The coalition government today published a new cancer plan – Improving Outcomes – A Strategy for Cancer – in which they set out a plan to prevent more cancers, improve the country’s cancer services and raise survival rates to match the best in Europe.
The Strategy – which has been allocated £750 million over four years – demonstrates the government’s commitment to improving outcomes for cancer patients in England.
But with the current financial challenges and looming radical restructures in the NHS, the most important element will be how the Strategy is put into practice.
This crucial challenge needs to be met to ensure cancer services continue to improve for patients and their families.
The Strategy aims to:
- diagnose cancer earlier,
- help people to live healthier lives to prevent cancer,
- screen more people,
- introduce new screening programmes and
- ensure that all patients have access to the best possible treatment, care and support.
But the underlying point of all this is to drive up England’s cancer survival rates so that by 2014/15 an extra 5,000 lives will be saved. This is vital – England continues to lag behind some of the best performing countries in Europe in terms of survival.
What does the strategy say?
Significantly, this is the first strategy which attempts to put the government’s proposed NHS reforms (set out in last year’s White Paper, Equity and Excellence: Liberating the NHS) into practice for a specific disease.
A central theme throughout the Strategy is the focus on ‘outcomes’ – the effectiveness and safety of treatment and care to patients – and how these will be used to monitor progress and improvement in the delivery of cancer services. The Strategy also emphasises the coalition government’s commitment to choice, commissioning and the importance of transparent, accurate, usable and timely information on service quality.
The Strategy correctly identifies that smoking is the major preventable risk factor for cancer, and commits to publishing a tobacco control plan. However, we need the government to take further action to face up to the scale of the challenge – as we have said before, this includes dealing with tobacco marketing, implementing Point of Sale legislation as soon as possible, and moving towards the sale of cigarettes in plain packaging.
It’s good news that the focus on spotting cancer early will continue. We’re particularly pleased by the announcement of a new policy research unit on Cancer Awareness, Screening and Early Diagnosis.
This will sit alongside improved primary care access to key diagnostic tests, awareness-raising campaigns about the signs and symptoms of cancer, and the introduction of flexible sigmoidoscopy to prevent more bowel cancer deaths (as announced last year).
Boosting radiotherapy services is also a positive step. As we pointed out last year, shortages of both staff and equipment means that some patients are missing out having radiotherapy as part of their treatment, and we lag behind the rest of Europe in offering cutting-edge radiotherapy techniques such as intensity-modulated radiotherapy (IMRT). The Strategy states that additional funding will be made available over the next four years – although it doesn’t actually pin an actual amount of money on this commitment.
However, all these commitments come at a time of restructure within the NHS. With responsibility for promoting awareness and early diagnosis being passed to a new body, called “Public Health England”, it will be important the reforms set out in Equity and Excellence: Liberating the NHS do not impede the commitments in the Strategy.
But what about clinical research?
We’ve said previously that clinical research studies in the NHS are vital for cancer research in this country to progress. But the new Strategy says very little about how the Department of Health will support the different areas of cancer research, from basic through to clinical, and how they plan to co-ordinate this support with other government departments such as Vince Cable‘s Department for Business, Innovation and Skills.
So we’d like to see more about how the current regulatory and governance barriers could be reduced to enable better access to patient data for use in research, and embed a culture of research in the NHS.
The Strategy makes clear that cancer will remain a political priority throughout this parliament, with the National Clinical Director for Cancer, Professor Mike Richards, required to deliver annual reports on how outcomes are improving, and the Secretary of State, Andrew Lansley, being tied to the commitment to save an additional 5,000 lives a year.
However, during this period of radical NHS change and financial austerity, there is still a risk that services could suffer. So the government will have to remain focused on delivering excellent cancer services to patients and their families.
Emily Arkell is a policy manager at Cancer Research UK