Report highlights progress slowdown in cancer services

In collaboration with the Press Association

The Department of Health and NHS England have "lost momentum" in improving cancer services in the last two years, MPs have warned.

“The report starkly illustrates the challenges facing existing cancer services and the loss of momentum in delivering improvements in recent years" - Sarah Woolnough, Cancer Research UK

While survival continues to improve, nearly a third of people still die within a year of being diagnosed and around half do not survive for five years.

This places the UK in a poor position compared to the rest of Europe, the Commons Public Accounts Committee (PAC) said.

Cancer Research UK’s executive director of policy, Sarah Woolnough, gave evidence to support the Committee’s Report. She said new strategies for services need developing as a matter of urgency, to change the “depressing” realities of waiting times and outcomes. 

Survival and access to treatment are poor for older people in particular, which is especially concerning as three in five cancers are diagnosed in people aged over 65, the report said.

It criticised NHS England for not understanding what lies behind the variations and not using the available data to hold poorly performing local areas to account.

The cross-party group of MPs said that although the number of people diagnosed with cancer continues to increase, leadership has been lost, the support for commissioners and providers to drive improvement has been reduced, and fragmentation of accountability has made progress more difficult.

PAC chairwoman, Margaret Hodge, said: "With more than one in three people developing cancer in their lifetime, cancer touches the lives of all of us at some point, and the Department of Health spends over £6.7 billion on cancer services a year.

"That is why it is so concerning that the Department of Health and NHS England have lost momentum in the drive to improve cancer services in the last two years.

"More and more people are getting cancer but the resources available to support improvement have gone down."

She said that previous progress in improving cancer services was driven by strong national leadership but NHS England has downgraded the position of National Clinical Director for Cancer to only a part-time role while the National Cancer Action Team has been disbanded.

"Focus on cancer has also been diluted at a local level," she added. "Across the country, the 28 regional networks dedicated specifically to cancer have been replaced by 12 'strategic clinical networks' covering both cancer and a wider range of other diseases.

"It is also alarming that the NHS is failing to meet important national cancer waiting time standards for patients, with the NHS failing to meet the 62-day target for patients to start treatment for the first three quarters of 2014. This is the first time this has happened since the standard was introduced."

Cancer Research UK’s Sarah Woolnough said: “The report starkly illustrates the challenges facing existing cancer services and the loss of momentum in delivering improvements in recent years. It is depressing that too many patients are waiting longer than they should for their diagnosis and effective treatment. 
“We hope it will urgently catalyse NHS England, the Department of Health and others charged with providing cancer care to deliver the best for all patients, no matter their age, the cancer they suffer from or where they live. All patients deserve the best treatment and care and many are not currently receiving it.

“More people are surviving cancer than ever before, as research is improving our ability to diagnose patients earlier and treat them effectively. But as our population ages, many more of us will develop cancer, so if we are to continue to drive improvements, we must put in place the right leadership, further investment and better planning now.

“The independent taskforce, chaired by Cancer Research UK chief executive Harpal Kumar, is developing a new strategy for cancer services in England that will seek to address these issues.”

Ms Hodge, Labour MP for Barking, said it is "unacceptable" that NHS England does not understand the reasons why access to treatment and survival is considerably poorer for older people.

"More generally, there is still unacceptable and unexplained variation in the performance of cancer services across the country - for example in the proportion of people diagnosed through an emergency presentation, in GP referral rates and in performance against waiting time standards.

"NHS England does not understand what lies behind the variations and is not using the available data to hold poorly performing local areas to account.

"Important gaps remain in information to support improvements in cancer services, for example in the completeness of 'staging data', which record how advanced a person's cancer is at diagnosis. There are also insufficient data to evaluate properly the impact of the Cancer Drugs Fund on patient outcomes.

"The Department and NHS England must seriously consider whether the new arrangements for promoting improvements in cancer care provide the leadership and support required. All the bodies involved must redouble their efforts to regain lost momentum and get improvements in cancer services back on track."