The Telegraph has reported on the publication of a new report by the Organisation for Economic Co-operation Development (OECD) that shows that Britain’s survival rates for cancer is significantly lower them many other European countries. The report found that for overall cancer mortality, Britain was eighth from bottom in a league table of 35 countries — on a par with Poland, Estonia and the Czech Republic, and worse than Russia. Moreover, the article reports that patients with breast, bowel and cervical cancer fare worse in Britain than in the vast majority of industrialised nations, with only Poland shown to be worse for all three of the cancers. The report also notes that health spending has fallen in real terms in Britain in the past two years, while waiting lists for many common operations have become longer. The Telegraph article is available here. The OECD report is available here.
Cancer Research UK has revealed that more children are beating cancer due to improvements in the treatment of the disease, with at least 80% now surviving compared to 30% in the 1960s. The number surviving for five years or more has increased from 79% to 82% in the past decade. The charity said the improvement is largely due to combining different chemotherapy drugs. Survival rates are higher for all children’s cancers, although liver and bone tumour treatments have made the most progress. More information can be found here.
The Department for Health has issued a refreshed Mandate to NHS England which will come into effect from 1 April 2014. In this Mandate, the Government has carried forward all existing 24 objectives from the previous one, but made some additions, although Mr Hunt adds that the changes have been kept to a minimum to ensure the Mandate remains strategic, outcomes focused and affordable. Mr Hunt notes that the Mandate also reflects work by NHS England to improve integrated care by supporting a fair playing field for providers and improving outcomes for children and younger people. He further adds that the Government has allocated extra funding to A&E’s to help handle pressures this winter. The full ministerial statement can be accessed here. The full Mandate can be accessed here
The Department for Health has issued a refreshed Mandate to NHS England which will come into effect from 1 April 2014. In this Mandate, the Government has carried forward all existing 24 objectives from the previous one, but made some additions, although Mr Hunt adds that the changes have been kept to a minimum to ensure the Mandate remains strategic, outcomes focused and affordable. Mr Hunt notes that the Mandate also reflects work by NHS England to improve integrated care by supporting a fair playing field for providers and improving outcomes for children and younger people. He further adds that the Government has allocated extra funding to A&E’s to help handle pressures this winter. The full ministerial statement can be accessed here. The full Mandate can be accessed here.
The Department of Health has published the NHS Outcomes Framework 2014/15. The framework sets out the outcomes and corresponding indicators used to hold NHS England to account for improvements in health outcomes. The technical detail for the live indicators in the NHS Outcomes Framework for 2014 to 2015 will be published in one document on the Health and Social Care Information Centre website in the spring of 2014. The NHS Outcomes Framework 2014/15 is available here for review.
There have been updates to some indicators and new measures included of particular interest to cancer are:
- Improvement area 1.4, under 75 mortality rate from cancer. This indicator will be published from February 2014 and will include one-year and five-year survival from all cancers, and one-year and five-year survival from breast, lung and bowel cancer combined
- Improvement area 2.1, proportion of people feeling supported to manage their condition. This indicator was announced last year and is now live
Following the publication of the NHS Outcomes Framework for 2014/15, NICE and NHS England released a document outlining how NICE Quality Standards can support improvement in quality in relation to the NHS Outcomes Framework (NHS OF). The document provides an update to indicators on the NICE menu for consideration by NHS England for the 2014/15 CCG OIS, and Quality Standards that will be published during the remainder of 2013-14 and during 2014-15, as well as listing current indicators and NICE work programmes. Of particular relevance, the document outlines the following indicators to be published in the Clinical Commissioning Group Outcome Indicator Set (CCG OIS) menu for consideration in 2014/15 regarding general cancer care:
- Cancers detected at stage 1 or 2
- Cancers stage at diagnosis
- Cancers diagnosed via emergency routes
The National Cancer Research Institute (NCRI) has published data which suggests that having on-site oncology consultants in hospitals with A&E departments could improve the diagnosis and treatment of patients, as well as reduce their stay in hospital. This comes following work carried out by The Clatterbridge Cancer Centre NHS Foundation Trust to ensure that cancer patients admitted through A&E have access to oncology consultants from the start to avoid confusion around diagnosis and treatment.
Analysis of the service showed that a large proportion of patients did receive “major benefit” from being seen by oncology consultants. Some of these benefits included more effective management of side effects and quick action on appropriate investigations for new cancer patients. Further to the successful clinical outcomes, the NCRI also says that it was economically successful as cost savings were made from reduced bed costs due to the reduced length of stay. More information on these findings can be found here.
The new scheme will see the NHS branded medicines bill stay flat over the next two years, and then grow slowly after that. The industry will make compensating payments to the Department of Health if NHS spending on branded medicines goes beyond the agreed growth rate.
NICE will continue to introduce the “broader value assessment for new medicines covered by value-based pricing”. According to the statement from the Department of Health, NICE will carry out a full public consultation before implementing the methods for this value assessment in 2014, giving patient groups more opportunity to contribute to the development of these new arrangements. Further details are available here.
Almost three quarters of cancer patients in England who die in hospital beds wanted to die at home, an estimated 36,000 people each year, according to new figures released this week by Macmillan Cancer Support. Analysis from a recent national survey of bereaved relatives and carers revealed that for cancer patients last year, care in hospitals was often poorer than the care received at home. Of those who died at home, 63% rated the overall quality of care received as excellent or outstanding, compared to only 37% of those who died in hospitals. Furthermore, it was reported that over two out of five (41%) people with terminal cancer were not always treated with dignity and respect by hospital doctors during their last hospital admission.
On the basis of these findings, Macmillan has launched its new report, Time to choose, which sets out new recommendations for improving choice at end of life for cancer patients. It calls on the Government to make social care free for everyone in the last weeks of life before the end of this Parliament in 2015, and to develop a strategy for the national implementation of electronic palliative care registers.
A Westminster Hall debate took place this week on cancer patient experience. As Chair of the All Party Parliamentary Group on Cancer, John Baron MP warned the Government that it risks a disconnect between well-meaning national priorities on patient experience and local implementation, with cancer patients' experience of their local NHS suffering as a result. For example, the focus on patient experience is built in at a national level through the NHS Outcomes Framework, but is not monitored locally, with its absence from the CCG Outcomes Indicator Set.
Public Health Minister, Jane Ellison MP, responded to the debate, and confirmed that the Government has committed to making England a global leader in cancer outcomes and saving an additional 5,000 lives by 2015. The Minister said she recognised the importance of making relational care a priority and said that important pledges had been included in the NHS Constitution, setting out what patients have the right to expect. She confirmed that NHS England will run the National Cancer Patient Experience Survey in 2014 and it will then undertake a review of all the surveys it runs. The debate transcript can be accessed in full online here.
Earlier detection and better treatment for cancer would cut death rates from the disease by around a third, saving the lives of nearly a million people in the developed world every year, according to a new report by the Organisation for Economic Co-operation and Development (OECD). Prepared with the support of the European Commission, and building on earlier World Health Organisation research, the OECD’s report notes that despite mortality rates improving slightly over the past 20 years in most OECD countries, 7.6 million people still die each year from cancer worldwide and this figure is projected to rise to over 13 million in 2030. It also notes that the chances of survival after a diagnosis of cancer vary widely across countries, and that cancer outcomes are persistently poorer in Central and Eastern European countries, whilst countries such as Iceland, Korea and Japan have managed to achieve better survival. The report subsequently suggests that improving care standards, cutting waiting times and spending resources more effectively are key steps to save many lives. More information on the report and OECD work on cancer is here.