The Bromley Council Health Scrutiny Sub-Committee was scheduled to meet to discuss an update from King's College Hospital NHS Foundation Trust (KCHFT) regarding the proposed reconfiguration of haematology services at the Princess Royal University Hospital (PRUH). The meeting was also scheduled to cover future meeting dates.

Reconfiguration of Haematology Services at PRUH

The Sub-Committee was scheduled to receive an update from Julie Lowe, Deputy Chief Executive Officer, and other representatives from KCHFT, regarding a proposal to redesign haematology services at the Princess Royal University Hospital (PRUH).

The primary aim of the proposal was described as being to deliver clinical quality improvements and optimise clinical outcomes for haemato-oncology patients¹. The proposals were also intended to enhance local service provision, improving the haematology patient journey for patients in the PRUH catchment area.

In shaping these proposals, we are informed by the NHS England Specialised Commissioning Operating Model 2023 on specialised services which emphasises equity, efficiency, and consistency of care.

Haematological cancers affect the blood, bone marrow and lymphatic system, and include conditions such as leukaemia, lymphoma and myeloma. Haemato-oncology is a specialised clinical subspecialty that brings together the fields of haematology and oncology in the treatment of cancer. According to the report pack, haemato-oncology care is delivered nationally through a tiered Haematology care hospital model, with each site registered at a specific tier level determining the level, type, and complexity of treatment that the site can provide.

King's College Hospital, Denmark Hill (KCH/DH) operates at the highest tier level as a site for highly specialised treatment and procedures, providing the full spectrum of haematological care and treatment, including stem cell transplantation, CAR-T and gene therapy. The PRUH provides a range of haematology care focusing on general haematology, outpatient clinics, with day-case procedures like blood transfusions, and supportive care for patients receiving low- to intermediate-intensity chemotherapy.

According to the report pack, Chartwell Ward is a 12-bedded mixed cancer and general medical unit at PRUH, accommodating approximately 8 Haematology inpatients and 4 Oncology or general cancer patients at any given time. The report pack stated that most chemotherapy administered on Chartwell is for haematological conditions (88%), and of these the majority (60%) are part of the AML regiment².

The report pack outlined a case for change, stating that the PRUH site has a relatively small number of new Haematology diagnoses a year, and some of these patients are referred to the KCH/DH site as more intensive chemotherapy is required. It also stated that nurses at PRUH have limited exposure and opportunities to maintain annual SACT[^4] competencies, introducing clinical risk when delivering chemotherapy on the ward.

The proposal was for the consolidation of inpatient Haematology care onto the KCH/DH site, and to enhance both the elective and emergency day case provision / pathways at the PRUH site. The report pack stated that there were no proposed changes to any other cancer pathways at the PRUH site. It was also proposed that a further 8 beds would be opened at KCH/DH to accommodate an increased number of elective and acute haematology patients from the PRUH site.

The report pack considered two options:

• Option 1: Maintain current model (status quo) - This option was not recommended due to maintaining inequity of access to enhanced patient pathways and wider clinical infrastructure available at the KCH/DH site, an inability to meet national standards, and the difficulty of staff to maintain SACT competences.
• Option 2: Planned reconfiguration - This option would consolidate inpatient (elective) Haematology to KCH/DH, with planned engagement and transition, and enhance the day case pathways at the PRUH site. This option was recommended as it aligns with NHSE best practice, provides immediate patient access to more treatments including clinical trials and novel therapies, and ensures all King's elective Haematology patients receive standardised care and benefit from the specialist care and support available at the KCH/DH site.

The report pack stated that a project team had been mobilised under a structured programme to facilitate the effective delivery of this work, and that the governance process would be informed by a robust Quality Impact Assessment and an Equality Impact Assessment.

The Sub-Committee was asked to note and consider the case for change and the proposed options, note the assessment of service change and the planned engagement approach, and agree how the committee would wish to be kept informed and involved as work progresses.

Future Meeting Dates

The Sub-Committee was also scheduled to note the dates of future meetings: Wednesday 21st January 2026 and Thursday 5th March 2026.