The future of cancer care: closing the “survival gap”

13 August 2015

Cancer represents one of the greatest medical challenges facing the NHS. Half of people born after 1960 will face a diagnosis in their lifetime and 2.4 million people in England will be living with cancer by 2020. By 2030, it’s forecast 360,000 people will be diagnosed each year. The quality and affordability of cancer care has never been more important.

Governments have been aware of this for some time. The Labour Government published a national cancer plan in 2000 pledging £570 million over 4 years to reduce the incidence of cancer and cut waiting times between diagnosis and treatment. The Coalition Government followed suit issuing its own cancer strategy in 2011 and committing £750 million over 4 years. It also introduced the Cancer Drugs Fund, at a price of £280 million annually, to fund treatments that NICE would not otherwise have approved.

But despite all this, progress has been disappointing. Indeed, research published last week found a “survival gap”:  across five common cancers English patients had the lowest five year survival rate of six similar health systems, including Australia and Canada.

This gap was acknowledged by the Five Year Forward View highlighting that, although the NHS has made improvements, cancer survival is “below the European average”. It defines an ambitious vision for cancer treatment based on prevention, swift diagnosis and improved care for those with cancer. With a view to making this a reality, in January 2015, NHS England commissioned an Independent Cancer Taskforce to develop a five-year action plan. The Taskforce delivered its report last month.

The Report’s key recommendations can be grouped under two headings. The first, early intervention, aims to upgrade prevention via national action plans to reduce smoking and obesity; and accelerate diagnosis with 95 per cent of patients receiving results of cancer tests within four weeks. The latter, patient centred care, argues patient experience must become a key metric of system performance; suggests greater integration of clinical and social care; and recommends a new approach for those living with cancer. The cost was estimated at £400 million a year.

If this plan is to succeed where previous reviews have failed, the challenge is now one of successful implementation. The political stakes are high. The Conservative Party’s 2015 manifesto pledged to “lead the world in fighting cancer”. And the pressure is only exacerbated by the fact that cancer is an emotive issue for the public. The scale of the task should not be understated.

Leo Ewbank, Researcher, Reform

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