pharmaphorumNovember 28, 2018
The performance of NHS cancer services in England is lagging behind those of comparable countries, according to a new report.
According to the report, Unfinished Business, by The Health Foundation think tank, England has made progress in improving cancer services since the introduction of a national cancer plan in 2000.
But according to former cancer tsar professor Sir Mike Richards, who led the review, the other countries have improved their services at a faster pace.
As a result, England is still lagging behind comparable countries in terms of survival rates.
Survival rates are improving, however – in 2000, 62% of patients survived for at least a year, but by 2015 this had risen to 72%. Five-year survival has increased from 42% to 53%.
But The Health Foundation’s report benchmarked the NHS’s performance compared with five other nations – Canada, Australia, Denmark, Norway and Sweden.
The report looked at how the NHS performed in six cancers – colon, rectum, breast, lung, ovarian and prostate.
According to the report, the UK has remained in the bottom two since 2000 for five-year survival, and it has only closed the gap with the best performers in breast cancer.
It estimates that 10,000 deaths could be prevented each year with better diagnosis.
A number of factors have held back performance, according to the report.
GPs are under pressure not to refer too many patients to hospitals, and if patients do make it to hospital there is not enough equipment or staff to carry out necessary tests and scans.
There has been a rise in referrals from GPs – but waiting times are also up and the NHS is struggling to meet targets.
And one in five patients are still diagnosed in accident and emergency units, associated with poorer outcomes as the disease is often more advanced at the time of diagnosis.
Political interference has also held back progress – according to the report a restructuring of the NHS led by former health secretary Andrew Lansley in 2012 has "led to a loss of momentum in improving cancer care, which has still not fully been regained.
"National leadership and support for cancer networks was significantly downgraded, impacting on progress on cancer."
The report made a series of recommendations to improve services, including better screening for bowel cancer using a revised Faecal Immunochemical Test, better detection of lung cancer, and implementation of a NICE guideline on how GPs should investigate patients with a higher risk of cancer.
There should also be more rapid diagnosis centres, potential modifications to the 62-day standard waiting time, more personalised care, better funding and monitoring against a set of key metrics.
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