Recommendations & Conclusions
30 items
1
Conclusion
Twelfth Report - Cancer services
We welcome the development of Rapid Diagnostic Centres and Community Diagnostic Centres, particularly in giving GPs more effective referral routes for possible cancer symptoms, especially those which are non-specific but concerning. However, we have heard differing accounts about the impact of the Covid-19 pandemic on the development of Rapid Diagnostic …
Government response. • Faster Diagnosis Non-Specific Symptom pathways are transforming the way that people with symptoms not specific to one cancer, such as weight loss or fatigue, are diagnosed or have cancer ruled out. This gives GPs a much-needed referral route, while …
Department of Health and Social Care
2
Conclusion
Twelfth Report - Cancer services
NHS England has been focusing on encouraging people to come forward with cancer symptoms during the pandemic, which is welcome, and has recently launched a marketing campaign to encourage people to overcome their reluctance to visit their GP to discuss symptoms. However, NHS England should continue to use marketing campaigns …
Government response. • Faster Diagnosis Non-Specific Symptom pathways are transforming the way that people with symptoms not specific to one cancer, such as weight loss or fatigue, are diagnosed or have cancer ruled out. This gives GPs a much-needed referral route, while …
Department of Health and Social Care
3
Conclusion
Twelfth Report - Cancer services
Cancer screening is a vital tool for early diagnosis, but even before the pandemic there were serious concerns about the effectiveness of national cancer screening services, particularly over IT systems and the speed at which innovations have been implemented. New programmes like the Lung Health Check programme offer some reason …
Government response. Through our NHS screening programmes we are able to reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage and, in the …
Department of Health and Social Care
4
Recommendation
Twelfth Report - Cancer services
The Government should implement the recommendations of Professor Sir Mike Richards’ review of cancer screening as a priority and ensure that there is a clear plan in place to rapidly conduct appointments missed during the pandemic.
Government response. Through our NHS screening programmes we are able to reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage and, in the …
Department of Health and Social Care
5
Conclusion
Twelfth Report - Cancer services
We understand the rationale for simplifying the Cancer Waiting Times standards. It is important that NHS cancer services are given a clear set of targets to achieve and that these targets are the ones that are most important to patients. However, we note that there are no current plans to …
Government response. The Department and the NHS have published the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care. This plan sets out a clear vision for how the NHS will recover and expand elective services over the next three years. …
Department of Health and Social Care
6
Conclusion
Twelfth Report - Cancer services
The Government’s recent announcement of a £2.3 billion investment in 100 new Community Diagnostic Centres is welcome and could provide a significant increase in physical diagnostic capacity. However, it is not yet clear how much additional capacity this investment will yield and whether it will allow England to catch up …
Government response. The Department and the NHS have published the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care. This plan sets out a clear vision for how the NHS will recover and expand elective services over the next three years. …
Department of Health and Social Care
7
Conclusion
Twelfth Report - Cancer services
The Government and NHS England must set out detailed plans for how the £2.3 billion investment in Community Diagnostic Centres will be utilised, in particular detailing how many additional CT, MRI and PET-CT scanners and endoscopy suites the investment will provide.
Government response. The Department and the NHS have published the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care. This plan sets out a clear vision for how the NHS will recover and expand elective services over the next three years. …
Department of Health and Social Care
8
Conclusion
Twelfth Report - Cancer services
The Government and NHS England must also develop a specific plan to address gaps in the diagnostic workforce, setting out how it will address both short-term and long- term shortages in key professions, and particularly what investment will be required to deliver sustainable long-term increases in these key professions.
Government response. Health Education England continues to take action to ensure that the NHS has the cancer workforce it needs. This includes investing £52 million in 2021/22 in the cancer and diagnostics workforce, through delivering additional medical places and providing grants to …
Department of Health and Social Care
9
Conclusion
Twelfth Report - Cancer services
There is huge potential in NHS cancer data, and a large amount of data from NHS cancer services is already collected and reported. However, there is significant room for improvement, particularly in reducing the two years it takes to collect and publish data on cancer stage. A major overhaul of …
Government response. The Government welcomes the Committee’s recognition of the work that is already under way to deliver on the ambition to diagnose 75% of cancers by 2028. The NHS Cancer Programme is focused around six priorities to increase early diagnosis: • …
Department of Health and Social Care
10
Conclusion
Twelfth Report - Cancer services
Notwithstanding the lag on published data, on the basis of evidence supplied by the Government and the NHS, and Cancer Research UK’s analysis, we do not believe that the NHS is on track to meet the 75% early diagnosis ambition set by the Government. It is clear that there is …
Government response. The Government welcomes the Committee’s recognition of the work that is already under way to deliver on the ambition to diagnose 75% of cancers by 2028. The NHS Cancer Programme is focused around six priorities to increase early diagnosis: • …
Department of Health and Social Care
11
Conclusion
Twelfth Report - Cancer services
The static trajectory in early diagnosis demands that the Government’s new plan for cancer services must include a clear action plan for achieving the 75% early diagnosis ambition which goes beyond current plans and considers much more radical proposals to kickstart progress. (Paragraph 72) Access to treatments
Government response. The Government welcomes the Committee’s recognition of the work that is already under way to deliver on the ambition to diagnose 75% of cancers by 2028. The NHS Cancer Programme is focused around six priorities to increase early diagnosis: • …
Department of Health and Social Care
12
Conclusion
Twelfth Report - Cancer services
We recognise that the disruption to cancer services during the pandemic was primarily driven by the need to mitigate the risk posed by Covid-19 to patients undergoing cancer treatment. We also recognise the efforts made by the NHS to maintain treatment or offer alternative treatment options. Nonetheless, we remain extremely …
Government response. Cancer diagnosis and treatment has remained a top priority throughout the pandemic, and the vast majority of cancer services have been maintained thanks to the tireless work of NHS staff. There were over 4.9 million urgent referrals and over 600,000 …
Department of Health and Social Care
13
Conclusion
Twelfth Report - Cancer services
The Department of Health and Social Care and NHS England must publish a detailed analysis of the extent of the cancer backlog to support the delivery of the elective care recovery plan. The Department should work with NHS England to set out: a) the latest estimate for how many fewer …
Government response. Cancer diagnosis and treatment has remained a top priority throughout the pandemic, and the vast majority of cancer services have been maintained thanks to the tireless work of NHS staff. There were over 4.9 million urgent referrals and over 600,000 …
Department of Health and Social Care
14
Recommendation
Twelfth Report - Cancer services
Based on these estimates the Department of Health and Social Care and NHS England should set out: a) an estimate of what level of additional capacity in NHS cancer services will be needed to address the backlog in cancer services and treatment by March 2023; and b) an action plan …
Government response. Cancer diagnosis and treatment has remained a top priority throughout the pandemic, and the vast majority of cancer services have been maintained thanks to the tireless work of NHS staff. There were over 4.9 million urgent referrals and over 600,000 …
Department of Health and Social Care
15
Conclusion
Twelfth Report - Cancer services
For patients with limited treatment options the approval of a new drug or therapy can make a significant difference even when the survival benefit is only months. Despite the effectiveness of the Medicines and Healthcare products Regulatory Agency’s regulatory process, and despite some progress by NICE in approving medicines more …
Government response. The Government is committed to supporting timely access for NHS patients to clinically and cost-effective new drugs. The 2019 Voluntary Scheme for Branded Medicines Pricing and Access (VPAS), agreed with industry, commits the National Institute for Health and Care Excellence …
Department of Health and Social Care
16
Recommendation
Twelfth Report - Cancer services
As part of its new cancer plan, the Government should include a plan for how to better align the technology appraisals carried out by NICE with the regulatory process applied by the MHRA, in order to reduce the delay between a drug being approved by the MHRA and recommended for …
Government response. The Government is committed to supporting timely access for NHS patients to clinically and cost-effective new drugs. The 2019 Voluntary Scheme for Branded Medicines Pricing and Access (VPAS), agreed with industry, commits the National Institute for Health and Care Excellence …
Department of Health and Social Care
17
Conclusion
Twelfth Report - Cancer services
The Government and the NHS have recognised some of the issues with radiotherapy delivery in the NHS and have made welcome commitments to resolve these, such as investing in new radiotherapy machines and the proton beam centres in Manchester and London. However, it is clear that there are still significant …
Government response. Until the 2021 Spending Review and subsequent publication of the NHS Capital Planning Guidance, the responsibility to replace equipment, including radiotherapy equipment, resided with NHS Trusts, using internally generated capital or other financing arrangements, i.e. leasing. Notwithstanding the responsibilities of …
Department of Health and Social Care
18
Conclusion
Twelfth Report - Cancer services
The Government’s new cancer plan should provide an update to the 2014 radiotherapy vision which should include a long-term rolling investment programme for outdated radiotherapy equipment as well as changes to the national radiotherapy tariff to incentivise the delivery of modern radiotherapy techniques and remove perverse incentives.
Government response. Until the 2021 Spending Review and subsequent publication of the NHS Capital Planning Guidance, the responsibility to replace equipment, including radiotherapy equipment, resided with NHS Trusts, using internally generated capital or other financing arrangements, i.e. leasing. Notwithstanding the responsibilities of …
Department of Health and Social Care
19
Conclusion
Twelfth Report - Cancer services
Major specialist cancer hospitals have better access to staff, expertise and technology, and patients referred to these sites are more likely to be offered potentially life- saving surgery. During the pandemic, these hospitals were the ones most likely to be able to continue treatment, perpetuating regional disparities. Creating more of …
Government response. The Cancer Call for Evidence, launched in February to inform our 10-Year Cancer Plan, has now closed and responses are being analysed alongside wider evidence. The Plan will be a new vision for how we will lead the world in …
Department of Health and Social Care
20
Recommendation
Twelfth Report - Cancer services
As part of the Government’s new cancer plan, the Government and NHS England should review the organisation of cancer surgery with a specific focus on whether more specialist hospitals should be established to ensure that more cancer surgery is carried out on sites without an emergency department.
Government response. The Cancer Call for Evidence, launched in February to inform our 10-Year Cancer Plan, has now closed and responses are being analysed alongside wider evidence. The Plan will be a new vision for how we will lead the world in …
Department of Health and Social Care
21
Conclusion
Twelfth Report - Cancer services
As part of the long-term plan for the cancer workforce, the Government and NHS England should develop specific proposals for improving the retention of experienced cancer staff, including targeting burnout and improving the day-to-day working conditions of staff. (Paragraph 115) Variation
Government response. Building on the progress, the Government’s forthcoming 10 Year Cancer Plan will set a new vision for how we will lead the world in cancer care, including ensuring we have the right workforce in place. The NHS People Plan and …
Department of Health and Social Care
22
Conclusion
Twelfth Report - Cancer services
Cancer Alliances have had a positive impact on transforming cancer services and sharing best practice, and enjoy strong support from the sector. However, it is clear that while they are having some success, there is still significant unwarranted variation across regions in England and that the ability of Cancer Alliances …
Government response. Cancer Alliances already lead the planning and delivery of cancer services and their improvement across their local systems. We recognise it makes sense for Integrated Care Boards (ICBs), when legally and operationally established, to look to the Cancer Alliances to …
Department of Health and Social Care
23
Conclusion
Twelfth Report - Cancer services
To support Cancer Alliances to embed transformation into local cancer services, new Integrated Care Systems must be required to appoint cancer leads, with responsibility for working directly with Alliances to embed best practice into their own systems. Cancer performance should also be Ofsted-rated by Integrated Care Boards as a sub- …
Government response. Cancer Alliances already lead the planning and delivery of cancer services and their improvement across their local systems. We recognise it makes sense for Integrated Care Boards (ICBs), when legally and operationally established, to look to the Cancer Alliances to …
Department of Health and Social Care
24
Recommendation
Twelfth Report - Cancer services
Cancer Alliances must reflect on new data provided to them by NHS England and the Department of Health and Social Care about cancer outcomes by ethnicity in their areas. In particular they should review the care provided to people from Black, Asian and minority ethnic backgrounds to ensure that no …
Government response. Tackling inequalities in outcomes, experience and access is a key focus of the NHS Long- Term Plan and 22/23 Planning Guidance, and remains a priority for the NHS Cancer Programme. Approaches to support this are embedded throughout the work of …
Department of Health and Social Care
25
Recommendation
Twelfth Report - Cancer services
The new Office for Health Improvement and Disparities should review the drivers of disparities in cancer outcomes and develop a joint strategy with NHS England to address these disparities.
Government response. The Government remains committed to levelling up outcomes across the UK and has published a landmark Levelling Up White Paper (LUWP), setting out bold new policy interventions to improve livelihoods and opportunity in all parts of the UK. The aim …
Department of Health and Social Care
26
Conclusion
Twelfth Report - Cancer services
There are specific challenges facing people with rare and less common and less survivable cancers, including that they are often harder to diagnose and that issues with spreading best practice for treating less common cancers are more pronounced. Despite some positive changes such as Rapid Diagnostic Centres, it is not …
Government response. Officials are currently analysing the responses received for the Cancer Call for Evidence alongside wider evidence to develop the 10 Year Cancer Plan. The Plan be a new vision for how we will lead the world in cancer care. The …
Department of Health and Social Care
27
Recommendation
Twelfth Report - Cancer services
The Government must consider rare, less common and less survivable cancers specifically as part of its new cancer plan. NHS England should also produce an action plan for rare, less common and less survivable cancers, containing clear commitments to address key issues around the diagnosis and treatment of those cancers. …
Government response. Officials are currently analysing the responses received for the Cancer Call for Evidence alongside wider evidence to develop the 10 Year Cancer Plan. The Plan be a new vision for how we will lead the world in cancer care. The …
Department of Health and Social Care
28
Conclusion
Twelfth Report - Cancer services
The impact of Covid-19 on cancer research was significant and it is concerning that trial recruitment has not yet reached pre-pandemic levels. However, the pandemic has provided a model for how cancer research can be conducted more efficiently, in more hospitals, to bring greater benefits to patients.
Government response. The multi-year Vision for the Future of UK Clinical Research Delivery was published on 23 March 2021. The vision describes how we will build on the lessons learnt during the pandemic, and sets out our ambition to create a patient-centred, …
Department of Health and Social Care
29
Recommendation
Twelfth Report - Cancer services
The Government should set out how it will build on the lessons learnt during the pandemic by making it easier for researchers to: a) access vital patient data; b) access staff needed for their studies, by providing more protected time for research in NHS contracts, and c) get studies open …
Government response. The multi-year Vision for the Future of UK Clinical Research Delivery was published on 23 March 2021. The vision describes how we will build on the lessons learnt during the pandemic, and sets out our ambition to create a patient-centred, …
Department of Health and Social Care
30
Recommendation
Twelfth Report - Cancer services
The Government should also establish a ring-fenced fund for cancer research infrastructure targeted at NHS trusts which have historically low levels of research activity. (Paragraph 149) 46 Cancer services
Government response. The Department provides sustained investment in research expertise, specialist facilities, a research delivery workforce and support services through the NIHR Infrastructure. This infrastructure spans the innovation pathway, from early translational research – including in our Biomedical Research Centres - through …
Department of Health and Social Care