One of the largest surveys of cancer patient experience sets out a roadmap for how the NHS can meet their needs, Care Services Minister Paul Burstow announced today.
The National Cancer Patient Experience Survey, one of the largest surveys of cancer patient experience, heard from 67,713 patients with a whole range of cancers. It reveals that 84 per cent of those who had received one to one support had significantly higher rates of satisfaction across all aspects of their care.
But other key findings include:
- only 58 per cent said doctors or nurses gave their family or someone close to them all the information they needed to help care for them at home;
- 68 per cent pf patients said their appointments started within 30 minutes of their appointment time at their last outpatient appointment with a cancer doctor;
- 50 per cent who said it was necessary had received information about financial help; and
- 62 per cent reported enough nurses were on duty when they were admitted to hospital.
Care Service Minister Paul Burstow said:
“Effective cancer care isn’t just about clinical evidence, we must also listen and learn from people affected by cancer.
“More can be done for those with cancer. The Coalition Government's aim is simple - to get cancer survival rates up there with the best in the world. To do this we need to make the best possible use of the resources available.
“That is why in less than six months, the Coalition Government has set in motion a raft of measures to accelerate progress including an early signs and symptoms awareness campaign that will launch in January, more money for screening and investing in cutting edge therapies.
“These studies provide the NHS with an essential insight into the views and experience of patients. It is a powerful tool for improving services.
An independent economic study, commissioned by the Department of Health entitled One to one support for cancer patients, has also been published today. The study looked at seven cancers and found that offering one-to-one support for cancer patients could save the NHS around £89 million by improving care and reducing unnecessary hospital stays and GP visits.
The analysis provides evidence for the potential benefits that investment in one to one support posts can achieve and has been backed by Macmillan Cancer Support who will invest £300 million to support the NHS in creating up to 2,700 support roles in hospitals and the community over the next decade.
The results come as the local NHS have been given increasing resources for cancer services – and should provide a solid evidence base for decision making on how to develop local cancer services to improve outcomes.
Paul Burstow added:
“Many patients are already benefiting from access to specialist nursing but more can be done. I am really pleased that Macmillan will help the NHS to provide this specialised service. And NHS commissioners have the rising resources from which they can make the decision to increase one to one support.
“Finding from these studies will be fed into the Department of Health’s updated cancer strategy that is due to be published in the new year.”
Ciarán Devane, Chief Executive, Macmillan Cancer Support says:
“People affected by cancer continually tell us that having one-to-one support makes an enormous difference to their cancer experience, especially once treatment finishes. This research now also proves that this type of support can save the NHS money and improve patient care.
“Macmillan improves the lives of people affected by cancer and we have committed to sustaining our funding of specific support for cancer patients both during treatment and in aftercare.”
NHS Trust level reports from the Cancer Patient Experience Survey will be published in the new year.
Notes to editors
1. For further information contact the Department of Health newsdesk on 020 7210 5221
2. Macmillan Cancer Support has today announced that it will invest up to £300 million to pump prime additional one to one support posts over the next seven to 10 years. For further information on this investment contact Macmillan’s press office on 020 7840 7821
3. The Department of Health commissioned Frontier Economics to model the cost effectiveness of one to one support. Macmillan, CLIC Sargent and the Teenage Cancer Trust have all contributed to this work.
4. The analysis, commissioned by the Department of Health, looked at the different models for providing one-to-one support across seven cancers, including the use of Clinical Nurse Specialists and care co-ordinator roles, and found they had the potential to improve care and reduce unnecessary hospital stays and GP visits. While one to one support for cancer patients is generally good during diagnosis and treatment, evidence suggests that not all cancer patients have access to support following treatment or if their cancer spreads.
5. The Cancer Patient Experience Survey 2010 and the Frontier Economics report, One to one support for cancer patients, are available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_122516
http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=417004&...
also at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati...
PDF version Cancer survival rates in the UK are lower than those in other developed countries, according to new research.
An international study compared survival rates of cancer patients in Canada, Australia, Sweden, Norway, Denmark and the UK (not including Scotland).
The Lancet journal report showed the gap between the worst and best performers is narrowing
However, the UK is still lagging behind, experts found.
The study examines cancer patients one and five years after diagnosis, a total of 2.4 million people suffering from four major cancers - bowel, lung, breast and ovarian.
Survival rates were highest in Australia, Canada and Sweden, while Norway was described as intermediate.
Stark variations
But while more people are surviving cancer than ever before, the rates were lowest in the UK and Denmark.
Researchers stressed though that the gap between the UK and the best performers is decreasing.
To read more http://www.bbc.co.uk/news/health-12054984
Improving outcomes: a strategy for cancer aims to help the reformed NHS deliver cancer outcomes that are amongst the best in the world.
Please note: the impact assessment document below is not fully accessible and is provided for printing.
- Download Improving outcomes: a strategy for cancer (PDF, 1008K)
- Download impact assessment (PDF, 310K)
- Download assessment of the impact on equalities (PDF, 629K)
- Stakeholder engagement report - Gateway reference 15408
- Download Review of waiting times standards - Gateway reference 15283 (PDF, 206K)
- Download The likely impact of earlier diagnosis of cancer on costs and benefits to the NHS - Gateway reference 15375 (PDF, 2247K)
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati...
Also see http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_123438
The first ever Government cancer awareness campaign to highlight the early signs and symptoms of bowel cancer is launched today (Monday 31 January), by Health Minister Paul Burstow.
The ‘Be Clear on Cancer’ campaign will initially be piloted in two regions and if successful will be rolled out across the country.
Improving cancer outcomes is a Government priority and the earlier cancer is diagnosed, the better the outlook. Featuring real GPs encouraging patients to talk to them about changes in their poo, the new adverts aim to make people aware of the early signs of bowel cancer and make it easier for them to discuss this with their GP.
Adverts will appear on TV, radio and in newspapers in the East of England and South West for seven weeks from today (Monday 31 January).
More than 90 per cent of people diagnosed with bowel cancer at the early stage survive for at least five years compared with only 6.6 per cent of those diagnosed at the late stage. Ten thousand lives, across all cancers, could be saved each year if England matched the best cancer survival rates in Europe.
Health Minister Paul Burstow said:
“No one likes talking about their poo – it’s embarrassing. But if we see something different and tell our GP it could save our life.
“Early diagnosis makes a huge difference to cancer survival rates and bowel cancer is one of the biggest killers. That’s why the ‘Be Clear on Cancer’ campaign uses simple messages to make people aware of the early signs of bowel cancer and to give them the confidence to talk to their GP about them.
“To make sure we get it right, we’re testing this campaign in two regions and, if it works, we’ll roll it out nationally.
"We want to concentrate on what is most important to patients and their families — cancer outcomes. Alongside the Cancer Drugs Fund and the actions outlined in Improving Outcomes - A Strategy for Cancer which is backed by £750 million over four years, this will help achieve that."
Sarah Lyness, Cancer Research UK’s executive director of communications and information, said:
“We welcome this campaign because spotting cancer early saves lives. Most changes in bowel habits probably won’t be cancer but if they are it is much better to be diagnosed and treated as quickly as possible.
“So if people notice a change that lasts three weeks or more - whether it’s looser poo, bleeding or anything else that is unusual for them - they should report the symptoms to their doctor without further delay.”
Mark Flannagan, Chief Executive of Beating Bowel Cancer, said:
"The launch of this bowel cancer symptoms awareness campaign is a major step forward in tackling the issue of late diagnosis. By increasing awareness of the disease and encouraging people to act on their symptoms, this campaign has the potential to save thousands of lives."
Deborah Alsina, Chief Executive, Bowel Cancer UK.
“We are delighted to support the launch of the Signs and Symptoms campaign which will feature bowel cancer. Early diagnosis is critical in order to save lives from the disease. It is the second biggest cancer killer in the UK, but it shouldn’t be as it is highly treatable if caught early.
“We hope that the campaign will encourage members of the public to recognise the symptoms of bowel cancer and act on them right away by making an appointment to see their GP so that the disease can either be ruled out or treated quickly.”
As well as the pilots for a national campaign, £9 million has been made available to fund 59 local cancer awareness campaigns led by the NHS and supported by Cancer research UK. These will target the three biggest killers, bowel, lung and breast cancer. The Government is already providing cutting-edge cancer therapies, through its commitment to invest £50 million in additional cancer drugs until the end of March and from April £200 million per year for a Cancer Drugs Fund until the end of 2013.
Examples of local activity being funded by this campaign include:
- NHS Leeds aims to reduce mortality from lung cancer in people aged over 50 through social marketing and community engagement. For example, they plan to advertise on bus routes in key areas and provide community health professionals with branded items directing people to new services, such as self referral chest X-Ray.
- NHS Brighton and Hove whose one and five year survival rates for colorectal cancer are well below the national average, will raise awareness among a target audience of the fact that a change in bowel habits is a possible sign of colorectal cancer.
- NHS Liverpool has cancer mortality rates (among under 75s) 38 per cent higher than the English average and significant variations exist across the city. Lung, colorectal and breast cancer account for nearly half of all cancer deaths in Liverpool. The aim of the project is to increase earlier presentation of the signs and symptoms of these cancers among prioritised groups through the application of social marketing principles.
Notes to editors
1. For further information please contact the Department of Health press office on 020 7210 5221.
2. Campaign materials are available to download at the following password protected FTP site:
ftp.mcsaatchi.com
username: Be Clear on Cancer
password: d0hbc0c
3. 10,000 lives could be saved each year if survival rates across all cancers matched the best in Europe. Work undertaken by the London School of Hygiene and Tropical Medicine estimated that 1700 deaths could be avoided each year by bringing bowel cancer survival in this country up to the best in Europe.
4. Advertising for the national pilot campaign has been developed by M&C Saatchi. The pilot campaigns have cost £1.75m in total.
5. £9 million has been allocated to PCTs in 10/11 to run local awareness and early diagnosis initiatives, targeting breast, bowel and lung cancers. There are 59 projects covering 109 PCTs across the country.
6. The campaign programme is part of a broader range of work to improve cancer services and outcomes. For example, in relation to bowel cancer survival rates, the actions include: extending the screening age to 75, introduction of flexible sigmoidoscopy screening at 55, promoting laparoscopic colorectal surgery, a training programme for lower rectal surgery and an enhanced recovery programme.
http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=417637&...
Our cancer survival rates are improving significantly for most cancers, and for cancer overall. The combined five-year survival rate for all cancers is now over 50 per cent. And while unfortunately some cancers – such as lung and pancreatic cancers – have seen little or no improvement, others – including breast and colorectal cancer – have seen great improvement over time.
In terms of international comparisons, a recent paper in the Lancet provides the best quality and, importantly, most up-to-date comparison of cancer survival rates between eight countries. It shows that survival is best in Canada, Australia and Sweden, intermediate in Norway, and worse in Denmark and the UK nations, with differences particularly significant in older people. And, while our rates are improving, so are everyone else’s – and at similar rates; we are not managing to close the gap. In lung cancer, the gap between us and the better performing nations has widened slightly. The gap does seem to be closing in breast cancer, but this is thought to be because the highest performing countries are reaching the ‘ceiling’ of realistically achievable survival levels.
The evidence as to why we are performing relatively poorly is complex, but points to late diagnosis as one of several factors. So, if the government wants to improve cancer survival rates one of the most important questions is: will it manage to diagnose more cancers earlier? The importance of early diagnosis was recognised in the recently published outcomes strategy for cancer. This included additional funding – not a phrase you expect to hear at the moment – to increase GPs’ rapid access to diagnostics, and retained the previous government’s cancer waiting time standards, arguing that they are clinically justified and so exempt from the cull of top-down process targets. Both of these decisions could help early diagnosis.
But will the broader health reforms improve early cancer diagnosis? There are arguments on both sides, not least because at this stage in the process it is obviously hard to predict how the reforms will progress through parliament and then play out in practice. On the ‘yes’ side, the right indicators in the outcomes framework will focus the system more on early diagnosis (such as one-year survival rates and stage at diagnosis), and perhaps transparency on these outcomes will drive providers to improve. On the ‘no’ side, with financial pressures on the service, there is the risk of a crude response that includes blanket efforts to reduce referrals from primary care, something that we know is already happening from previous King’s Fund research. The commissioning of cancer care is hugely complex, so with the loss of primary care trusts and the potential loss of associated expertise in cancer networks there’s a risk that commissioning for cancer will get worse, not better – at least in the short term. Neither of these risks are adequately addressed in the outcomes strategy.
Read John Appleby's article in the BMJ for another view on international survival rates.
Public Accounts Committee reports on cancer reform strategy
The Rt Hon Margaret Hodge MP, Chair of the Committee of Public Accounts, today said:
"This Committee fully supports the work by the Department of Health over the last 10 years to make tackling cancer a priority. Mortality rates have been falling and cancer waiting times targets consistently achieved.
But the one year survival rates in England are still poor compared with the best performing European countries and that is generally a sign of low awareness of symptoms, among the public and GPs, and late diagnosis. There also remain unexplained wide variations across the country in how cancer services perform and in types of treatment available.
It is very disappointing that, a decade after publication of the NHS Cancer Plan, there is still not enough good quality and timely information on such important aspects of cancer services as the use of chemotherapy and the stage at which patients' cancers are being diagnosed.
The Department must maintain the momentum it has recently established in improving information on cancer services, and make sure this information is used to improve the use of resources and, most importantly, to deliver better outcomes for cancer patients."
Margaret Hodge was speaking as the Committee published its 24th Report of this Session which, on the basis of evidence from the Department of Health (the Department), examined its and the NHS's performance in delivering cancer services; improving information on activity, cost and outcomes of cancer services; and how the Department intends to deliver cost-effective cancer services in the new NHS.
Each year in England, around 255,000 people are diagnosed with cancer and around 130,000 die from the disease. The NHS spent £6.3 billion on cancer services in 2008–09. Tackling Cancer has been a priority for the Department of Health (the Department) since its ten year NHS Cancer Plan was published in 2000. In 2007 the Department published its five year Cancer Reform Strategy (the Strategy) to deliver improved patient outcomes.
Over the last ten years, the NHS has made significant progress in delivering important aspects of cancer services, with falling mortality rates and consistent achievement of the cancer waiting times targets. Since publication of the Strategy in 2007, improvements have also been made in reducing the average length of stay and numbers of patients treated as day cases.
A significant increase in resources has contributed to these improvements, but the progress has also been achieved through clear direction and high profile leadership underpinned by strong performance management linked to waiting times and mortality targets.
We welcome the Department’s and NHS’s commitment to improving the outcomes for cancer patients. We are concerned, however, that early diagnosis does not happen often enough; whilst cancer survival rates have improved and mortality rates have fallen, the gap in survival rates between England and the best European countries has not been closed. There remain wide, unexplained variations in the performance of cancer services and in the types of treatment available across the country.
It is very disappointing that ten years after the publication of the NHS Cancer Plan 2000 there remain significant gaps in information about important aspects of cancer services, in particular information on chemotherapy, on follow-up treatment, and on the stage that a patient’s cancer has reached at the time of diagnosis. The Department cannot yet measure the impact of the Strategy on key outcomes, such as survival rates, and does not know if cancer services are being commissioned cost-effectively, due to poor data on costs and because outcomes data are not sufficiently timely.
We were surprised that value for money has not been a stronger focus for commissioners, both in securing services to meet the health needs of their local population or in assessing the performance of its suppliers. Few commissioners make best use of the information available and most do not know whether their commissioning is cost-effective.
The Department has recently refreshed its approach to delivering improvements in cancer services with the publication in January 2011 of Improving Outcomes: A Strategy for Cancer.
We consider it a priority that the Department should continue to improve information on cancer-related activities. We look to the Department to develop robust mechanisms to ensure the collection of high quality, comprehensive and timely data to raise awareness of cancer, provide transparency in the performance of commissioning consortia, and ultimately drive improved outcomes for cancer patients.
Further Information
http://www.parliament.uk/business/committees/committees-a-z/commons-sele...
The Department of Health (DH) still doesn't know how well it is doing in its attempts to deliver better outcomes for cancer patients, the Committee of Public Accounts has said.
Looking at how the department intends to deliver cost-effective cancer services in the new NHS, the committee acknowledged that since the DH published its 10-year 'NHS Cancer Plan' in 2000 and its five-year 'Cancer Reform Strategy' in 2007, "significant progress" had been made, with falling mortality rates, waiting times targets being met and reductions in the average length of stay for patients in hospitals.
But the committee was "concerned" that early diagnosis didn't happen often enough and the gap in survival rates between England and the best European countries hadn't been closed. There remained "wide, unexplained variations" in the performance of cancer services and in the types of treatment available across the country.
The committee added that it was "very disappointing" that 10 years on there were still "significant" gaps in information about chemotherapy, follow-up treatment and what stage a patient's cancer had reached when diagnosed. The DH still has no way of telling what impact its cancer reform strategy is having on survival rates and doesn't know if cancer services are being commissioned cost-effectively. Finally, the committee said it was "surprised" that value for money hadn't been a stronger focus for commissioners, with most of them not knowing .if their commissioning was cost-effective.
Committee chair Margaret Hodge said: "This committee fully supports the work by the Department of Health over the last 10 years to make tackling cancer a priority. Mortality rates have been falling and cancer waiting times targets consistently achieved. But the one year survival rates in England are still poor compared with the best performing European countries and that is generally a sign of low awareness of symptoms, among the public and GPs, and late diagnosis. There also remain unexplained wide variations across the country in how cancer services perform and in types of treatment available."
She added: "It is very disappointing that, a decade after publication of the NHS Cancer Plan, there is still not enough good quality and timely information on such important aspects of cancer services as the use of chemotherapy and the stage at which patients' cancers are being diagnosed. The department must maintain the momentum it has recently established in improving information on cancer services, and make sure this information is used to improve the use of resources and, most importantly, to deliver better outcomes for cancer patients."
The Department of Health has committed to funding Cancer Networks in 2012/13, Health Secretary Andrew Lansley has announced.
The networks provide expertise to help commissioners, providers and patients work together to plan and deliver high quality cancer services.
Speaking at the launch of the Anglia Cancer Network’s Be Clear on Cancer campaign last night, Andrew Lansley also announced that, beyond 2012/13, the NHS Commissioning Board will support strengthened Cancer Networks.
Andrew Lansley said:
"Over the last decade, Cancer Networks and clinical networks in other areas of care have had a crucial role, taking the lead in the development of great advances in treatments, promoting excellence and improving outcomes.
“I am determined that we build more clinical leadership into designing services, bringing together new clinically-led commissioning consortia with colleagues in specialties across medical, nursing and health professions, to design services that meet quality, choice and outcome objectives.
“Clinical networks are a clear example of how this way of working delivers better quality.
"We are listening to the views of clinicians in the field, and will respond by ensuring that, through the reforms, the role of a broad range of clinical networks is centre stage to how clinical services are designed. This will help deliver for other conditions the sense of clarity of purpose established in cancer services.”
The Coalition Government’s cancer strategy - Improving Outcomes: A Strategy for Cancer – was published in January 2011 and committed to funding Cancer Networks in 2011/12.
The Government is currently taking advantage of a natural pause in the passage of the Health and Social Care Bill to listen and reflect, so that it can further improve its plans for a stronger, more personalised NHS. Subject to the outcome of the listening exercise and the passage of legislation, the NHS Commissioning Board will be established as a statutory body in 2012.
http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=419587&...
The Government’s first ever cancer campaign to increase awareness of bowel cancer is to be rolled out nationally as part of a £8.5 million package following a successful trial, Health Minister Paul Burstow announced today.
The ‘Be Clear on Cancer’ bowel cancer awareness will launch nationally in January. The ads will feature real GPs encouraging patients to talk to them about changes in their poo. They aim to make people aware of the early signs of bowel cancer and make it easier for them to discuss this with their GP.
Results from the regional pilots in the South West and East of England, found:
- There was a 48 per cent increase in the number of people who visited their GPs with symptoms.
- There was a 32 per cent increase in urgent referrals to hospitals over six months - which included the period the campaign ran.
- Campaign recognition was high with 75% of the public in South West and East of England saying they had seen the advertising
- There was overwhelming support for the campaign - 96 per cent of the public and 89 per cent of GPs believed it was important.
Building on the success of the bowel cancer campaign, the Department of Health is now also launching a new regional campaign to highlight the signs and symptoms of lung cancer across the East and West Midlands. From October, local TV and radio ads will show that people with a persistent cough for more than three weeks should visit their GP.
Lung Cancer is the UK’s biggest cancer killer claiming over 28,000 lives a year. One thousand three hundred lives could be saved each year if England matched the best survival cancer rates in Europe.
Paul Burstow said:
“No one likes thinking about cancer, or talking about their poo. But the plain fact is no one dies of embarrassment, they can die of cancer if they don’t get an early diagnosis. Tell your GP. It could save your life.
“Early diagnosis makes a huge difference to your chance of survival. Results from our regional bowel cancer campaign shows campaigns really work to raise awareness and get people to their GPs.
“We are concentrating on what is most important to patients and their families - improving cancer outcomes. We’re investing £750million over the next four year to deliver our ambition of saving at least 5000 additional lives. Alongside the Cancer Drugs Fund, these campaigns will improve health outcomes for cancer all cancer patients.”
Harpal Kumar, Chief Executive, Cancer Research UK, said:
“We very much welcome the extra money to raise awareness of the early signs and symptoms of bowel, lung and a range of other cancers. The key reason our cancer survival lags behind the best in the world is that we diagnose the disease late.
“Cancer Research UK and the Department of Health have set up the National Awareness and Early Diagnosis Initiative (NAEDI) to work towards ensuring that cancer is diagnosed as early as possible when treatment is more likely to be successful. Campaigns to raise awareness are a vital part of this approach.”
Deborah Alsina, CEO, Bowel Cancer UK and Mark Flannagan, Chief Executive of Beating Bowel Cancer said:
“We are fully committed to working with the government to raise awareness of the symptoms of bowel cancer. We know 90% of people will survive if diagnosed at the earliest stage of the disease. The tragedy however is that only 9% are. We work with people every day who tell us they are living proof that bowel cancer is curable.
“Worryingly awareness of symptoms and the disease is still way too low. We hope this campaign will help change that and encourage people to take the important first step of going to their doctor if they have concerns.”
This year, the Government is also funding 18 projects across the country to trial symptom awareness campaigns focussing on oesophagogastric cancer, the symptom blood in urine (an indicator particularly for kidney and bladder cancers) and targeting women over the age of 70 who may have breast cancer.
The Government is also providing cutting-edge cancer therapies, through its commitment to invest £200 million per year for a Cancer Drugs Fund until the end of 2013.
Notes to editors:
1. For further information please contact the Department of Health press office on 020 7210 5221.
2. Bowel Cancer Symptoms may vary, but we know those which might be bowel cancer include:
- A persistent change in normal bowel habit, such as going to the toilet more often and diarrhoea, especially if you are also bleeding from your back passage
- Bleeding from the back passage without any reason, particularly over the age of 50
- A lump in your tummy or a lump in your back passage felt by your doctor
- Unexplained iron deficiency in men or in women after the menopause
- Unexplained extreme tiredness
3. Advertising for the national pilot campaign has been developed by M&C Saatchi. The pilot bowel campaigns cost £1.75m.
4. The campaign programme is part of a broader range of work to improve cancer services and outcomes. For example, in relation to bowel cancer survival rates, the actions include: extending the screening age to 75, introduction of flexible sigmoidoscopy screening at 55, promoting laparoscopic colorectal surgery, a training programme for lower rectal surgery and an enhanced recovery programme.
http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=421239&...
The cost of treating cancer in the developed world is spiralling and is "heading towards a crisis", an international team of researchers says.
Their Lancet Oncology report says there is a "culture of excess" with insufficient evidence about the "value" of new treatments and technologies.
It says the number of cancer patients and the cost of treating each one is increasing.
It argues for reducing the use and analysing the cost of cancer services.
About 12 million people worldwide are diagnosed with cancer each year. That figure is expected to reach 27 million by 2030.
The cost of new cancer cases is already estimated to be about £185bn ($286bn) a year.
Rising costs
A group of 37 leading experts from around the world say the burden of cancer is growing and becoming a major financial issue.
Cancer patients challenge NHS in court over long journeys for treatment
Cancer patients who have to endure long journeys to receive their daily treatment are to make legal history by contesting their health authority's decision not to provide radiotherapy services at their local hospital. The patients, some with terminal cancer, make round trips of up to six hours a day to have their 10-minute radiotherapy treatment at hospitals in the north and east of Essex.
The debilitating treatment, which lasts for up to six weeks, means they cannot drive and are dependent on others for transport. Legal experts believe that, if successful, their application for a judicial review would have far-reaching consequences for anyone with a disability.
Their claim centres on a decision by Mid Essex health authority to abandon a plan to provide radiotherapy services at Broomfield hospital in Chelmsford, considered a centre of excellence for treating several forms of cancer.
Instead, radiotherapy services are provided only at hospitals in Colchester and Southend. For patients with no access to a car, this can mean journeys into London on a train and then out to Colchester, with a taxi or bus ride to the hospital at the other end.
Helen Sale, a nurse and mother of a five-year-old son, was 38 when she started treatment for breast cancer, and began her chemotherapy treatment at Broomfield, 20 minutes from her home in South Woodham Ferrers.
She said that having to travel to Colchester had been an exhausting experience: "Radiotherapy drains you. It's not painful, doesn't make you sick, but it drains you physically and emotionally. It's not safe to drive yourself."
She quickly reached a point where she became reliant on others to help. "My husband couldn't take any more time off work because he had taken an enormous amount of time off during the initial diagnosis, operation and chemotherapy, so my mum very kindly offered to move in with me so that she could do the driving."
Essex's four primary care trusts had initially backed plans to introduce radiotherapy services at Broomfield. The plans were part of the trusts' vision for developing Essex's cancer services to reflect the county's ageing population. A report commissioned from independent experts suggested expanding radiotherapy services at Chelmsford "would significantly reduce travel times for a large portion of Mid Essex".
But the plan was dropped, provoking outrage among councillors, MPs, patients and families. In testimonies submitted as part of the legal action, the daughter of one elderly cancer patient said: "We could have used the transport which for some is good, but my father [was] 90. Transport collects very early, you have to go to various locations, both on the way to and from the hospital, which could make the whole experience a day long. Far too much travel at any age, let alone 90 years."
Another said: "I do not drive and have stage four cancer which means that I have to arrange transport with several people since I cannot use public transport beyond the Chelmsford area due to tumours in my spine, fatigue and a lowered immune system. I cannot afford taxis to and from Colchester."
The cancer patients claim that, under section 149 of the Equality Act, a public authority must "eliminate discrimination", and "advance equality of opportunity".
Allison Tibbats, 44, who has terminal cancer that has spread to her bones, said the case had important implications for other patients. "We want them [Essex primary care trusts] to look at the decision again and to listen to patients. We believe this is a flawed decision that has been made without thinking about the human costs. Patients will realise they can challenge these decisions, they are not set in stone."
Oliver Wright, of Lewis Hymanson Small Solicitors, who is representing the patients, said the legal challenge was of national interest. "This case is very important to people living in Mid Essex but it also has a significant wider public importance for disabled people across England and Wales and has the potential to influence a great many future administrative decisions in favour of disabled people."
http://www.guardian.co.uk/world/2011/nov/13/cancer-patients-challenge-jo...
Downloads
"The Department of Health's strong direction and high profile leadership has resulted in improved cancer services in key areas. Further improvement depends, to a significant degree, on raising standards of practice around the country up to the best. A key factor in driving this is a much improved approach to information on cancer services."
Amyas Morse, head of the National Audit Office, 18 November 2010
Improvements and efficiencies have been made in key areas of cancer care since the Cancer Reform Strategy was published in 2007, according to an NAO report today. However, a lack of high quality information on costs of cancer services and their outcomes inhibits substantial further improvements. The performances of Primary Care Trusts (PCTs) still vary significantly and there is scope for greater efficiencies, worth hundreds of millions of pounds each year, in the delivery of care.
There have been high levels of achievement against cancer waiting times standards and significant reductions have been made in the number of days cancer patients spend in hospital - largely as a result of increasingly treating patients as day cases. However, whilst the Strategy aimed to minimise emergency admissions for cancer patients, these are still increasing, with wide variations between PCTs and poor understanding of the reasons for those variations.
The NAO estimates that cancer cost the NHS approximately £6.3 billion in 2008-09, but the Department of Health has limited assurance as to whether the implementation of the Strategy is achieving value for money. Reported spending on cancer care varies between PCTs - in 2008-09 varying from £55 to £154 per head - and there is unexplained variation from year to year.
There are opportunities to achieve better outcomes and free up resources to meet the increasing demand for cancer services. For example, by reducing the average length of stay in hospital to the level of the best performing PCTs, efficiencies worth some £113 million a year could be achieved. And if the number of inpatient admissions per new cancer diagnosis was reduced to the level of the best performing PCT, bed days equivalent to around £106 million each year could be saved. In addition, radiotherapy machines could be used more productively to help the NHS meet increasing demand.
High quality information is essential to be able to commission services successfully and to monitor performance. Some information on cancer has improved, but significant gaps still remain. For example, data on chemotherapy activity and outcomes are poor and the introduction of a national chemotherapy dataset is almost two and a half years behind the original commitment made by the Department.
Publication details:
HC: 568, 2010-2011
ISBN: 9780102965551
http://www.nao.org.uk/publications/1011/cancer_reform_strategy.aspx