Taskforce report aims to boost cancer survival and transform patient experience 

Six strategic priorities have today (Sunday) been recommended by the Independent Cancer Taskforce to help the NHS achieve world-class cancer outcomes.

The cancer report outlines how an additional 30,000 patients every year could survive cancer for  10 years or more by 2020. Of these, around 11,000 would be through earlier diagnosis.

The plan, which aims to make substantial improvements in cancer care in England, comes at a time when cancer cases are increasing. 280,000 people were diagnosed with cancer in England in 2013/14 and this is expected to reach more than 300,000 by 2020, and more than 360,000 by 2030. One in two people will develop cancer at some point in their lives.

With survival rates also increasing each year, more people are living with cancer. The report sets out proposals for how patient experience can be transformed both during and after treatment.

This hike in cancer cases, driven largely by the UK’s ageing population, means that NHS cancer services are under unprecedented pressure. Resolving the pressure has been a key focus for the Taskforce.

The six strategic priorities are:

A radical upgrade in prevention and public health. The strategy outlines how the NHS should work with the Government to improve public health, including adopting a new tobacco control strategy within the next 12 months, and a national action plan on obesity. The Taskforce wants to see a reduction in smoking from 18.4 percent now, to less than 13 percent by 2020.

A national ambition to achieve earlier diagnosis. The ambition set out is that, by 2020, 95 percent of patients referred for testing by a GP are definitively diagnosed with cancer, or cancer is ruled out, and that patients get this result within four weeks. This requires a significant increase in diagnostic capacity, giving GPs direct access to key investigative tests, and the testing of new models which could reduce the burden and reliance on GPs. Currently, patients urgently referred for suspected cancer by their GP need to be seen by a specialist within 14 days of referral, but no guidance exists for when patients can expect to get the results.

Patient experience on a par with clinical effectiveness and safety. The strategy recommends giving all consenting patients electronic access to all test results and other communications involving further care by 2020. Patients should also have access to a clinical nurse specialist or other key worker to help coordinate their care. The NHS must continue to develop and adopt meaningful ways to measure a patient’s experience, including the annual Cancer Patient Experience Survey.

Transformation in support for people living with and beyond cancer. By 2020 every person with cancer should have access to elements of a ‘Recovery Package’ – a comprehensive plan that outlines treatment as well as post-treatment support and care. A national quality of life metric should be developed by 2017 to ensure better support for people after treatment has ended. Clinical Commissioning Groups (CCGs) must ensure they commission appropriate End of Life care, in accordance with NICE guidelines and the Choice Review.

Investment to deliver a modern high-quality service, including:

• A replacement plan for radiotherapy machines (linacs) as they reach 10-years and upgrading of existing linacs by the time they have been operational for six years;
• A permanent and sustainable model for the Cancer Drugs Fund to help patients get access to innovative cancer treatments;
• A nationally-commissioned, regionally-delivered, molecular diagnostics service, to guide more personalised prevention, screening and treatment;
• Plans to address critical deficits in the cancer workforce.

Overhauled processes for commissioning, accountability and provision. Clearer expectations need to be set by the end of 2015 for how cancer services should be commissioned, with most treatment then being commissioned at population sizes above CCG level. By 2016, a network of Cancer Alliances should be established across the country. These will bring together key partners at a local level, including patients. The Alliances would use a dashboard of key metrics to address variation and support service redesign.

The Taskforce has recommended that a National Cancer Team (NCT) should oversee the delivery of the Strategy.

Harpal Kumar, chair of the Independent Cancer Taskforce, said: “We have an opportunity to save many thousands of lives from cancer every year. We’re better informed than ever about how best to prevent, diagnose and treat the disease, and how to deliver better patient experience and quality of life. What’s needed now is action.

“Three previous cancer strategies did a great job of setting England on the path to a world class cancer service. But we are a long way from where we should be. Our expectation is that the Government and NHS will now make the investments required and implement this strategy with commitment and speed.”

Simon Stevens, NHS England chief executive, said: “One in two of us will get cancer at some point in our lives, and the good news is that survival rates are their highest ever. But two fifths of cancers are preventable, and half of patients are currently diagnosed when their cancers are advanced. That’s why the NHS will be backing this groundbreaking route map for prevention, earlier diagnosis, modern treatments and compassionate care, which the Taskforce estimates could save 30,000 lives a year.”

Duncan Selbie, chief executive of Public Health England, said: “Four in ten cancers are preventable and without concerted action on risk factors like smoking, alcohol and diet, cancer will spread even greater misery to those affected. The Cancer Taskforce rightly state that we need a radical upgrade in prevention and public health.

“PHE plays a critical role in the national response to cancer, including providing the data and intelligence on which the NHS depends, and we warmly welcome the Taskforce’s report. We look forward to considering the recommendations, especially the action plans to reduce smoking and tackle obesity, in detail, and working with our partners to realise the vision of a society that is serious about prevention.”