The Health Service Journal (HSJ) has reported that responsibility for commissioning certain specialised services, including chemotherapy, could be given to clinical commissioning groups as part of an NHS England review which is in its early stages. The review is also considering which services should cease to be classified as specialised, with chemotherapy under reconsideration. According to HSJ, the original rationale for classifying chemotherapy as specialised was the high cost of the drugs used in the treatment. There has also reportedly been speculation that radiotherapy services could be handed back to CCGs, which would likely be resisted by clinicians.
Cancer Research UK (CRUK) and the National Cancer Intelligence Network (NCIN) have published Cancer by Deprivation in England, which examines the link between deprivation quintile in England and cancer incidence and mortality. Key findings of the report are as follows:
- Incidence and mortality for all cancers were higher in more deprived quintiles than the least deprived. If rates in the most deprived quintiles had matched those in the least deprived, 15,300 fewer cancers would have been diagnosed each year and 19,200 fewer people would have died from cancer each year between 2007-2011
- Such deprivation related differences in incidence and mortality have not improved over time. In men, the difference between those in the least and most deprived quintiles in the incidence of non-Hodgkin lymphoma and Melanoma actually increased over the last 15 years
- Between 2006-2010 the incidence of female breast cancer was highest in the least deprived quintile but the most deprived quintiles had a statistically higher mortality rate with an estimated 350 excess deaths each year between 2007-2011
- When comparing deprivation quintiles, lung cancer was found to have the largest number of excess cases (11,700) and deaths (9,900) in more deprived quintiles. Other cancers related to smoking also had strong links between deprivation, incidence and mortality
- For all cancers, the ‘deprivation gap’ was not statistically different between males and females. However, in seven cancer sites specifically, including colorectal cancer, the deprivation gap was larger in males than females
The NICE board held one of their regular meetings this Wednesday. Of particular interest, they discussed the potential to update the process by which Quality Standards are reviewed and issued a draft statement clarifying what constitutes as compliance with a technology appraisal. The board meeting papers are available here.
The Sunday Times has reported on the “postcode lottery” in cancer care, based on preliminary early diagnosis figures released by Public Health England.
The figures demonstrate that in the best performing areas, such as South Cambridgeshire and North Devon, six out of ten cancers are diagnosed at an early stage. In other parts of the country, such as East Sussex and Tower Hamlets, less than four in ten patients are diagnosed at an early stage. The data demonstrate that 42 per cent of cancers are diagnosed early, and that there are large variations around the country. The article notes that this may be partly due to differences in the quality of data, and also because of patients’ failure to report symptoms, as well as medical delays in diagnosis.
The Sunday Times has reported on Public Health England figures which are expected to show that half of the most commons cancers are being diagnosed after the disease has already spread. Other figures which the article notes are that:
- Older people and those from less affluent areas are more likely to suffer from late diagnosis
- 10,000 lives could be saved with faster diagnosis and improvements in care
- Four out of ten patients are diagnosed when their cancer is at an advanced stage
- Approximately half of ovary, kidney, and oesophageal cancer patients are diagnosed at an advanced stage
- Less than one in ten colon cancer patients are diagnosed at the earliest stage of the disease and five year survival rates for colon cancer are 51.3 per cent in England, compared to a European average of 57 per cent
- 14 per cent of breast cancer patients are still diagnosed once the cancer has spread, despite screening programmes improving treatments
- 59 per cent of cancers were diagnosed at stage one or two in 2011
- For every increase of 1 per cent of patients diagnosed in stage one or two, an additional 1,200 patients would be alive after five years
Cancer Research UK publishes figures which show that half of all cancer patients now survive ten years
CRUK has published new figures showing that half of people diagnosed with cancer today will survive for at least ten years. These figures have been covered by The Telegraph, The Daily Mail, The Guardian and The Times.
In their press release, CRUK outline a new strategy to accelerate progress, with the ambition that three quarters of all cancer patients diagnosed in 20 years time will survive at least ten years. This compares to 50 per cent of people with cancer today and just 25 per cent of people who had cancer in the early 1970s. The new figures show that women with breast cancer now have a 78 per cent chance of surviving at least a decade, compared to 40 per cent 40 years ago. They further demonstrate that just five per cent of lung cancer patients diagnosed today can expect to live for ten years.
The Sunday Times reports on Macmillan's findings that significant numbers of patients are diagnosed in A&E
The Sunday Times has covered a report from Macmillan which reveals that one in four cancer cases are diagnosed in accident and emergency after being “ignored by patients or missed by GPs”. Macmillan argue that this late recognition of symptoms means that thousands of patients are dying unnecessarily from cancer. Figures show that 32 per cent of ovarian cancers, 39 per cent of lung cancers and nearly two thirds of brain cancers are diagnosed in A&E. For patients referred by their GP to see a specialist within two weeks, the average one year survival rate is 72 per cent. For patients diagnosed after being admitted as an emergency, the average survival rate drops to 40 per cent. The report can be read in full here: here.
The Sunday Times has reported on polling figures regarding cancer services, following a YouGov poll they commissioned as part of their Beat Cancer campaign. Key findings of the polling of cancer patients, or those who had a relative with cancer, are as follows:
- 40 per cent experienced delays with referrals, tests or treatment
- 17 per cent experienced a delay in getting referred by a GP
- 15 per cent experienced a delay in getting an appointment with a consultant
- 13 per cent experienced a delay in getting scans or other tests
- 11 per cent experienced a delay in getting treatment
- 48 per cent of those who experienced delays thought it had a negative impact on the quality or outcome of treatment
- 81 per cent thought the treatment they received from the NHS was good
- 37 per cent of those surveyed have “little or no confidence” in the ability of GPs to spot the signs of cancer
- Over a quarter believe cancer treatment in the UK is worse than in the USA and Europe
- More than a third said insufficient priority was given to pancreatic, bowel and bladder cancer
Hugh Bayley MP (Lab, York Central) this week presented a Bill on right to treatment in the NHS under a Ten Minute Rule Motion. It should be noted that Ten Minute Rule Motions rarely become legislation but provide MPs with opportunities to raise issues of importance. Mr Bayely described the NHS as a lottery in which access to treatment depends on where a patient lives and the local NHS budget. He said that the Bill would:
- Require the Government to set up a public register of all individual funding requests (IFR) made to NHS England and CCGs, as well as the decision on whether the NHS will pay for treatment
- Introduce a presumption in favour of treatment where a treatment is recommended by an NHS clinician (unless the procedure or medicines is not improved by NICE or is designated in a statutory instrument as a treatment no longer available on the NHS)
- Ensure that patients who have treatments supported by their doctor, but who are turned down by the NHS, are given the right of appeal to an independent tribunal
Jane Ellison MP, Parliamentary Under-Secretary of State for Public Health, made a statement to the House of Commons this week on standardised packaging of tobacco products. She announced the results of Sir Cyril Chantler’s review on the issue and said that she was minded to introduce regulations to provide for standardised packaging of tobacco products. The regulations will be published alongside a short consultation, which will ask for any new information since the last consultation, in 2012, that is relevant to the introduction of the policy. The details of this consultation are to be published shortly.