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Improving early diagnosis of cancer

In the latest of series of blogs marking 70 years of cancer care, and what the future might hold, the Programme Director of the West Midlands Cancer Alliance explains how implementing a digital pathology programme now will support the 100,000 genomes project and unlock the personalised medicines of the future.

Celebrating 70 years of NHS cancer treatment and care as part of the NHS anniversary made me think about how we are building on those real breakthroughs in cancer diagnosis, treatment and care.

In particular, I thought about how we need to challenge speed and variation in routes to cancer diagnosis and the potential offered by the 100,000 Genomes Project.

The cancer taskforce report describes earlier diagnosis as the key to improving outcomes and calls for a ‘stage shift’ in diagnosis.

Significant variation in the proportion of cancers diagnosed at either stage one or two ranges from 61%, which is the highest in the country, to 38.7%. The route which people take to get a diagnosis of cancer is often an indicator of the stage at which a cancer is diagnosed. Cancers diagnosed through an emergency presentation are often at a later stage and have worse outcomes for people. The proportion of cancers diagnosed through emergency presentation across the West Midlands region varies from 16.2% to 25.9%.

The 100,000 Genomes Project has been a driver for change within the West Midlands, bringing the 16 Trusts within the region closer together. This has meant that all our patients across the region can access this national project – that is the global leader for whole genome sequencing.

This project is playing a major part in developing our knowledge about how cancer and rare diseases, once identified, can be targeted with specific treatments resulting in ‘personalised’ approaches to treatment.

It is projects like this that open doors and lead the way for others. West Midlands Cancer Alliance has been successful in a bid for transformation funding for its Digitalisation of Pathology Project that will develop new and transformational approaches to early diagnosis of cancer.

The programme will integrate a digital pathology system into the pioneering infrastructure used by the West Midlands Genomic Medicine Centre (WM GMC) in the 100,000 Genomes Project. This will speed up the processing of diagnostic tests.

A team, made up of experts in the fields of cellular pathology, procurement and project development and implementation across the West Midlands, major hospital trusts and health commissioners, has been formed. The team will support the development of new technology and systems to allow for the assessment and reporting of cellular pathology against common datasets and protocols. Their first stage – to look for a partner(s) who can design, install and integrate the new equipment and digital network – is already underway.

A major benefit to patients will be increasing the speed at which diagnostic tests are processed and assessed, so patients receive their diagnosis more quickly.

Our multi-disciplinary teams working in cancer services in our general practices and in our hospitals will benefit from improved quality and consistency of diagnostic services due in part to closer collaborative working and easier access to expert opinions across the West Midlands. This transformation programme will be central to the Cancer Alliance’s commitment to ensure all patients are given a definitive diagnosis of cancer within 28 days of referral to an acute hospital.

For people working in providing cancer treatment and care and for those patients living with and beyond cancer, this major transformation programme managed by the Cancer Alliance will have the effect of bringing our cancer healthcare community ever closer together.

It will facilitate clinicians in working across the whole health system and will provide a regional digitalised pathology network solution and be recognised as a significant breakthrough in our approach to early diagnosis in the future.

Dr Andrea Gordon

Dr Andrea Gordon is the Programme Director for the West Midlands Cancer Alliance.

She has held the post since September 2018 following roles working with NHS trusts in the Black Country and at University Hospitals Birmingham NHS Foundation Trust. Prior to this she worked in regulation for over fifteen years, more latterly as Deputy Chief Inspector of Hospitals for the Care Quality Commission.

The West Midlands Cancer Alliance has an ambitious transformation programme that spans from early diagnosis to living with and beyond cancer. In order to make a difference; improve services, responsiveness and outcomes, the team has to work with a range of stakeholders to include patients, charities, regulators and NHS trusts and colleagues in primary care.

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