On Thursday 8 December MPs will debate the Cancer Strategy: One Year On, in a General Debate in the House of Commons.
This debate was scheduled by the Backbench Business Committee following representation from John Baron MP, who also holds the position of Chair of the All Party Parliamentary Group on Cancer (APPGC).
MPs will have an opportunity to debate the progress of the Cancer Strategy report, published in July 2015, and the accompanying implementation plan, published in May 2016. The debate follows the APPGC publishing the report of its inquiry into the progress in implementing the Cancer Strategy, in September 2016. The APPGC report can be accessed here.
Details of the debate can be found here.
Teenage girls with cancer are not being given enough advice about their future fertility, or the opportunity to freeze their eggs, according to Valerie Peddie, a fertility expert.
Ms Peddie, Director of fertility nursing at the University of Aberdeen, highlighted the problem at the Royal College of Nursing's Centenary Conference, on Tuesday. She told the conference that it was often left up to the patient's mother to ask about the options for freezing eggs.
NHS hospitals regularly offer to freeze the sperm of young men facing chemotherapy, while failing to inform young women of the opportunity to cryopreserve their eggs.
Ms Peddie said, "Deciding whether to have children is a central part of many lives, and no one should be denied this opportunity because they were unaware of their options...Teenage patients are unlikely to have even considered their future fertility or know it could be impacted by their cancer treatment, therefore it is essential that these issues are raised and discussed by healthcare staff."
Research published by the University of Sheffield has estimated that, unless urgent action is taken, alcohol-related cancers will cause up to 135,000 deaths and cost the NHS £2bn by 2035.
The study examined the potential impact of a Minimum Unit Price (MUP) for alcohol in England. The University of Sheffield's analysis 'found that a 50p minimum price per unit of alcohol could, over 20 years, reduce alcohol-related deaths in England by about 7,200, including about 670 cancer deaths. It would also reduce healthcare costs by £1.3bn, the research suggests.'
The Chair of the Alcohol Health Alliance, Prof Sir Ian Gilmore said: “It is clear from the report that MUP will save lives, including those lost to cancer, and ease the burden on our health service. Importantly, MUP will do this while leaving moderate drinkers and prices in pubs and bars unaffected."
The Guardian has reported on analysis of NHS-wide performance data which shows that 133,138 patients last year did not see a cancer specialist within the required 14 day waiting time following referral, as hospitals struggled with the growing number of patients.
The article states that 6,713 patients did not receive their first treatment within 31 days and a further 24,285 were not treated within 62 days, despite being referred urgently by their family doctor. It is also stated that the NHS has breached the 62 day target in every quarter for the last two and a half years*.
Dr Giles Maskell, former-President of the Royal College of Radiologists, said, "There are gaps right across the NHS cancer workforce, including oncologists, therapists, nutritionists, nurse specialists and other groups. The shortage of radiologists – who interpret x-rays and scans – is so serious that one university hospital in the south-east recently had 11 of its 33 consultant radiologist posts unfilled because there were too few applicants".
A spokesman from the Department of Health said in a statement, “The reality is the NHS is seeing over 90% more patients with suspected cancer within two weeks – that’s over 800,000 more people – and treating nearly 50,000 more patients following a GP referral compared to 2010.”
*Since this story was published, latest provider-based waiting time data shows that the 62 day target has been breached for eleven consecutive quarters since Q4 2013-14. More detail is provided below.
The Health Select Committee has called for the Government to address the severity of the financial shortage facing the NHS.
Dr Sarah Wollaston MP, Chair of the Health Select Committee, in a letter written to Philip Hammond MP, Chancellor of the Exchequer, states that “the continued use of the figure of ten billion pounds for the additional health spending up to 2020/21 is not only incorrect but risks giving a false impression that the NHS is awash with cash.”
The letter makes two requests, “The first is that it seriously consider a means of increasing the capital funding available to the NHS… The second is that the Government responds to the crisis in social care provision.”
The letter is also signed by: Dr James Davies MP (Con, Vale of Clwyd), Ben Bradshaw MP (Lab, Exeter), Emma Reynolds MP (Lab, Wolverhampton North East), and Dr Philippa Whitford MP (SNP, Central Ayrshire).
The letter continues, “The ten billion pounds figure can only be reached by adding an extra year to the spending review period, changing the date from which the real terms increase is calculated and disregarding the total health budget”.
NHS Providers Chief Executive, Chris Hopson, described the letter as “clear-sighted analysis”, adding that “the gap between what the NHS is being asked to deliver and the funding it has available is too big and is growing rapidly.”
NHS England has published a progress report, Achieving World-Class Cancer Outcomes: A Strategy for England 2015 - 2020, One Year On, 2015 -2016, against the delivery of the recommendations made in the Cancer Strategy.
The progress report outlines that over the past year there has been "rapid progress" in establishing the local structures needed to drive improvements in cancer services, facilitating the Independent Taskforce’s vision for stronger devolved leadership.
The progress report also highlights other markers of success made against the recommendations in the Cancer Strategy, including:
- Testing rules for a new 28-day faster diagnosis standard in four areas of the country, awarding funding to support long-term change in diagnosing cancer earlier
- Piloting multi-disciplinary diagnostic centres at six sites, to speed up early diagnosis for patients
- Together with the National Institute for Health and Care Excellence (NICE), launching a new approach to funding cancer drugs through the Cancer Drugs Fund (CDF)
- Making available, as standard, six genetic diagnostic tests, to ensure each patient can access the best personalised treatment
- Supporting the launch of a new national Be Clear on Cancer campaign for lung cancer symptoms
- Developing the first Quality of Life (QoL) indicator to support NHS England ensure it improves QoL for patients after treatment
- Launching a new Cancer Dashboard, which gathers together all data and intelligence about performance and patient outcomes in one place, enabling Alliances to see where improvements need to be made
Sir Harpal Kumar, Cancer Research UK's Chief Executive, said: "Good progress has been made since the NHS cancer strategy was published last year. But it will be critical over the next twelve months to start tackling the severe staff shortages in key cancer services if we are to see real advances in areas such as earlier diagnosis. There's no easy fix but we must start now if we want to make serious improvements to patient care over the next few years".
You can access the progress report online here.
The National Institute for Health and Care Excellence (NICE) and NHS England have published a joint 12-week consultation, 'Proposals for changes to the arrangements for evaluating and funding drugs and other health technologies appraised through NICE’s technology appraisal and highly specialised technologies programmes'.
The Times has led with this story on its front page, stating that 'patients with dementia and cancer will have their access to life-extending new drugs rationed by the NHS'. Commenting on the consultation's launch, Sir Andrew Dillion, Chief Executive of NICE, has stated “The fact that the NHS is in a really difficult position financially is certainly a reason for doing it now”.
The consultation document states that it aims to facilitate greater collaboration and earlier engagement between the life sciences industry and the NHS, whilst taking account of the “fixed resources available” in the health service. The proposals make reference to the recommendation of the House of Commons Public Accounts Committee that NHS England and NICE should “ensure affordability is considered when making decisions that have an impact on specialised services”.
NICE and NHS England are consulting on five broad proposals, further details of which are set out below:
- The introduction of a ‘budget impact threshold’ for the first three years of a treatment’s use in the NHS
- Amending the timescales for NICE-approved medicines to be funded where the proposed budget impact threshold is expected to be exceeded
- A ‘fast track’ NICE appraisal process for technologies with an incremental cost-effectiveness ration (ICER) of below £10,000 per quality adjusted life year (QALY)
- £100,000 QALY for highly specialised technologies appraised by NICE
- Amendments to the NICE single technology appraisal (STA) process to enable dialogue between manufacturers and NHS England where the budget impact threshold is likely to be met or exceeded
The Prime Minister, Theresa May, and Secretary of State for Health, Jeremy Hunt, have delivered their speeches to the Conservative Party conference gathered in Birmingham this week. Key points of interest to the CCG membership are outlined below.
Prime Minister, Theresa May:
- The Prime Minister’s speech focused heavily on the themes of division, injustice and unfairness, and the need to overcome them
- On the potential impact of Brexit, the life sciences industry was one of the sectors identified as being of strategic importance to the economy, and the Prime Minister committed to do all she could to encourage, develop and support it
- Speaking to the challenges facing the health service, Mrs May thanked the doctors and nurses working in the NHS and criticised the Labour Party for trying to use the NHS to divide people, pointing out it was the Labour Party who had expanded privatisation fastest and cut spending in the NHS in Wales
- Mrs May praised the Secretary of State for Health, Jeremy Hunt, for being a passionate advocate for patients and those working in all parts of the health service, saying that the Conservative Party had become the new Party of the NHS and of workers
The full transcript for Mrs May's speech can be accessed here.
Secretary of State for Health, Jeremy Hunt:
Mr Hunt’s speech was steered by a central theme of honesty, citing the NHS’s new duty of candour, and discussing the blame culture which led many professionals to spend too much time being forced to protect their reputation and guard against litigation.
Committing to speak “frankly about the state of our National Health Service”, the Secretary of State was also keen to underline recent achievements noting, for example, that the NHS was doing 4,400 more operations every day compared to 2010.
Specific to cancer, to which Mr Hunt dedicated a considerable section of his speech, he raised the following points:
- Every day, compared to 2010, the NHS is undertaking 16,000 more diagnostic tests and as a result 130 more people begin their cancer treatment each day
- Mr Hunt noted that the new cancer plan, which includes a new maximum 4-week wait from GP referral to diagnosis, can lead to an estimated 30,000 lives being saved each year
- Commenting on the new ‘Ofsted-style' cancer ratings for Clinical Commissioning Groups, the first results of which were published almost in parallel to his speech , Mr Hunt said that they do not make for “comfortable reading” but are vital if the NHS is to learn and improve
A full transcript of Mr Hunt’s speech can be accessed here.
The Telegraph reports that a study undertaken by the Royal Marsden NHS Foundation Trust has found that patients taking part in trials of new cancer drugs have unrealistic expectations that experimental treatment will save them. The article explains that research on more than 300 patients living with cancer asked about taking part in early stage research found almost 50 per cent of patients believed their tumours would shrink.
In addition, the research showed that overall, patients were keen experiment with new drugs, with up to 84 per cent of those taking part in research saying they would be willing to enrol but 47 per cent of patients were keen to do so, because they expected the research to shrink tumours, which had often failed to respond to any other treatment.
Lead researcher Dr Udai Banerji, from The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, said: "There is a positive message in this, which is that 84 per cent of patients are willing to participate in Phase I oncology studies after a discussion with clinical and nursing staff who lay out the conservative estimates of benefit and requirements of hospital visits".
The full Telegraph article is available online here.