Lives of the fellows

Roger David James

b.31 March 1946 d.2017
MRCS LRCP(1970) MB BChir(1971) MRCP(1977) FRCR(1978) FRCP(2002)

Roger James was director of Kent Cancer Services. He was born in Wolverhampton, Staffordshire, the son of David James, a steel worker, and Florence James née Reynolds, a housewife. He was educated at Wolverhampton Grammar School and went on to Trinity College, Cambridge and St Bartholomew’s Hospital Medical School.

He held house officer and senior house officer posts at Southend General Hospital and was then a registrar at Middlesex Hospital. From 1977 to 1979 he was a senior registrar at Mount Vernon Hospital, London. During this period, he was a Berkeley scholar at Massachusetts General Hospital. In 1979, he became a consultant in oncology and radiotherapy at the Christie Hospital in Manchester.

In April 1999 he was appointed by the Mid Kent Healthcare Trust as director of Kent Cancer Services. Historically, patients from Kent had been required to travel into London for most of their cancer care, with the result that local services were poorly resourced and of variable quality. Maidstone participated in a national audit of cancer waiting times in the mid-90s. The results were shocking, showing a very poor quality of care nationally, with enormous variations between and within localities.

The Trust’s strategic goal was to develop high quality cancer services for patients in Kent. Roger’s appointment was a key part of this strategy and there were high expectations placed upon him from the outset. He did not disappoint.

Roger quickly set out his vision for Kent Cancer Services, which would be evidence-based, coordinated across the whole health system, and delivered by clinical specialists. His previous experience at the Christie Hospital had convinced him of the benefits of multidisciplinary working and this was central to his plans. He proposed the creation of a cancer services network across Kent and Medway, and the establishment of CATS (clinical advisory teams) and DOGS (disease orientated groups) that would bring together clinicians, managers and commissioners to develop new standardised treatment protocols and optimal patient care pathways. While the phraseology initially caused some cynicism, the plans were well received and supported.

The Kent and Medway Cancer Network was the first to be established in the UK and was held in high regard nationally. The network ensured a whole systems approach, from primary and community care through to tertiary links with London specialists. It placed the need for sub-specialisation in cancer services high on the agenda for Kent and had a significant impact on the development of radiology and cellular pathology services, the expansion of consultant oncologist numbers and surgical sub-specialisation. When the NHS Cancer Plan was published in 2000, Kent had already implemented many of its recommendations as a result of Roger’s vision and leadership, and this gave added legitimacy to the new ways of working.

None of this was easy. Roger met many challenges along the way. Competition between trusts, rivalry between consultants, reversing funding flows from London and a general unwillingness to change were daily obstacles. Roger remained pragmatic, yet focused and determined. None of us can remember Roger losing his temper despite extreme provocation. He worked tirelessly across the entire network of services, raising the profile of hitherto ‘Cinderella’ services such as palliative care, and pioneered the development of ambulatory care pathways and palliative care in the home.

Alongside the development of the Network, Roger also worked to develop an academic health sciences centre with the University of Kent, and to raise the Network’s profile and participation in research and development, ensuring that patients had the opportunity of participating in clinical trials.

Roger was recognised nationally for clinical excellence in colorectal research at the highest level. He served on the council of the Association of Coloproctology of Great Britain and Ireland, and was instrumental in representing oncology in this group and driving improved standards through their membership.

He also maintained a busy clinical role as an oncologist, specialising in colorectal care. He drove miles to run clinics in remote locations. This may be why he was an early pioneer of and advocate for remote IT links! He was delighted that he could participate in three multidisciplinary team meetings in one morning (in Margate, Hastings and Ashford) from the oncology centre in Maidstone.

Roger had enormous reserves of energy and was always full of new ideas. He was very hard to keep up with. Working with Roger could be frustrating at times, but it was always exciting, inspirational and fun. His phone never stopped ringing! He had a wonderful sense of humour and a great love of music, which he indulged by singing and playing the guitar in the oncology centre band, which entertained us all at oncology centre parties.

Roger’s leadership transformed cancer services across Kent and Medway. Today patients are assured prompt, coordinated and high quality cancer care, a lasting legacy of his great work. He had three children from his marriage to Enid Mary Griffiths.

Lynne Clemence
Saad M B Rassam

(Volume XII, page web)

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