NHS cancer services need increased investment or ‘cracks will begin to show’
NHS cancer services in England are at tipping point as staff fight a brave ‘rear-guard action’ to keep the services viable for cancer patients, according to a new report commissioned by Cancer Research UK.
In the wake of years of efficiency savings and the recent NHS reforms, as well as growing demand, cancer services and staff have been under mounting pressure. The report calls for urgent action to increase investment, particularly in diagnostic services, and also highlights the need to review both the leadership and commissioning of cancer services so they are fit to meet the looming demands of an ageing population and the predicted rapid increase in cancer cases.
"In their own words the people that have propped up these NHS services tell us in this report that ‘enough is enough’." - Harpal Kumar, Cancer Research UK's chief executive
The research highlights a number of concerns and key challenges facing the NHS:
- A rising demand for services and a lack of capacity to respond to this demand;
- Due to the removal of the National Cancer Action Team and cancer networks, there has been a loss of leadership capacity at national and local level;
- A fragmentation of commissioning across the patient pathway;
- Wide variation in the roles and responsibilities of new NHS organisations and the need to rebuild relationships and regain expertise.
Responses in the report revealed a strong consensus that urgent action is needed, with one expert commenting: “We need more funding. Instead of progressing/developing our cancer services which are already significantly underfunded, our services are actually being cut. It is becoming impossible to deliver all the new cancer targets and quality of care is deteriorating.”
In 2013-14 alone, over 1.4 million patients in England were referred by their GP for suspected cancer. This represents a 50 per cent increase in referrals from 2009-10. There have also been significant increases in the number of diagnostic tests being carried out and the number of patients receiving treatment for cancer following a referral from their GP.
Generally, waiting time targets have held up. But the 62 day target – the wait between urgent referral and first treatment – has dropped below the standard of 85 per cent for the first time since 2009-10.
Harpal Kumar, Cancer Research UK’s chief executive, said: “In many ways, NHS cancer services have held up remarkably well. They have coped. Staff have bravely dug-in and done their best in the face of overwhelming change, increased demand, squeezed budgets and fragmented leadership. But that cannot continue indefinitely.
“In their own words the people that have propped up these NHS services tell us in this report that ‘enough is enough’. They can’t go on like this with no help or support coming over the horizon. And they certainly can’t improve services so that our cancer outcomes are up there with the best in the world.
“More people are surviving cancer than ever before – survival rates in the UK have doubled in the last 40 years because research is delivering better diagnosis and treatments. But the number of cases is also going up as the UK population ages. This combination means we’ll be diagnosing more people, treating more people and helping more people recover from cancer in coming decades. The NHS will need to be fit to meet that purpose and that needs increased investment, planning and leadership now.”
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