Cancer care in the UK is in need of a radical reset in order to address the poor survival rates for many tupes of the disease, according to a group of researchers.
According to the group of researchers, the loss of a National Cancer Care Plan (NCCP) and the closure of the National Cancer Research Institute have compounded recurrent issues with cancer care, including major workforce deficits and the area’s increasingly complex nature.
The Policy Review, published in medical journal The Lancet Oncology , has urged policymakers to develop “radical, yet sustainable” cancer control plans fit for the future, as 2,000 extra cancer cases a week are expected by 2040.
According to the review, “chronic underinvestment and lack of workforce planning are being compounded by increased service demands,” while “staff shortages increase workforce stress and burnout, leading to more people leaving the workforce.”
'Grave concerns'
The Covid pandemic “dramatically” reduced cancer screening, with more than a million breast cancer screens being missed or delayed in England in 2020–21.
Charlotte Beardmore, executive director of professional policy at the Society of Radiographers, said the society was keen for cancer to remain a priority for government, and the loss of the NCCP is cause for concern.
Ms Beardmore said: “Without a specific cancer plan there is grave concern that the downward trends in terms of access will continue as patients wait even longer for diagnosis and treatment. The evidence shows a concerning picture with waiting times spiralling downwards, rather than improving… this is shocking given the positive impact radiotherapy can have on patient outcomes.”
Undeserved neglect
The report said that “radiotherapy has been undeservedly neglected in both investment priority and visibility, reflected in much lower access rates than outlined in international standards” – almost half of recommended levels.
Ms Beardmore explained the NCCP had delivered improvements in care, supported strategic and co-ordinated development of all services, and enabled better intelligence about where the challenges are, adding its loss is “acutely felt.”
“Investment in diagnostic and treatment capacity is essential,” she added. “Radiographers are working under significant pressures both in imaging and radiotherapy to ensure patients have access to world-class diagnosis and treatment.”
A 10 Point Plan
The group of researcher has published a 10-point plan laying out the steps needing to be taken for a new and improved cancer strategy capable of making up the gap between the UK’s performance on cancer care compared to the international community.
1. Create a UK-wide National Cancer Control Plan, through a more integrated and devolved government consultation, that is patient centred, empowers clinical frontline staff, and delivers equitable, affordable, data-informed, research-active cancer control.
2. Re-establish a strengthened National Cancer Research Institute, and broaden cancer research strategic agenda and funding.
3. Deliver on NHS workforce plans, with fair pay and better working environments coupled with a rethink on future cancer workforce skill sets.
4. Substantially strengthen primary care, and deliver on the target of 75% of cases diagnosed at stage 1 or stage 2 by 2028 through enhanced screening.
5. Properly fund a prevention programme, particularly for tobacco control, alcohol, and obesity.
6. Integrate hospice care into the NHS, and increase support for psychosocial and survivorship, keeping patients and those living with cancer out of hospitals.
7. Address vulnerable population solutions in national planning, such as in radiotherapy, surgery, pathology, imaging, systemic therapies, and in children and young adults.
8. Develop an integrated digital infrastructure, that delivers intelligence-driven service design, performance assessment, and quality improvement. This should be combined with cancer targets that reflect the totality of the system: time to diagnosis, time to treatment, quality metrics.
9. Deliver a sustainable plan for equipment and infrastructure, to assist the work force and increase productivity to ensure patients can get access to appropriate technologies and that proven innovations are equitably implemented through a value-based approach.
10. Reassess governance, structure, and advice for cancer, reinstate the role of an independent National Cancer Director and office of support, with authority to drive through changes and liaise between government and the NHS to provide robust independent oversight.
The paper also recommended any plan focus investment on new radiotherapy machines to meet present demand, obtaining machines to replace those that have already reached the end of their life span, and making projections for machines that will be needed in five years' time.
Beardmore added: “We support the 10 proposals and importantly a properly resourced and dedicated cancer control plan with appropriate coordination and monitoring and investment in cancer prevention, radiography workforce, effective infrastructure and research capacity.
“Without sustained investment to increase staffing numbers, the future workforce capacity will not support the continuing increase in demand. This translates to patients who will be waiting longer to receive their cancer treatment.”