England’s cancer strategy set out bold ambitions to save thousands more lives each year by 2020 through preventing more cancers, diagnosing cancer earlier and modernising treatments.
To help achieve this, NHS England established 16 Cancer Alliances, bringing together NHS staff from diagnosis to treatment to improve local cancer care.
Alliances are the backbone of cancer care and they’re putting together plans to work out what staff they need. This is in response to last year’s NHS cancer workforce plan, which promised 5,000 extra staff by 2021 to help deal with the growing pressure on services.
So what issues are they facing? We spoke to one of our network of clinicians to find out.
‘The money is there but the people are not’
“It’s difficult, in the northern region up to a third of many clinical jobs are not filled,” says Dr Chris Tasker, a cancer GP for the Northern Cancer Alliance.
This strain is felt across NHS cancer care but some parts, such as diagnostic services, are especially hard hit.
“Across England, 10% of radiologist posts are vacant, and in our region that rises to a quarter of posts,” says Tasker. “On top of that, in the next 5 years a quarter of the radiologists in the region will be ready to retire.”
Some factors are specific to different regions, but some are making things worse across the country.
“From my experience, the uncertainty around Brexit means many healthcare professionals are leaving the UK, and those EU citizens who may once have considered a career in the NHS are rethinking their options,” says Tasker.
And within England, geography plays its part. “All too often people move to other areas to find work after their training,” says Tasker. “If more staff stayed in the north after their training there wouldn’t be as much of a problem.”
Staff shortages have caused delays for some patients getting tests and treatment on time.
“In some areas like the north, services like breast cancer clinics have had to close because of shortages of surgeons or radiologists, meaning patients have to travel further,” says Tasker.
And shortages mean that, while diagnostic equipment like CT scanners are often in constant use, there aren’t enough staff to quickly report on the results.
Every Cancer Alliance is pulling together their own local cancer workforce plan to come up with solutions. But there’s no easy fix, and a solution in one area may not be as effective elsewhere.
“The Northern Alliance is working hard to help fill these posts. We are told there will be more doctors and healthcare professionals but it’s not clear where from,” says Tasker. “Our Alliance and many others have increased the number of trainee places but this won’t fix the problem any time soon; the extra medical students will only have an effect in 7 to 8 years.”
So Alliances are looking to innovate:
- Introducing ‘passports’ that let consultants work in different hospitals are helping to make sure cover is in place when needed;
- Digitising the results of scans or samples means they can be analysed by staff in different departments without the patient having to move;
- New technologies, such as artificial intelligence, could help spot warning signs of cancer on scans and reduce staff workload, but this hasn’t been fully proven.
A long-term cure is needed
Already stretched NHS cancer services are under growing pressure.
An ageing population means more people are getting cancer. Now, more than 330,000 people are diagnosed per year. But by 2035 this will increase to 500,000.
And earlier diagnosis efforts and better treatments mean more people are surviving for longer.
The plans being put in place now should address staff shortages over the next few years and hopefully alleviate some pressure. But the Alliance plans only cover up to 2021, and a longer-term approach to workforce planning is needed.
“Governments are elected for 5-year terms but NHS workforce plans need be for the next 15–20 years, if not longer,” says Tasker. Health Education England is working on plans covering part of that.
It’s clear addressing staff shortages isn’t an easy task. That’s why we’ll be looking at the Alliance plans in April, and responding to Government consultations on long term options.
The NHS is struggling to cope. The next few months provide a critical chance to make sure it gets the staff it needs now and for the future.