With the state of cancer diagnosis a source of national disgrace, chairman of the APPG on Cancer John Baron MP says it is time for government action.
As the general election looms closer, cancer care has become a high-profile topic both in Westminster and in the public eye. And so it should be. By the end of the next Parliament in 2020, almost three million people will be living with cancer in the UK.1 The NHS will not be able to cope with this surge in demand unless it is successful in delivering a dramatic improvement in outcomes for people with cancer. And this means driving forward initiatives which promote earlier diagnosis.
Too many cancer patients continue to be diagnosed too late. It remains a national disgrace that a quarter of all cancers are first diagnosed as late as A&E. If we matched the best survival rates in Europe, the Government estimates that 10,000 lives a year would be saved. We should strive to make this a reality.
This is why the All-Party Parliamentary Group on Cancer (APPGC), together with the wider cancer community, has campaigned for the one-year cancer survival rates to become part of the of DNA of the NHS at a local level through the Clinical Commissioning Group Outcomes Indicator Set (OIS). As late diagnosis makes for poor one-year figures, highlighting the one-year figures at a local level should act as a spur to promote a range of initiatives promoting earlier diagnosis – these could include better awareness campaigns, more diagnostics at Primary Care, better screening uptake, and faster GP referral.
To this end, the APPGC is dismayed that the recently-introduced tier of accountability which now sits above the Clinical Commissioning Group OIS – the Delivery Dashboard of the NHS Assurance Framework – contains no specific cancer outcome indicators. This error sends the wrong message and dilutes the efficacy of the OIS’ outcome indicators in promoting earlier diagnosis. Correcting this error remains a key objective of the APPGC.
However, the APPGC welcomes the strong commitments from political parties and the NHS leadership to improve the NHS’ performance in this crucial area – earlier diagnosis truly is cancer’s ‘magic key’. Jeremy Hunt has announced a package of measures to improve diagnosis and treatment, as well as a ‘Four Pillar Plan’ for the NHS which focuses both on improving compassionate care and on older people. At their Party Conference, the Liberal Democrats voted in favour of introducing free social care for people on an end of life care register, something which will particularly resonate with people affected by cancer. Furthermore, Ed Miliband has committed to provide support to help GPs diagnose cancers early, as well as public information campaigns and access to tests for all urgent diagnostics within one week by 2025.
In addition, NHS England’s visionary Five Year Forward View, published in October, acknowledges that improvements in outcomes for people affected by cancer will require better prevention, swifter access to diagnosis, as well as better treatment and care for all those diagnosed with cancer.
All these announcements are welcome, and are testament to the fact that improving the lives of people with cancer is a key priority which goes beyond party politics. However, with less than six months to the general election, the APPGC is keen to see the policy detail beneath these commitments. We are hosting our annual cancer care conference, ‘Britain Against Cancer’ – the UK’s largest one-day cancer conference – next week and would like to see the party leaders and NHS England representatives use this opportunity to present their detailed thinking.
It’s as simple as this: cancer survival rates in England are currently amongst the worst in Europe – there is much work to be done. The APPGC hopes the ‘Britain Against Cancer’ conference will be used to address our poor survival rates and set out the further necessary steps for the UK to match the best in Europe.
A further area of concern is the uncertainty around the future of the National Cancer Peer Review programme. This quality assurance programme is important for accountability and to inform patient choice. Ministers have confirmed that peer review will continue to play a critical part in the health service. As such, the conference is the perfect opportunity to present details on how the NHS will continue to ensure peer review is valued and retained.
Finally, we’ve seen the NHS take great strides in improving the experience of care of patients. However, we still have a long way to go on this. People with rarer cancers continue to report poorer experiences than people with more common tumours. Similarly, people with a long term condition other than cancer (or multiple long term conditions), some ethnic minority patients and younger patients are less positive than other groups about their care and treatment.2 This variation is unacceptable. The Britain Against Cancer conference should be used to indicate how the next government and the NHS will make sure that all people with cancer are always treated with the dignity and respect they deserve. And, in addition, how they will ensure that staff on the ground are equipped and supported to be able to deliver compassionate care.