Queen’s expert raises alarm about “major misstep” in UK cancer policy in new plan to improve care
The loss of a dedicated UK National Cancer Control Plan has been a “major misstep” at a time when the NHS is facing massive workforce shortages and cancer services have struggled to recover after the COVID-19 pandemic, warns leading cancer experts.
The Policy Review report has been published in The Lancet Oncology which will be launched today at an event in the UK Parliament.
It highlights the actions needed to tackle record cancer treatment waiting times, workforce shortages, and the lingering impact of the COVID-19 pandemic.
Professor Mark Lawler, Professor of Digital Health at Queen's University Belfast, Chair of the International Cancer Benchmarking Partnership and co-author on the research paper will be one of several leading cancer experts to address government in the House of Commons today, outlining a 10-point plan blueprint to tackle the cancer crisis.
To develop their 10-point plan, the researchers performed a series of different analyses, including an international scorecard to understand the relationship between consistency of cancer policy and improvements in five-year overall survival for seven different cancers. For six of the seven cancers, there was a correlation between dedicated cancer control policies and better survival.
Commenting on the report findings, Professor Lawler said: “Disappointingly, all UK nations were in the bottom half of this “cancer league table”, with Northern Ireland rated the lowest out of the devolved nations - a situation not helped by it having published and implemented only one cancer plan during the last 20 years.
“The current Northern Ireland Cancer Strategy remains unimplemented, 20 months after it was belatedly launched, gathering dust on a shelf as patients suffer due to lack of action.”
The diverse group of senior clinical cancer specialists who authored the report call for the development of radical, yet sustainable cancer control plans as they anticipate a need for a cancer service "fit for the future," with up to 2,000 extra cancer cases a week expected in the UK by 2040.
The authors argue the UK’s approach to cancer care contradicts “international consensus”. Citing research by the International Cancer Benchmarking Partnership, which demonstrates that the country's approach to cancer is "not working”. They caution that the lack of a cancer plan is "an incomprehensible decision not in the best interests of people with cancer." Therefore, the group of cancer experts has published their own 10-point plan as a blueprint for a new cancer strategy.
Professor Pat Price, joint senior author, leading oncologist and Visiting Professor at Imperial College London said: “We need to address the cancer workforce crisis, deliver treatments on time and stop the situation that sees us lagging behind on cancer technologies in key areas, like radiotherapy. The urgent need for a cancer specific control plan is clear, and it beggars belief that clinicians are finding themselves having to produce one instead of the Government.”
Professor Richard Sullivan, joint senior author and Director of the Institute of Cancer Policy at King’s College London said: "Cancer needs to be a top political priority for the whole of the UK. The failure to deliver specific and properly resourced cancer plans with a research agenda that is fit-for-purpose is also leading to widening patient inequalities, healthcare staff burnout and poor outcomes. All the ingredients are there to address these issues. But we need political will.”
Professor Lawler concludes: “Abandoning a dedicated National Cancer Control Plan in favour of a Major Conditions Strategy is an incomprehensible decision not in the best interests of people with cancer. Our research has shown conclusively that cancer policy consistency is associated with superior 5-year survival outcomes - getting rid of a dedicated cancer strategy will cost lives.
"Dismantling the National Cancer Research Institute is also a big mistake, particularly as we have just shown through the Lancet Oncology European Groundshot Commission that cancer research is a necessity for delivering 21st century cancer care, not a luxury."
The ten-point plan to improve cancer care includes:
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Create and properly resource a dedicated UK-wide National Cancer Control Plan through a more integrated devolved government consultation, that are patient centred; empower clinical frontline staff; and deliver equitable, affordable, data-informed, research-active cancer control.
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Re-establish a strengthened and more comprehensive National Cancer Research Institute and broaden cancer research strategic agenda and funding.
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Deliver on National Health Service (NHS) Long Term Workforce Plan with fair pay and better working environments coupled with a rethink on future cancer workforce skill sets.
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Substantially strengthen primary care and deliver on the target of 75% of cases diagnosed at stage 1 or stage 2 by 2028 through enhanced screening.
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Properly fund a UK-wide evidence-driven prevention programme particularly for tobacco control, alcohol, and obesity
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Integrate hospice care within the NHS and increase support for psychosocial and survivorship, keeping patients and those living with cancer out of hospitals.
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Address domain specific and vulnerable population solutions in national planning such as in radiotherapy, surgery, pathology, imaging, systemic therapies, and in children and young adults.
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Develop an integrated pan-UK data and digital infrastructure that delivers intelligence-driven service design, performance assessment, and quality improvement. This should be combined with cancer targets that focus on delivery of the main 62-day treatment target and reflect the totality of the system; time to diagnosis, time to treatment, quality metrics.
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Deliver a sustainable plan for equipment and infrastructure across the UK to assist the work force and help increase their productivity and ensure patients with cancer can get access to appropriate technologies and that proven innovations are equitably implemented through a value-based approach.
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Reassess governance, structure, and advice to government and NHS England for cancer. Reinstate the role of an independent National Cancer Director and office of support with authority to drive through changes and liaise between the government and the NHS to provide robust independent oversight.
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