The Joint Health Overview and Scrutiny Committee was scheduled to discuss the reprovision of services at the Mount Vernon Cancer Centre (MVCC) and receive updates on the Care Closer to Home initiative. The committee was also due to consider a formal scrutiny response to the public consultation on proposed changes to services currently provided at MVCC.

Mount Vernon Cancer Centre Reprovision Consultation and Care Closer to Home Updates

The committee was scheduled to receive an update on the public consultation regarding proposals for the Mount Vernon Cancer Centre. This included information on how the consultation was being delivered and governed, participation data, and emerging themes from the first half of the consultation period. Actions being taken to address gaps in engagement were also to be outlined. Concerns raised at a previous meeting about the consultation progressing before capital funding was secured were to be clarified, with confirmation that assurance processes began in early 2025 and a route to capital funding was agreed in January 2026. The alignment of the MVCC scheme with the Watford scheme was to be discussed, noting that feasibility had been tested but was subject to the outcome of the public consultation.

Updates were also expected on the delivery programme, with the NHS in wave two of the West Hertfordshire delivery scheme, and a provisional start date of 2031/32. Aspirations to bring this timeframe forward due to the need to relocate the cancer centre were noted, but the consultation period needed to be completed before final details could be confirmed. Feedback from this scrutiny was anticipated by the end of June 2026.

A programme had been developed to support structured engagement with groups facing barriers to traditional consultation methods, working through Voluntary, Community, and Social Enterprise organisations. Direct funding was provided to cover their costs and access to an additional participation fund to help remove barriers to engagement.

Questions were raised about whether consultation responses submitted after the closing date of 29 March would still be considered. It was explained that while the NHS wished to receive as many responses as possible, a cut-off date was necessary to complete the final report.

Engagement with cancer patients was to be discussed, noting that the consultation questionnaire included a question about respondents' patient status. Patients were informed via the cancer centre, referring hospitals, and cancer support groups. Banners at Mount Vernon Hospital directed patients to the consultation website. Due to consent requirements, direct written communication with current patients was not possible, but information was included in appointment letters. It was noted that most attendees were former patients or family members, as confirmed by an NHS consultant.

Carers' groups had been contacted, and the Integrated Care Board was asked to support engagement through its communications and engagement teams. Local social prescribers were also contacted to help disseminate information. Engagement with oncologist leads at neighbouring hospitals was ongoing to ensure wider sharing of consultation information, as patients were drawn from a wide geographical area.

Modelling undertaken regarding potential travel costs and impacts for each council was to be discussed, alongside a running travel and access survey and updated modelling of demand and footfall for the Watford site. This work would inform consultation responses, particularly public and patient views on delivering care closer to home. The potential for certain treatments to be delivered at home was noted, removing the need for travel. More detailed transport planning would be undertaken in collaboration with local authorities.

Three options for radiotherapy provision were presented: A) all services to Watford; B) Watford with an additional unit at Lister Hospital, Stevenage; or C) Watford with an additional unit at Luton and Dunstable Hospital. Based on consultation responses to date, support for options B and C was broadly even, with option A also attracting significant support. Criteria for radiotherapy relocation, including acute services, parking, public transport, health inequalities, rurality, patient numbers, and treatment range, were to be considered. The weight given to consultation responses versus the principle of care closer to home was questioned, with the explanation that unless there was strong public support for centralisation, radiotherapy is a specialised service. Any satellite service would be delivered by the Mount Vernon team. No decision had been made on the most appropriate location for satellite radiotherapy, but providing it at more than one site could benefit more patients.

Concerns were raised about the low proportion of male and ethnic minority respondents. Engagement activities undertaken to encourage greater participation from these groups were to be discussed, including translated materials, advertisements, work with diverse FM radio, visits to organisations, microgrant programmes, and targeted engagement. Communications about an event in Wembley on 14 March were coordinated through Integrated Care Boards and trusts, with additional promotional activity including geo-targeted newspaper advertising and social media campaigns. Wembley was chosen for its central location. Efforts had been made during consultation meetings to explain the clinical need for change and address access concerns, highlighting that within the current configuration, the NHS could treat all clinically eligible patients. The possibility of an Option D for radiotherapy provision was queried, but it was explained that elements of Option A were incorporated into Options B and C, with chemotherapy at home also being a potential option.

The committee was asked to note the conclusions of the consultation, including the public consultation being live from 19 January to 29 March 2026, compliance with legal and regulatory requirements, participation levels, actions to address under-representation, early themes being raised, and local intelligence that should shape the remainder of the engagement programme.

Mount Vernon Cancer Centre Transport and Access Update

An update was provided on the work concerning transport and access in support of the Mount Vernon Cancer Centre consultation. Transport and accessibility were noted as the most frequently raised issues and a significant concern for patients. Key themes included car parking availability and cost, and public transport connectivity across Hertfordshire, particularly east-west travel. Access to Watford Hospital and car parking provision were viewed unfavourably by some respondents, though it was confirmed that a large multi-storey and surface-level car park was in place. The proximity of Watford Football Club was considered, with match days not currently coinciding with cancer treatment schedules and any potential future clashes expected to be minimal.

Suggestions to mitigate access issues included park-and-ride facilities, minibus services, and voluntary transport. An independent social research organisation was commissioned to carry out a separate engagement exercise on how patients accessed the centre. Findings would inform the Decision-Making Business Case, focusing on current travel patterns, behaviours, circumstances influencing choices, and barriers to using MVCC services. This survey was due to close at the end of May 2026, with indicative feedback to be provided at the 16 June meeting.

A suggestion for a dedicated bus service linking the hospital with mainline railway stations was noted, though the NHS had limited influence over bus routes. Discussions with local authorities would explore potential innovative solutions as further modelling progressed. The importance of public health considerations when assessing transport route access was emphasised.

A visit to the Watford site was considered helpful for committee members to experience the journey and see the proposed site, to be arranged by the Programme Director, Ruth Derrett. Discussions with bus service providers had not yet taken place as no formal decision had been made. The development of the hospital would allow scope for these discussions once a decision was confirmed. Intelligence on travel hotspots and areas where changes might be required was being gathered to inform future planning.

Members were asked to note the ongoing work around travel and access and to consider writing to Local Authorities urging them to partner with the NHS in improving access to a new cancer centre in Watford for patients across the three regions and ten local authority areas.

It was noted that patients currently travel to London for haematology services, which would move to the Watford site under the proposals, improving accessibility for many. UCLH managing both London and Watford centres would offer greater flexibility in determining the most appropriate treatment location while supporting patient choice. The wider consultation concerned the future configuration of services, and the survey was introduced to address a gap in understanding patients' travel choices and the factors influencing them.

MVCC Relocation Case for Change

This report aimed to update the Joint Health Overview and Scrutiny Committee on the clinical case for change underpinning proposals to relocate Mount Vernon Cancer Centre (MVCC). It served to refresh members on the reasons for change and provide high-level feedback from the recent consultation as the programme moved towards the decision-making phase.

The report stated that MVCC provides specialist non-surgical cancer services for over two million adults across Hertfordshire, Bedfordshire, Buckinghamshire, Berkshire and North London. Clinicians have consistently advised that specialist cancer services cannot be sustained indefinitely on the current site in Northwood due to a lack of acute hospital services. Advances in cancer care have made treatments more complex, and patients are living longer with multiple conditions, requiring access to critical care and specialist medical teams not available on the current site. Consequences include the loss of inpatient and outpatient haematology services, the inability to undertake early phase clinical trials, and patients needing to receive treatment elsewhere or be transferred by ambulance when they become unwell. Recruiting and retaining staff is also becoming more challenging.

The public consultation identified concerns about travel, transport, parking, and accessibility, but these did not challenge the underlying clinical evidence for the need for acute hospital services.

The committee was asked to note the challenges and consider the case for change. The report detailed that concerns about MVCC's sustainability have been raised for many years, amplified by rapid evolution in cancer treatments and technology. An Independent Clinical Advisory Group in 2019 concluded that the status quo was not viable, highlighting the need for comprehensive medical, surgical, and critical care support not available on the current site. Modern cancer services rely on close collaboration with a wide range of acute medical and surgical specialties. The limitations of the current site are evident, with services for blood cancer patients having already moved elsewhere. Patients requiring highly specialised treatment often travel outside the local area, and some become seriously unwell during treatment, requiring emergency transfer. Access to clinical trials is also limited. Without change, the gap between MVCC and other specialist centres is likely to widen, making it less attractive for staff. Maintaining services on a standalone site risks continued loss of services, reduced access to modern treatments, recruitment difficulties, greater reliance on other organisations, and fragmentation of patient pathways. Co-location onto an acute hospital site provides immediate access to critical care, acute medicine, specialist surgery, emergency diagnostics, specialist inpatient services, and multidisciplinary clinical expertise, enabling advanced treatments and rapid response to complications.

Feedback on the clinical case for change indicated that the concerns about sustainability and the benefits of co-location provide a compelling case for relocation, with remaining on the current site posing a real risk of closure. No evidence presented during the public consultation undermined this case. However, qualitative feedback showed some respondents, particularly from North West London, wanted the centre to remain on the current site. A small number of alternative non-acute sites were suggested, but these were reviewed and found not to address the clinical challenges, ultimately leading to longer journeys and closure.

The conclusion stated that evidence confirms specialist cancer services at MVCC cannot be sustained indefinitely on the current site. Consultation findings do not contradict the clinical evidence supporting co-location with acute hospital services for safe, sustainable, and modern cancer care.

MVCC Core Proposals

This report aimed to update the committee on the proposal to relocate Mount Vernon Cancer Centre to Watford, how proposals were tested with patients and the public, feedback from the public consultation (January-March 2026), and the next steps in the decision-making process. The paper focused on the core proposal to relocate specialist cancer services to a new purpose-built cancer centre at Watford General Hospital.

The report stated that the Mount Vernon Cancer Centre Strategic Review was established to address longstanding clinical concerns regarding the sustainability of specialist cancer services on the current site in Northwood. Following extensive clinical review, options appraisal, public engagement, and programme assurance, relocation to a purpose-built centre on the Watford General Hospital site was identified as the preferred solution.

A public consultation between January and March 2026 sought views on these proposals and associated service changes, with over 3,500 people participating. The consultation survey received 2,222 responses, and a community microgrant programme enabled local organisations to run their own discussions, resulting in 68 independently organised community events.

The consultation showed a range of views, with many respondents recognising the clinical challenges at the current site and supporting relocation. Others expressed concerns regarding travel, transport, parking, accessibility, and the potential loss of the current centre's calm environment. The findings provide an evidence base for the Decision-Making Business Case, with commissioners considering the findings, reviewing suggestions, and undertaking further analysis before developing final recommendations.

The background detailed that the proposal is the result of years of clinical review and public involvement. Independent clinical advice in 2019 concluded that specialist cancer services require access to acute hospital services, and maintaining the status quo was not viable. A range of options were considered, including maintaining services at the current site, dispersing services, building smaller centres in each region, and relocating to a new facility adjacent to acute services. Patients, carers, staff, and stakeholders were involved throughout the process. Options were assessed against clinical, operational, workforce, deliverability, and accessibility criteria. Dispersing services was discounted due to concerns about fragmentation and workforce sustainability. Building smaller centres was ruled out due to insufficient scale for specialist expertise. Watford General Hospital emerged as the preferred acute hospital site as it met clinical criteria and had the lowest overall impact on travel times. Core clinical criteria included on-site critical care and a range of medical and surgical specialties. Core travel criteria included minimal increase in average driving times, no significant increase in drive times over 30 minutes, minimal increase in public transport travel times, and no increase in proportion of patients travelling over 75 minutes. Watford General Hospital met all these criteria, being the closest acute hospital, capable of accommodating a purpose-built centre, and part of the national 'New Hospitals Programme'.

Consultation findings showed 48% of respondents supported the proposals, with 42% opposing them. Support was stronger among healthcare professionals (69%) than the public. The central finding was that views mainly reflected perceived impacts on access rather than disagreement with the clinical case. Support was determined by whether respondents believed access would improve or worsen for their locality. Improvements in access were a key factor for supporters, who accepted the need for change and believed co-location would improve safety, access to treatments and trials, and the long-term future of services. Opponents commonly raised concerns about travel times, transport, parking, costs, reliance on carers, and the loss of the current site's environment. People living in London boroughs were most likely to oppose. Travel, transport, and accessibility were the dominant issues. Support was often conditional on credible solutions for parking, patient transport, travel costs, wayfinding, maintaining the centre's culture, and transition arrangements. Many respondents supported the clinical ambition but questioned the sufficiency of mitigation for access impacts.

Themes requiring further consideration included travel and accessibility, with a joint working group being established. Patient experience and design groups were looking at consultation responses. Health inequalities required further investigation, with a revised Equality Health Impact Assessment underway. Questions regarding deliverability and transition were also noted, with further work to strengthen assurance on funding, timelines, workforce, and implementation. A recurring concern about decisions already being made was identified, stemming from the presentation of a preferred proposal. Alternative suggestions received during the consultation were being assessed against the same criteria. Over 100 ideas were made, including alternative hospital sites, travel and design suggestions, and clinical considerations.

The report identified seven principles for future arrangements: maximising patient access to safe, high-quality care; minimising unnecessary travel; minimising practical burdens; delivering care locally where safe; reducing existing inequalities; preserving valued qualities of MVCC; being realistic and deliverable; maximising research and innovation; and ensuring coordinated patient pathways. The conclusion stated that the consultation does not challenge the clinical rationale for change but provides a strong mandate for commissioners to demonstrate that access, transport, inequalities, and patient experience have been fully considered.

The committee was asked to note the report.

Mount Vernon Cancer Centre Reprovision Consultation and Care Closer to Home Updates

The committee received an update on the consultation regarding the proposals for Mount Vernon Cancer Centre (MVCC). This included how the consultation was being delivered and governed, participation data, and emerging themes. Actions to address gaps in engagement were outlined. Concerns about capital funding were clarified, with a route to funding agreed in January 2026. The MVCC scheme was to be aligned with the Watford scheme, subject to consultation outcomes.

Updates were provided on the delivery programme, with aspirations to bring forward the relocation timeframe. Feedback from this scrutiny was expected by the end of June 2026. A programme had been developed to support structured engagement with groups facing barriers to consultation methods, working through Voluntary, Community, and Social Enterprise organisations.

Questions about considering responses after the closing date were addressed, with a cut-off date necessary for the final report. Engagement with cancer patients included questionnaires and information provided through the cancer centre, referring hospitals, and support groups. Carers' groups were contacted, and the Integrated Care Board was asked to support engagement. Patients were drawn from a wide geographical area, necessitating ongoing engagement with oncologist leads at neighbouring hospitals.

Modelling on potential travel costs and impacts was underway, alongside a travel and access survey. This work would inform consultation responses, particularly regarding care closer to home. The potential for treatments to be delivered at home was noted. More detailed transport planning would be undertaken with local authorities.

Views relating to radiotherapy provision were discussed, including three options: A) all services to Watford; B) Watford with an additional unit at Lister Hospital, Stevenage; or C) Watford with an additional unit at Luton and Dunstable Hospital. Support for B and C was broadly even, with A also attracting significant support. Criteria for radiotherapy relocation were considered, including acute services, parking, public transport, health inequalities, rurality, patient numbers, and treatment range. The weight given to consultation responses versus the principle of care closer to home was discussed, with the explanation that radiotherapy is a specialised service requiring dedicated equipment and staff. No decision had been made on the location of satellite radiotherapy, but providing it at more than one site could benefit more patients.

Concerns were raised about the low proportion of male and ethnic minority respondents, and engagement activities to encourage participation were discussed. Communications about an event in Wembley were coordinated through Integrated Care Boards and trusts, with additional promotional activity including geo-targeted newspaper advertising and social media campaigns. Wembley was chosen for its central location. Efforts had been made to explain the clinical need for change and address access concerns. It was clarified that all clinically eligible patients could be treated within the current configuration. The possibility of an Option D for radiotherapy was queried, with elements of Option A incorporated into Options B and C, and chemotherapy at home also being a potential option.

The committee was asked to note the conclusions of the consultation, including the live period, compliance with legal requirements, participation levels, actions to address under-representation, early themes, and local intelligence.

Mount Vernon Cancer Centre Transport and Access Update

The committee received an update on work concerning transport and access in support of the Mount Vernon Cancer Centre consultation. Transport and accessibility were identified as the most frequently raised issues and a significant concern for patients. Key themes included car parking availability and cost, and public transport connectivity across Hertfordshire, particularly east-west travel. Access to Watford Hospital and car parking provision were viewed unfavourably by some respondents, although a large multi-storey and surface-level car park was confirmed to be in place. The proximity of Watford Football Club was considered, with match days not currently coinciding with cancer treatment schedules and any potential future clashes expected to be minimal.

Suggestions to mitigate access issues included park-and-ride facilities, minibus services, and voluntary transport. An independent social research organisation was commissioned to conduct a separate engagement exercise on patient access patterns, with findings to inform the Decision-Making Business Case. This survey was due to close at the end of May 2026, with indicative feedback to be provided at the 16 June meeting.

A suggestion for a dedicated bus service linking the hospital with mainline railway stations was noted, although the NHS had limited influence over bus routes. Discussions with local authorities would explore potential innovative solutions as further modelling progressed. The importance of public health considerations when assessing transport route access was emphasised.

A visit to the Watford site was considered helpful for committee members to experience the journey and see the proposed site, to be arranged by the Programme Director, Ruth Derrett. Discussions with bus service providers had not yet taken place as no formal decision had been made. Intelligence on travel hotspots and areas requiring changes was being gathered to inform future planning.

Members were asked to note the ongoing work around travel and access and to consider writing to Local Authorities urging them to partner with the NHS in improving access to a new cancer centre in Watford for patients across the regions and local authority areas.

It was noted that patients currently travel to London for haematology services, which would move to the Watford site under the proposals, improving accessibility for many. UCLH managing both London and Watford centres would offer greater flexibility in determining the most appropriate treatment location while supporting patient choice. The wider consultation concerned the future configuration of services, and the survey was introduced to address a gap in understanding patients' travel choices and the factors influencing them.

Scrutiny Response to Consultation on Proposed Changes to Services Currently Provided at Mount Vernon Cancer Centre

This report was presented to the Joint Health Overview and Scrutiny Committee (JHOSC) to propose a collective response to the NHS consultation on the future of Mount Vernon Cancer Centre (MVCC) services. The committee was asked to agree the content of the JHOSC response, its formal statutory position, and whether further action or escalation was required.

The report detailed that MVCC provides specialist non-surgical care for over two million adult patients across Hertfordshire, London boroughs of Hillingdon, Harrow, Brent and Ealing, Buckinghamshire, Luton, Central Bedfordshire, Bedford, and Slough. NHS England conducted a public consultation between January and March 2026 on proposals including relocating MVCC to a new centre adjacent to Watford General Hospital, increasing chemotherapy at home and at Hillingdon and Northwick Park Hospitals, repatriating haematology services for Hertfordshire and Bedfordshire patients to Watford, increasing local diagnostics and monitoring, and providing an additional radiotherapy unit in Stevenage or Luton.

The JHOSC, comprising representatives from ten local authorities, had previously considered the clinical case for change, co-location at Watford, UCLH as the preferred provider, the consultation plan, interim responses, transport and access, and plans for Care Closer to Home. The Committee Chair was invited to submit a formal response by 16 July 2026.

The committee was presented with two options for its formal response: Option A, where the committee is satisfied that needs have been considered and no further recommendations are needed; or Option B, where the committee is broadly satisfied but recommends actions to address outstanding concerns.

The report stated there were no financial or legal implications arising from the report. It also noted that no Equalities Impact Assessment (EqIA) or Sustainability & Equality Evaluation Decision Support (SEEDS) assessment was undertaken as they were not applicable.

The committee was asked to agree its formal response and consider the proposed actions to address outstanding concerns.