Cancer patients in Greater Manchester have led the way in designing what will become the first specialist surgical centre of its kind in the region. Over recent months people with stomach and gullet cancers have been working with doctors and NHS managers to set out what they want to see change.

Unique ID: NHS_UCLH_DAY 1 SIGNAGE_0002 Caption: Hospital interior. Information sign above a door. Direction to operating theatres, OR. Restrictions: Copyright: ©

Now doctors and health commissioners have this week agreed that surgery for stomach and gullet cancers will take place in one dedicated centre for Greater Manchester, at Salford Royal Hospital. This means that the expertise and experience can all be focused in one team, which will mean better and more consistent high quality care for patients.

At the moment Salford Royal Hospital carry out a majority of the 150 operations each year, with others being undertaken at the Manchester Royal Infirmary and Wythenshawe Hospital. These patients will now all have their major surgery at Salford Royal; though following the specific request of patients themselves, outpatient appointments will remain local. Doctors and nurses from all three sites have worked together to design this cutting-edge service.

Greater Manchester Health and Social Care Partnership has worked with individuals affected by these cancers through patient groups including the Oesophago-gastric Patient Association and the Upper-gastrointestinal (UGI) Support Group to address inconsistencies across Greater Manchester and ensure that everyone will benefit from the same high standards of care and access to treatment.

Dr Nigel Guest, Chief Clinical Officer for NHS Trafford Clinical Commissioning Group said “Bringing three separate services together to jointly develop one leading service will allow us to make significant improvements in the quality of care, leading to better patient outcomes. We’ve been told by patients what matters to them and what changes would make a difference to their lives. We’ve listened and this feedback has shaped the changes made”.

“From named keyworkers introduced to patients at the time of diagnosis; to seven-day access to scans; jargon free written information about their condition and a detailed end of treatment care plan; every stage has been led and informed by patients. These standards are all written into the contract that the hospital will deliver on.”

Sue Kernaghan, a patient representative, who has sat on the External Clinical Assurance Panel, shares her story:

“I was diagnosed with breast cancer fourteen years ago. I had an operation, chemotherapy and radiotherapy: the full hit. This was a really scary time. After nine months of treatment, I was in remission, yet I didn’t feel well enough to re-enter the real world.”

“As a result, I changed my job, but in the meantime, was asked to become a patient representative over in Merseyside. This led to me being chair of a patient group in Chester and I was also invited to sit on several clinical network groups; one of which was for UGI cancer. It is ironic that whilst sitting on this group, I was diagnosed with a GIST – a rare UGI cancer. After a big operation and part of my stomach removed, I felt I had earned my badge to sit on the group.”

“It is amazingly powerful to speak at these meetings and start a sentence with ‘as a patient’. The professionals listen to you and respect our input. We have had many successes of tweaking the system for the good of patients.”

“When asked if I could sit on a group in Greater Manchester, I was delighted to bring my patient experience to the table to give patients a voice, shape good practice and make a difference. As I was from outside the area, I didn’t have any preconceptions and could give my view. The group also included two eminent UGI surgeons who have national recognition for their expertise, an oncologist, a clinical nurse specialist and manager. It was a truly multi-disciplinary team and all key parts of someone’s day-to-day experience in hospital.”

“There have been challenges, yet throughout, we didn’t lose sight of the need to make meaningful change for Greater Manchester residents. We’ve started from scratch from diagnosis to recovery.  I’ve helped ensure that referral pathways to other parts of the hospital were in place, such as referral to psychological support.”

“I feel it is important that we develop specialised centres like this one. In rarer cancers, the surgical expertise needs to be brought together under one roof. I would rather be operated on by a surgeon who is doing these operations time and time again and has the expertise needed for someone like me.”

“I also championed the clinical nurse specialist as patients’ named worker. We know that they are wonderful at explaining things and answering questions; and that patients value their support and input. They look at you holistically and take into account your practical and psychological needs. The introduction of CNSs as key workers helps enormously, not only for the medical side, but by signposting to other relevant people to help in the journey e.g. counsellors, talking therapy and charities that provide additional support. This is how a multi-disciplinary team can help. This personal support will continue after leaving hospital, with a community key worker too. This really helps in reducing the worry and stress felt after treatment.”

“I feel proud that there are a set of standards, developed by patients and professionals.”

Lord Peter Smith, Chair of Greater Manchester Health and Social Care Partnership Board said “We know that Greater Manchester has some of the highest rates of premature cancer death in the country. Although still in its infancy, this news is a fantastic example of transforming life-saving care and making a difference so that every single person across the region has access to consistent high-quality care and support”.

“Devolution is helping to improve health services in Greater Manchester by putting forward bold ideas to make sure we have a strong and sustainable NHS and social care in the region.”

Continuing Greater Manchester’s reputation as a centre for excellence within clinical research, patients will be invited to participate in clinical trials where appropriate.

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