England still trailing on cancer care

A new report has noted that cancer patients in England still have poorer survival rates than in other European countries, despite pledges and funding to improve care.

The Health Foundation has published a report assessing progress on cancer care in England over almost two decades, reverting to the launch of the NHS Cancer Plan in 2000 and taking into considering the promise that, by 2010, ‘our five-year survival rates for cancer will compare with the best in Europe’.

While progress has been made, the gap in survival rates has not been closed, meaning that there will have to be radical improvements in the early diagnosis and detection of cancer if care is to be improved and survival rates increased. The Health Foundation states that, in order to achieve this, the NHS will need to invest significantly in boosting diagnostic equipment and workforce as the UK has fallen far behind other countries in the availability of diagnostic equipment per person, ranking 35th out of 37 countries for CT scanners, and 31st out of 36 for MRI scanners.

Early detection and diagnosis of cancer is critical to improving a person’s chances of survival, as early-stage cancer is more responsive to treatment than late-stage cancer. If caught early, five-year survival for bowel cancer is over 90 per cent, but less than 10 per cent if diagnosed late. However, a person diagnosed with colon cancer in the UK has a 60 per cent chance of survival after five years, compared with 71 per cent for those living in Australia.

Research has found that patients in England are more reluctant to bother their GP than people living in other countries, with Cancer Research UK finding that 22 per cent of the public would be worried about wasting the doctor’s time and 45 per cent saying they found it difficult to make an appointment. So, alongside primary care being resourced to meet demand for appointments, there also needs to be more progress on helping the public understand the symptoms associated with cancer, so they might seek help earlier.

To help improve performance, outcomes and survival rates, the report also recommends: offering periodic low-dose CT scans for people at risk of lung cancer; accelerating the piloting and evaluation of rapid diagnostic centres; measures to improve the screening of bowel cancer; making sure it is clear which NHS bodies are responsible for delivering progress in early diagnosis at national and local level; investment in prevention; and more funding and support for GPs.

Professor Sir Mike Richards, former National Cancer Director, who helped lead the report, said: “The NHS Cancer Plan in 2000 and all subsequent cancer strategies have set ambitions for England to match the best in Europe or the world in relation to cancer survival. Although progress has been made on many aspects of cancer, these aims have not been achieved. Every year thousands of deaths could be avoided if we achieved these goals. This is the equivalent to a jumbo jet of people falling from the sky every two weeks.

“The Prime Minister’s ambitious target to increase early detection of cancer from one in two people today, to three in four by 2028, is welcome, but if we are serious about moving the dial on early diagnosis, then setting targets and handing out money will not be enough. The NHS must change the way that care is currently organised to make it easier for people to be seen and diagnosed as quickly as possible, as we know this gives them the best chance of survival.”

Ruth Thorlby, assistant director of policy at the Health Foundation, said: “Our report highlights the importance of the infrastructure that needs to be in place to engage and support clinicians and managers to improve a complex service such as cancer. The disruption caused by the Health and Social Care Act 2012 was profound, and financial pressure has compounded this. Although investment is clearly needed in workforce and equipment, the experience of the past 20 years in cancer shows that staff need support, evidence and skills to implement change. Without these, the injection of resources alone will not be effective.”

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