Our policy on providing world-class cancer services and treatment

Over the last 30 years, survival rates for cancer patients in the UK have more than doubled. While better detection and prevention have a significant role to play, better cancer services, new targeted treatments and coordinated national standards for care also mean that patients across the UK can now expect to live longer, with a better quality of life, after their diagnosis.

However, for some cancers, cancer outcomes in the UK still lag behind the best performing countries in Europe. It is therefore essential that research into new treatments is transferred into clinical practice in the shortest possible time.

Cancer Research UK is calling on the Government to make cancer outcomes across the UK among the best in Europe within the next ten years. To achieve this we need to ensure that all patients have access to the best possible treatments, regardless of where in the UK they live.

The impact of the NHS reforms on cancer services

With the passing of the Health and Social Care Act in summer 2012, most NHS services will be reorganised, with cancer services no exception. Find out more about our recommendations for improving commissioning of cancer services.

A team of researchers from the Health Services Management Centre at the University of Birmingham have produced a report for us looking at how the changes to the NHS are affecting cancer services. Find out more and see the report and our recommendations here.

Reducing variations in access to treatments

As a priority we want the Government to reduce variation in access to cancer treatments across the UK. This variation is not limited to cancer drugs, but also occurs in radiotherapy and surgery.

We also know that the UK lags behind other countries in the speed at which it adopts innovation in the NHS. More needs to be done to address this.

Find out more about our calls to Government in the following areas:

There are also other ways in which we think Government could improve the delivery of cancer treatment:

Improving commissioning

The way that cancer services are commissioned is key to ensuring that all cancer patients have access to the same high quality health care.

In England, commissioning is the process by which services for cancer patients are designed and purchased from all parts of the NHS, such as acute hospitals, independent contractors (GPs, dentists, pharmacists and optometrists), community providers, and voluntary or private sector organisations.

Cancer Research UK supports the principle of decision-making close to patients, which is underpinned by clinical insight and knowledge of local health needs. If implemented correctly, the proposals for GP commissioning as set out in the NHS White Paper Equity and Excellence: Liberating the NHS could potentially incentivise and raise the quality of cancer services at a local level and be responsive to the needs of the local population. However, because of the very complex nature of cancer treatment, how and at what level cancer services are commissioned is key to the delivery of world class cancer treatment. This is particularly important for rarer types of cancers and specialised cancer services.

GP consortia will require access to relevant and up to date information, data and good quality cost metrics to improve the planning and procurement of service decisions. To facilitate more robust planning, analytical capability must be improved.

We also welcome the commitment made in the consultation document that the National Commissioning Board will be responsible for commissioning research in the NHS. Research is vital in providing the new knowledge needed to improve health outcomes and reduce inequalities.

Providing information for patients

Information plays a crucial role in enabling people with cancer to take a more active role in their treatment and improve their quality of life. Information can help people affected by cancer, and those supporting them, to make sense of their situation and the choices that are available to them about how, when and where they, or their relatives, receive their care.

The Government is an important partner in the development and dissemination of information about cancer.

Read about how we want the Government to support our work on providing information for patients.

Providing information on the quality of services

In order to ensure that we are meeting our aim to reduce variation in access to treatment, and improve overall quality of the services being offered to cancer patients across the NHS, it is important that we accurately measure our success.

Measuring cancer outcomes means measuring the quality of care over the long term, particularly for measures such as 5 year survival, where data are typically not available until 7-8 years after the year in question. The impact of service redesign or a change to the patient pathway this year will often therefore not have a measurable impact on these cancer outcomes for several years. One potential risk is that it could take several years to realise that a service change is having an adverse effect on survival or leading to increased inequalities.

Proxy outcome measures

Because of the delay in collecting information, it is important to consider identifying a number
of proxy measures to use to indicate progress towards the improvement of cancer outcomes.

These could include:

The stage of cancer at diagnosis
1 year cancer relative survival for breast, lung and bowel cancer
5 year cancer relative survival
5 year cancer relative survival for those who have survived 1 year beyond a cancer diagnosis
excess mortality
5 year breast cancer relative survival in the over 75s
death from, or emergency admission with cancer, where the patient previously visited their GP with cancer related symptoms
percentage of smokers who are referred to NHS Stop Smoking Services

Patient Recorded Outcome Measures

The use of Patient Recorded Outcome Measures (PROMs) as part of day to day patient care could provide some real benefits and information about treatment and care but it is essential that they are developed in a way which is quick and easy to use. PROMs currently operate as lengthy pre and post-operative questionnaires for patients who have elective surgery and they should be expanded for use in other planned sequential treatment such as cancer. PROMs for cancer patients could include the side effects (and severity of these) a patient is experiencing 1, 2 or 5 years after treatment and a patient’s recovery from illness following a cancer diagnosis.

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