Best of both worlds

Shams Maladwala, managing director of The Royal Marsden Private Care, on the Trust’s integrated model of private and NHS care and its new Cavendish Square facility

Interview: Ellie Costigan

I have been with The Royal Marsden Private Carefor nearly seven years now. As managing director of private care, I‘m responsible for the governance and management of private patients within the framework of the Trust, including operational, clinical and commercial aspects.

We have an integrated model; it’s the best of both worlds, private and NHS. In practical terms, it means we have distinct areas within the Trust—the NHS side and the private care side—but it is very much a symbiotic relationship. There are also areas that are shared between NHS and private patients, such as surgery and the ICU. It is much more efficient and a betterquality experience to have a shared resource for these clinically key areas.

The integrated model works on a number of levels. It works for patients, most importantly, because they get the safety assurance and governance that is so important in private healthcare. It works for sponsor groups, insurers and embassies, because they are assured that whatever pathway is taken, it will be evidence based. When drugs are prescribed, they are prescribed within the context of a multi-disciplinary team. It works for consultants, because they can carry out their private and NHS practice within the confines of one organisation, alongside the Trust teams they’re used to working with on a day-to-day basis. This leads to more time spent with patients and a better quality and continuity of care.

And, fundamentally, this integrated model also works for the Trust. All revenue generated via the private care division goes back into the Trust. This enables further investment into our teams, our kit, our staff, our research, and that benefits all patients. I believe this model has been a contributor to the fact that the private care side has doubled in size in the past five years. We also have an outstanding CQC rating. These results are testament to the success of our integrated model. Other Trusts have similar arrangements, but The Royal Marsden is the largest of these private patient units in the country.

The fact that we are research-led is another very big differentiator of The Royal Marsden. It means patients can access the very latest and most innovative treatments in oncology. We have clinical trials happening all the time. We work in partnership with the Institute for Cancer Research, so we really do offer cutting-edge treatments: whether it’s the latest genetic tests, CAR T-cell therapy, or the latest type of MR imaging. Having access to that, whether you’re a private or an NHS patient, is, I believe, the basis for outstanding care. Our new Cavendish Square site is an embodiment of that.

The new centre, due to open in the spring, is all about enabling us to diagnose cancers faster and earlier. We will have a full diagnostic imaging suite on hand, including MRI, CT, x-ray, mammography and ultrasound, plus nasoendoscopy and colposcopy. Chemotherapy will be available and there will be very clear pathways to and from The Royal Marsden. There will be on-site pathology and pharmacy. Patients will have fast and direct access to The Royal Marsden’s world-leading diagnostic and researchactive consultants. It really gives patients and referrers assurance that The Royal Marsden, as Europe’s largest cancer centre, is providing a comprehensive set of services—and it’s all backed by research. We are making a statement about our ability to deliver the kind of service we think is right. On the same day, they can have a consultation, diagnostics, bloods and get the results. That speed is key.

While COVID-19 has presented challenges, I’m pleased to say we have managed to create, in partnership with the independent sector and with the government’s support, a cancer hub to ensure that patients have access to lifesaving surgery and other treatments in a protected environment. There are also several things we’ve found through the pandemic that help drive efficiency and those are things that we’re going to look to retain. For example, virtual consultations are a great way to minimise the time patients spend in a hospital while also maximising consultants’ time. We are also developing our home-based services, such as at-home chemotherapy.

Over time, a greater number of international patients have sought to access The Royal Marsden’s treatments from all over the world, not just the traditional health markets. We’ve found through virtual technology—not just consultations, but the ability to provide training and education in those markets— that there are ways we can give those patients better access to treatment. With Cavendish Square, there is even greater opportunity to offer all our patients, both domestically and internationally, treatments and rapid diagnostics of the very highest quality.