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The aim is a radical improvement in outcomes for cancer patients
NHS England is making a series of new senior appointments, including a number of National Clinical Directors. We will introduce them in a series of blogs this week and here, Professor Chris Harrison, newly appointed as Cancer NCD, looks at what he sees as his main challenges:
I am delighted to be joining the national cancer team to work with Cally Palmer, the National Cancer Director, and other team members in implementing the national strategy, “Achieving World Class Cancer Outcomes”.
We have a lot more to do if we are to achieve the objective of bringing about radical improvement in the outcomes that the NHS delivers for people affected by cancer. But it can be done and by setting out a vision for what cancer patients should expect from the health service, the strategy sets out how.
All of us working in health care have responsibility for people who have, or may have cancer. Half of all people born since 1960, the year I was born, will at some stage in their lives be diagnosed with cancer.
I was first introduced to cancer care as a medical student on the wards of hospitals in Manchester witnessing some of the huge variations in care and attitudes prevalent at that time. As a young hospital doctor I was thrown, unprepared, into discussing the possibility of cancer with patients and their relatives. Later I saw more of the wider impact on families and some of the difficulties of diagnosis as I sat with and learned from experienced and compassionate GPs in Lancashire. Cancer affected my own family and close friends with an impact going far beyond the medical aspects of treatment.
These early experiences shaped much of my later career by convincing me that we could prevent many cancers by organised efforts to support people and communities. And that we should be organising and leading cancer services more professionally so that specialist care, including palliative and supportive care, was available to all.
Much has changed since then but the twin aims of prevention and improving services remain at the core of the national programme, and is an important reason why I am so pleased to be involved.
In the 1990s, as a Director of Public Health in Lancashire, I had the privilege of overseeing plans for the new cancer centre in Preston with the associated development of the system of cancer care across the county. Later, as Regional Cancer Director in the North West, I led a peer review visiting programme to every hospital in the region, seeing for myself the opportunities to standardise and improve hospital care, and also through our primary care programme the importance of excellent primary care.
For 11 years I’ve been a trust medical director in both a specialised cancer centre – The Christie in Manchester – and then a large group of teaching hospitals – Imperial College Healthcare in West London. Both areas have moved towards ways of working between cancer services which allow whole pathways to be thought of and managed coherently rather than in isolation. I have seen at first hand the challenges and opportunities for cancer care both in highly specialised centres and also acute hospitals, but if we are to make the step change in cancer outcomes called for in the national strategy all parts of the health system must work together within the national framework.
The number of people with cancer will continue to increase and if our efforts at prevention and treatment are successful there will be more people alive with and surviving cancer in older age groups each year. This is one reason why improving the experience of cancer care is vital and given the same level of importance as improvements in survival and treatment.
At the same time the NHS faces unprecedented financial pressures and we must find new ways of organising and doing things. This means challenging existing approaches to develop effective mechanisms for commissioning and funding, and finding creative ways to work with voluntary, charitable and commercial organisations.
It also means challenging some ways of organising services, for example, finding faster more convenient ways of patients and GPs being able to access tests, using the whole range of professional skills available in the NHS, and using the lessons from the national cancer vanguard pilots.
National action alone cannot achieve these objectives but it can set the framework for local decisions and developments. I see my role as providing a focus for clinical advice into national policy and, as importantly providing support, encouragement and guidance to those seeking to improve outcomes for cancer patients and their families across the country.
Congratulations on your appointment. I do hope you make it a priority to reverse the perverse decision to remove PRRT as a treatment for patients of NET cancer sooner rather than later. There is clinical data availble (and has been since the week after it was removed from the list in 2015) indicating that the drug prolongs life. My husband was diagnosed in 2014. For 18 months the disease (which had already spread from the lungs to the liver, lymph node and spine when it was discovered) has been treated with Lanreotide which has prevented further growth – until now. The latest scan showed growth in the lungs and liver. The team at the Royal Free told him that he has lots of receptors and is an ideal candidate for this drug – if only he lived in Scotland, Northern Ireland or Wales. This is unfair.