trials closed to recruitment.  A dire situation for all those with cholangiocarcinoma …

This was picked up and answered by Peter Johnson – who spoke about surgery, but didn’t address staffing and testing problems, nor on the seeming limitations to other treatments such as chemotherapy because of COVID-19 risks.

A: Professor Peter Johnson – National Clinical Director for Cancer, NHSE/I (NHS England and Improvement)
“Cholangiocarcinoma is obviously surgically tricky, and has a high requirement for intensive care post operatively and I know that this is an area of difficulty around the country.  People are trying to prioritise it as much as they can, and think about alternative modes of treatment such as pre-operative chemotherapy, but it is recognised as an area of pressure. And again the surgical specialities are thinking about ways of addressing this and I think the surgical hubs are going to be important for people with this diagnosis.”

AMMF is in frequent contact with members of the charity’s Medical/Clinical Advisory Board, for advice on behalf of CCA patients – although many of our board members are now having to take frontline duties as the numbers of patients with the coronavirus increases.  We will also continue to raise the problems so many CCA patients are currently experiencing when and where we can with the NHS and other concerned bodies.

For more information and current advice for those with cholangiocarcinoma during this current coronavirus pandemic, see: https://ammf.org.uk/covid-19-advice/


07 April 2020