Two years ago England’s cancer strategy was launched with an ambition of saving 30,000 more lives each year by 2020.
It featured vital commitments to prevent more cancers, diagnose cancers earlier, and modernise the NHS to help treat cancer better.
But plans need action.
Our Chief Executive, Sir Harpal Kumar, chairs the National Cancer Advisory Group, which keeps track of how the plans are being made reality, and earlier this week he gave evidence to MPs about what’s changed in two years.
Some progress has been made, like the announcement of funding to upgrade radiotherapy machines, but there’s a lot more to be done. This is especially true for supporting understaffed NHS teams that diagnose cancer, as well as addressing cuts to cancer prevention services.
Progress so far
NHS England’s own assessment of progress can be read here, and earlier this week the National Cancer Director, Cally Palmer, said a quarter of the cancer strategy is done and another half is underway.
A National Cancer Team has been created to provide leadership, which led to Palmer’s appointment as National Cancer Director – we’re pleased that the team around her has grown to get more done.
Providing better care for people affected by cancer is the focus of new guidance, as well as a clear plan of what the NHS will do, and when, to make the cancer strategy a reality.
It costs money to make some of the changes the strategy recommends. And so far a significant amount has been invested on top of existing NHS spending on cancer:
- £130m to upgrade radiotherapy machines
- Up to £300m per year in additional funding for diagnosis
- £200m in funding to improve cancer services
It’s great that the Government is putting money behind the strategy. We’re especially pleased with the investment to diagnose more cancers earlier – earlier diagnosis can have a big impact on a patient’s chances of survival.
Since the publication of the cancer strategy, 16 Cancer Alliances and 3 National Cancer Vanguards have been set up across the country. These are groups of doctors and NHS managers from hospitals, specialist units and general practice with the specific goal of working together to plan to improve local cancer services, which is really good news.
But they need money from NHS England to make these plans a reality and change local services. Cancer Alliances also need to be able to share what works and what doesn’t, allowing examples of good practice to be developed more widely. Palmer told MPs that there is more NHS England can be doing to help Cancer Alliances talk to each other, which was good to hear.
There have also been initiatives aimed at cancer prevention, diagnosis and treatment, for example:
- The soft drinks industry levy – or ‘sugar tax’ – will come into effect in April 2018 to help tackle obesity.
- The Faecal Immunochemical Test (FIT) will replace the test currently used for bowel screening to make screening easier and more effective.
- 75% of drugs on the old Cancer Drugs Fund have now been made available through the new fund, making sure patients can access the latest drugs.
- Test centres are trialling how to ensure patients are diagnosed within 28 days of referral. This is positive news – NHS England should use these pilots to improve how people with suspected cancer are treated, making their journey quicker and easier.
This progress is encouraging, but some significant challenges remain before we can reach the ambitions the strategy set. And at a time when the NHS is under considerable strain this won’t be easy.
Read more about the short staffed NHS
Big challenges for the NHS
Despite the progress, some of the big challenges the NHS and cancer services face include:
- Workforce: The NHS staff who diagnose cancer working hard to deliver an excellent service, but they are failing to keep pace with growing demand. This will affect the ability of the NHS to diagnose more cancers early, a key commitment of the strategy. The key focus of MPs’ questioning earlier this week was on developing a sustainable cancer workforce – there is widespread recognition of this huge problem.
- Prevention: The NHS has promised a “radical upgrade in prevention” to prevent illness and disease including cancer. But since the cancer strategy was published, local public health budgets have received substantial cuts, undermining prevention efforts. This has been especially damaging to local Stop Smoking Services, many of which have seen cuts. Cancer minister Steve Brine agreed with Harpal that prevention is crucial, so we will keep pushing for action in this area.
- Great care everywhere: Some areas of the country have seen more progress than others. The new Cancer Alliances and Cancer Vanguards must be supported to come up with new ways to improve local cancer services and share their expertise.
Addressing these challenges is crucial if ambitions are to be met and cancer patients in England are to receive care matching the best in the world.
We are calling for the following steps to be taken:
- The Government must stop cutting local public health budgets and give councils the funding they need for vital services, such as Stop Smoking Services.
- The Government, NHS England and Health Education England need to publish a plan to tackle shortages in the cancer diagnostic workforce. You can join our campaign for action on this here.
If these challenges aren’t met, there’s a growing danger that the ambitions of the cancer strategy will not be reached.
And that would mean an estimated 30,000 extra lives a year would be at risk, rather than saved.
Matt Case is a policy advisor at Cancer Research UK