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NHS cancer services not holding up, says report

Published on 08/09/14 at 12:05pm
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NHS cancer services are in urgent need of investment and review, according to a new report commissioned by Cancer Research UK.

The charity says that years of efficiency savings, the impact of recent NHS reforms, and increasing demand have driven the services to a ‘tipping point’ as staff fight to keep them viable.

Among the causes for concern highlighted by the report are the loss of leadership capacity at a national and local level, a fragmentation of commissioning across the patient pathway, wide variation in the roles and responsibilities of new NHS organisations and the need to rebuild relationships and regain expertise.

Of particular concern is a rising demand for cancer services and a lack of capacity to respond to this demand. The report calls for increased investment, particularly in diagnostic services, and a review of leadership and commissioning to help tackle this.

The report’s findings were based on an online survey of 450 NHS cancer personnel and anonymous interviews with 45 leading cancer experts, many of whom emphasised the need for urgent action.

That rising demand is predicted to surge rapidly in the future as the UK faces an increasingly ageing population. There has already been a 50% increase in referrals from GPs for suspected cancer since 2009-10, up to over 1.4 million patients in 2013-14.

The 62-day target for the wait between urgent referral and first treatment is also under strain, having dropped below the standard of 85% for the first time since 2009-2010.

The loss of leadership capacity needed to ‘drive the cancer agenda’, meanwhile, is largely attributed to the removal of previous national infrastructure such as the National Cancer Action Team and cancer networks under NHS reform.

The report also says that the roles and responsibilities of the new NHS organisations are ‘not well understood’, leading to fragmentation in the commissioning of a patient pathway between different bodies.

One of the experts interviewed, an Allied Health professional, comments: “We need more funding. Instead of progressing or developing our cancer services which are already significantly underfunded, our services are actually being cut. It is becoming impossible to deliver all the new cancer targets and quality of care is deteriorating.”

Public health minister Jane Ellison says in response to the report: “This government has prioritised cancer, investing three-quarters of a billion pounds over four years to improve early diagnosis and treatment.

“Just last month we announced an extra £160 million for the Cancer Drugs Fund and £6m towards a revolutionary new type of radiotherapy. Demand is growing - but survival rates are improving just as we treat record numbers of NHS patients for cancer.”

Harpal Kumar, Cancer Research UK’s chief executive, adds: “In many ways, NHS cancer services have held up remarkably well. They have coped. But that cannot continue indefinitely. In their own words the people that have propped up these NHS services tell us in this report that ‘enough is enough’.

“They can’t go on like this with no help or support coming over the horizon. And they certainly can’t improve services so that our cancer outcomes are up there with the best in the world.”

George Underwood

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