GP and leading light at pioneering centre is retiring – but not calling it a day

Leading the work to create a pioneering centre that has shaped services across and beyond Wales is enough of a challenge for anyone.

But while Heather Wilkes is retiring from her twin roles as a GP and the clinical director of the Rapid Diagnosis Centre at Neath Port Talbot Hospital, she is not ready to put her feet up just yet.

“It’s time for me to look for other things and it’s always good for other people to come into a service,” she said. “Everybody has new ideas.

“I’ve been here since 2016 and been a GP in Briton Ferry since 1995. I’m looking to do some more locum work and see what else I feel I can add value to. I’m not retiring from clinical work yet. I’m going to see what’s out there, by way of new challenges.”

Heather has been closely involved with the RDC, which opened its doors in Neath Port Talbot seven years ago next month, from the beginning. And even after formally retiring she is doing locum shifts there.

GPs with concerns about patients who do not have the traditional red flag sings of cancer can refer them to the RDC.

They are usually seen within a week and are investigated and given the results or next steps all in one morning.

If the patient is found to have cancer they are referred to the relevant specialist team for assessment without unnecessary delay.

Some patients are found to have non-cancer conditions and also signposted to the appropriate team. Others are reassured all is okay.

Heather’s work with local cancer services and, eventually, the RDC, began 10 years ago when she became co-chair of the ABMU (Swansea Bay’s predecessor organisation) Cancer Commissioning Board.

“As part of that work we were looking at primary care access to diagnostics, to improve cancer outcomes,” she said.

“Being a GP, you can see things from every angle. Whereas once you’re in a hospital setting, sometimes you can be blind as to how patients got there.

“People don’t realise how difficult it can be to get somebody to the right place as quickly as possible.”

In 2016, Heather was part of an all-Wales team that went to Denmark to look at their work there.

That led to funding being agreed for the first two RDCs in Wales, one in Neath Port Talbot – where the name was coined – the other in Cwm Taf.

“We opened in 2017 and it was such a success,” Heather recalled. “That’s where most of my cancer services work continued. During that time I was also the health board’s Macmillan GP for a few years.

“Then the success of the RDC in Neath Port Talbot became the template for the rollout nationally. The Welsh Government felt it was worth having it in every health board and so the team here took the lead on that, and I was the national lead for the two and a half years of the project.”

Last year the Wales Cancer Network, including strong representation from the NPTH team, won an NHS Wales Award for its partnership approach to establishing RDCs across Wales.

Thanks to its efforts, Wales is now the first UK nation to have an RDC service in all areas.

Neath Port Talbot’s expertise has also helped support the development of rapid diagnosis centres in Scotland and Northern Ireland.

Unsurprisingly, the RDC has also won awards over the years and is shortlisted in this year’s Moondance Cancer Awards.

And the association with Welsh not-for-profit organisation Moondance Cancer Initiative extends well beyond that.

Two years ago Moondance funded a pilot expansion of the RDC. Its contribution of £700,000 allowed the single-visit approach to be extended to investigating colorectal cancer and neck lumps, along with other key improvements.

With the Moondance funding having reached its agreed end, Swansea Bay University Health Board has approved the permanent continuation of the neck lump service.

It has agreed additional funds which will also mean an extended biopsy service, established during the two-year pilot will continue and be further extended to include patients with lymphadenopathy.

A third weekly vague symptoms clinic is also being introduced, to meet a sharp increase in demand since Covid.

Despite the RDC’s ongoing success, however, Heather said getting it up and running in the first place had not been straightforward.

“It was very difficult because it was a brand-new concept. The service, the RDCs, didn’t exist, but also patient category of vague symptoms that could be due to something serious didn’t exist either,” she said.

“It was a big challenge getting that accepted and recognised. But the teams in NPT were fabulous in hosting and supporting.

“The managerial and estates teams but also the clinical teams that worked here to get this set up initially, particularly Dr Martin Bevan, Dr Firdaus Adenwalla, Dr Derrian Markham and Dr Sian Phillips. It’s a true team effort.”

And while Heather hoped, during those early days, that the RDC would become a success, it has exceeded her expectations.

“When I went to Denmark, I thought, if we can make this work, this will be one of the things that is desperately needed,” she said. “I was conscious that the problems I faced as a GP were the same everywhere.

“I hoped it would be successful but to become the first country where we had a national RDC based on the one in Neath Port Talbot, I never dreamt that would happen. Wales is the first UK nation to have complete national coverage, and it started here.

“I am proud of what we have achieved. But the best thing has been developing the team and seeing what we can achieve together, and the difference it has made to the people who come here.”