On Thursday 19 November, a Backbench Business Debate on the topic of the Cancer Strategy was brought to the House by the Chair of the APPG on Cancer (APPGC), John Baron MP (Con, Basildon and Billericay). Within his remarks, Mr Baron specifically thanked the Cancer Campaigning Group for our on-going work.
The debate was co-sponsored by David Tredinnick MP (Con, Bosworth) and Jo Churchill MP (Con, Bury St Edmunds). A full transcript of the debate is available. The debate largely focussed on:
- The implementation of the Cancer Strategy
- The importance of early diagnosis and the use of one-year survival as a marker for success
- Accountability of Clinical Commissioning Groups (CCGs) toward improving cancer outcomes and the establishment of a National Cancer Advisory Board (NCAB)
- The Cancer Drugs Fund (CDF)
- Reductions in public health expenditure
Ben Gummer MP (Parliamentary Under-Secretary of State for Health) responded for the Government.
On the issue of CCG scorecards, he said that they are immensely complex and have behind them a huge volume of data. He added that consultation on the operation of CCG scorecards will be launched next month. Mr Gummer said that the CDF will have to change in order to respond to the changes in genomics research over the last 5 years. He continued to say that the PM made a personal commitment to the CDF and will be watching very carefully how the CDF develops. Mr Gummer added that the CDF‘s growth since 2010 demonstrates the commitment to cancer drugs; the recently published consultation by NHS England and NICE aims to build on the success of the CDF.
On early diagnosis, Mr Gummer stated that, as an outcome of NHS England's Accelerate, Coordinate Evaluate (ACE) programme, imaging will be expanded within primary care and that the Department will write shortly to provide more details to members.
Public Health England has published the complete Routes to Diagnosis 2006-2013 data. The data confirms that the proportion of cancers diagnosed as an emergency in hospital has decreased, whilst the proportion diagnosed through urgent GP referral with a suspicion of cancer has increased.
The now publically available data covers in excess of two million patients diagnosed with cancer from 2006 to 2013, from across 56 different cancer sites. The data shows that in 2006, almost 25 per cent of cancers were diagnosed as an emergency, compared to 20 per cent in 2013.
Julia Verne, Head of Clinical Epidemiology at Public Health England, said: "The latest Routes to Diagnosis data shows a positive trend in how cancer is diagnosed in England. The earlier the better if we are to catch up with comparable European countries. It is hugely satisfying to see innovative use of big data help improve cancer diagnosis and thus, survival. Our work however, is not complete; while emergency presentation is declining it still remains high for cancers like liver and pancreas"
The Guardian, BBC News and the Telegraph led the coverage of the story that a one-year old with acute lymphoblastic leukaemia is the first person to have been treated with cells which were genetically engineered to target her cancer. Layla Richards was given the highly experimental treatment, which had only been trialled on mice, after specialists applied for emergency permission from health regulators and Great Ormond Street Hospital's ethics committee.
The process, developed with a team at University College London, involved using microscopic scissors - or Talens - to precisely engineer the DNA inside a donor's immune cells. The cells were designed to seek out and kill only leukaemia cells which were then injected into Layla. Doctors have emphasised that, at this point, this should not be considered a cure, but said that Layla's progress to date was "almost a miracle".
The ‘postcode lottery’ which exists in cancer diagnosis in England was highlighted by new statistics highlighted this week. Extensive coverage, including in The Telegraph and The Guardian, showed that patients in many regions in England were not getting the early diagnosis (stage one or two) which can increase, by more than three times, the survival rates for those with of some of the most common cancers. Sara Hiom, Director of Early Diagnosis at Cancer Research UK, who published the data said, “Wherever you live, an early diagnosis of cancer will give you more treatment options and a better chance of survival”. If all the regions of England achieved the same rates of early diagnosis as in South-West England, the best in the country, nearly 20,000 patients would have been given a better chance of survival.
The Guardian reports on a potentially 'game-changing' trial into the effect of aspirin on preventing the recurrence of some of the most common cancers.
The study, which will take place over 12 years and involve around 11,000 patients who have had, or continue to receive treatment for bowel, breast, oesophageal, prostate or stomach cancer.
The BBC noted the debate that has long engulfed the effect of a drug which has been shown to reduce the likelihood of heart attack or stroke in some patients.
The lead investigator Prof Ruth Langley, from the Medical Research Council's clinical trial's unit, based at University College London, said: "There's been some interesting research suggesting that aspirin could delay or stop early stage cancers coming back but there's been no randomised trial to give clear proof. The trial aims to answer this question once and for all."
Simon Stevens, Chief Executive of NHS England, has appointed Cally Palmer, Chief Executive of the Royal Marsden Foundation Trust, as National Director of Cancer Services. Ms Palmer will lead the implementation of the NHS Cancer Taskforce’s five year strategy for cancer care improvement, as well as new cancer Vanguards using outcomes-based commissioning to redesign care and the patient experience.
Mr Stevens has also appointed Dr Jonathan Fielden, previous Medical Director at University College London Hospitals Foundation Trust, as Director for Specialised Services and Dr Arvind Madan, Partner and Chief Executive at London’s Hurley Group GP provider, as Director for Primary Care.
Dr Fielden and Dr Madan will also serve as Deputy Medical Directors to the National Medical Director, Sir Bruce Keogh. Dr Fielden will be responsible for developing a specialised services strategy for NHS England, including responsibility for the Cancer Drugs Fund. It is understood that Dr Madan will lead on primary care commissioning which will include work on reform and modernisation of the primary care provider model, and developing co-commissioning with clinical commissioning groups. Additionally, a National Director for Commissioning Operations is expected to be appointed shortly, who will have responsibility for performance, planning and clinical commissioning group assurance.
The Secretary of State for Health, Jeremy Hunt MP, has spoken at the Conservative Party Conference in Manchester this week. He began his address by saying the NHS had been set up to “universalise the best” and that this was the vision of the Conservative Party today. He said he wanted the Conservatives to be the “party of the NHS” and described it as progressive, fighting for higher standards and tackling problems head-on, so as to ensure that high quality care is accessible for all.
Within his speech, Mr Hunt also highlighted plans for seven-day services, honesty and whistle-blowing, the new contract for GPs and NHS culture.
The following day the Prime Minister, David Cameron MP, delivered his speech to conference. He focused on central theme of “building a Greater Britain” and “finishing the job we have started”, placing particular emphasis on housing policy, social mobility and tackling extremism.
The latest monthly commissioner and provider based cancer waiting times were published this week. Of note, these data show that:
- 93.2 per cent of people were seen by a specialist within two weeks of
an urgent GP referral for suspected cancer, down from 93.9 per cent in July 2015
- 82.4 per cent of people treated began first definitive treatment within 62 days of being urgently referred for suspected cancer by their GP, up from 81.6 per cent in July 2015
The full commissioner and provider based waiting times statistics can be accessed here.
Norman Lamb MP, Liberal Democrat Health Spokesperson, has delivered a speech to the Liberal Democrat party conference in Bournemouth. Mr Lamb, who served as Care Minister in the Department of Health from 2012-2015, said that the NHS would “crash” without additional funding. Mr Lamb called for a tax increase to fund the health service through a “dedicated NHS and care contribution” which would be “clearly identified on your payslip”. Mr Lamb also stated that:
- There is need for a "new Beveridge report" into how the welfare budget could support the health service
- Local areas should be able to raise additional funds for local health care services
- The NHS should "take advantage of new technology" and patients should be given the "right to control their medical records"
- “A national conversation” is required about the emerging crisis in care
Jeremy Hunt MP, Secretary of State for Health, has announced a series of measures, alongside £300 million of increased diagnostic spending a year by 2020, which is intended to help save up to 11,000 lives a year.
The new measures, which are described as "more patient-centred", include plans to:
- Implement the Cancer Taskforce's recommendations on molecular diagnostics
- Give patients more control of their information and the ability to access information on treatments and test results online
- Introduce a tailored recovery package, that are designed to help each person live well beyond cancer. These could include, for example, physical activity programmes, psychological support, and advise about returning to work. They will also specifically help those suffering with depression
- By 2016, there will be a new national quality of life measure to help monitor how well people live after their treatment has ended, so priorities for improvements can be identified. NHS England will develop this measure with cancer charities