The Welsh Government has just published its first ever comprehensive cancer plan – Together Against Cancer – in which it sets out how it will prevent more cancers and improve cancer services in Wales.
The plan’s overall aim is to provide a clear strategy to improve Wales’ cancer survival rates so that they are comparable with the best in Europe. This is vital – Wales continues to lag behind some of the best performing countries in Europe.
The plan demonstrates the Government’s commitment to improving outcomes for cancer patients in Wales.
But the financial climate represents a significant barrier to putting the plan into action. This crucial challenge must be met to ensure cancer services continue to improve for patients in Wales and their families.
Here’s a quick review of what the plan covers, and our reaction to it.
What does the plan say?
Over the coming years, the Welsh Government aims to:
- help people maintain a healthy lifestyle and minimise their risk of cancer;
- detect cancer quickly;
- deliver fast, effective treatment and ongoing support, both to give people the best possible chance of recovery, and so they feel well-informed and able to cope with the effects of cancer;
- plan and deliver the treatment and care that best suit every individual patient.
Significantly, this is the first comprehensive cancer plan for Wales – it covers every stage of the cancer journey: prevention, early diagnosis, screening, delivering high-quality cancer services, supporting people living with cancer, as well as improving cancer information, and promoting research.
A central theme throughout the plan 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 plan also emphasises the Welsh government’s expectations for the NHS in Wales:
- to prevent and treat cancer and to show leadership and vision for tackling cancer and its consequences;
- ambitions for what NHS services will look like by 2016;
- the themes for action up to 2016 through local cancer services delivery plans;
- and how success will be measured.
The plan also commits the government to reduce the number of people smoking.
But we need them to take further action to face up to the scale of this particular challenge. As we’ve said before , this includes implementing Point of Sale legislation as soon as possible – meaning that businesses would no longer be able to display tobacco products to the public – and moving towards the sale of cigarettes in plain packaging.
Both measures would help discourage children in Wales from taking up smoking by minimising their exposure to tobacco advertising.
Awareness and early diagnosis
We’re delighted that the plan focuses on promoting awareness and early diagnosis of cancer, and we’re particularly pleased by the announcement to give GPs direct access to tests if they suspect a patient might have cancer.
This will sit alongside efforts to actively improve the proportion of people who attend screening when invited, and to ensure there’s sufficient capacity to treat and care for people referred by the cancer screening programmes.
But we also want the Welsh government to introduce a test called flexible sigmoidoscopy as a priority, as research has shown that this can prevent a third of bowel cancers and reduce deaths from bowel cancer by up to half among those people who are screened.
It’s also good to hear about the plans to invest in radiotherapy services, by planning the location of equipment with Cancer Networks.
As we’ve pointed out before, shortages of both staff and equipment mean that some patients are missing out having radiotherapy as part of their treatment, and the UK lags behind the rest of Europe in offering cutting-edge radiotherapy techniques such as intensity-modulated radiotherapy (IMRT).
Clinical research studies in the NHS are vital for cancer research to progress. The new Welsh plan stipulates that Local Health Boards must foster a strong culture of research to support and encourage protected research time for clinically active staff and build on and extend academic training schemes to develop a highly skilled workforce.
So it’s good to see that the plan includes research as a specific policy aim. We know that patients treated in research-active environments receive better care and the UK has led the way in increasing the number of cancer patients involved in clinical trials. Continued support for cancer research is crucial to underpin improvements in cancer services, and, ultimately, outcomes.
In principle we think it’s a great idea that Local Health Boards [link] are responsible for turning the ideas in Together Against Cancer into a reality. This will enable services to be developed in response to patient need and local demand.
But if it’s to be a success, it will also be essential for a whole range of organisations – the Welsh government, the Cancer Networks and the Cancer Implementation Group – to work together and monitor implementation of the plan’s aims and ambitions.
Putting it all into practice
But as we said above, all these commitments come at a time of financial pressures within the NHS. With constraints on budgets increasing from all directions it will be important that financial concerns do not impede the commitments in the plan.
The economic situation, and the uncertainty about how events will pan out around the world, is never far from the headlines.
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 if it’s to continue to improve Welsh cancer services and, ultimately, improved outcomes for patients and their families.
Emily Arkell is a policy manager at Cancer Research UK