the cancer control programme in england lindsay wilkinson head of cancer policy team – department...

The Cancer Control Programme in England

Lindsay WilkinsonHead of Cancer Policy Team – Department of Health

(England)

Overview

» The problem of cancer in England in the 1990s

» Developing the momentum for change

» Agreeing what needs to be done

» Making change happen

» Monitoring progress» Keeping abreast with developments in science and

society

The problem of cancer in England in the 1990s

» High incidence/mortality» Poor survival rates compared with Western Europe

(EUROCARE)» Inequalities (geographical and by socio-economic group)

» Underfunding compared with Western Europe

» Long waits

» Fragmentation of services

Developing the momentum for change

» Evidence of the problems

» Acceptance of the problems (winning hearts and minds)

» Effective advocacy

» The role of the media

» Political will

» Leadership

Agreeing what needs to be done

» Developing the NHS Caner plan relatively straightforward once the momentum for change had been built

» Writing and publication took around 6 months

Components of a Cancer Control Programme (1)

Themes:

» Prevention» Screening» Early diagnosis» Treatment» Information and support» Supportive and palliative care» Research and development

Components of a Cancer Control Programme (2)

Infrastructure

» Service structure» Workforce» Facilities» Data systems and monitoring» Quality assurance and quality improvement processes» Funding

NHS Cancer Plan: 4 Key Aims

1. Save lives

2. Improve patients’ experience of care

3. Reduce inequalities

4. Build for the future

Making Change Happen (1)» Clear vision and consensus on the way forward

(eg a National Cancer Plan)

» Leadership at all levels

» Continuing high levels of support (political, managerial, clinical & patient groups)

» Clear commitments: targets and milestones

» Funding arrangements

Making Change Happen (2)» Delivery systems

- National: cancer taskforce- Local: cancer networks

» Guidance on service configuration(Improving outcomes guidance – NICE)

» Quality Assurance(Standards and peer review)

» Quality Improvement (Cancer Services Collaborative)

» Information systems» Levers and sanctions for non-achievers

Cancer Networks

» Typically cover populations of 1 – 2 million

» Partnership of organisations involved in commissioning and providing healthcare

» Encompasses primary, secondary and tertiary care

» Bring together all relevant clinicians, managers and patient representatives

Monitoring Progress on Cancer in the UK

» The National Audit Office (which is independent of government) conducted 3 reviews into progress on cancer in 2004/5 (links at end).

» These reviews show that substantial progress has been made, but more needs to be done

Cancer : Progress on Outcomes

» Cancer mortality falling(14% in 7 years in people under 75)

» Survival rates improving across a wide range of cancers

» Experience of care has improved between 2000 and 2004 (surveys conducted by DH and NAO)

Cancer : Progress on Specific Areas

Prevention : Tobacco strategyAdult smoking prevalence 28% 25%

Screening : Extension of breast screening31% increase in cancers detected

Waits : Progress towards targetsServices : Establishment of MDTsWorkforce : 1000 extra consultants

More nurse specialistsMore radiographers

being trainedNew ways of working

Facilities : New CT and MRI scanners New LinacsResearch : Accrual to clinical trials doubled

Keeping abreast of developments

Societal Changes» Obesity» Ageing population» Rising expectations

Scientific Developments» New technologies (eg PET-CT)» New treatments

Summary

» Change is hard…….but possible

» Cancer services in England are improving…….…but there is a long way to go

Useful linksDepartment of Health www.dh.gov.uk

NHS Cancer Plan:www.dh.gov.uk/assetRoot/04/01/45/13/04014513.pdf

NHS Cancer plan 3 year progress reportwww.dh.gov.uk/assetRoot/04/06/64/40/04066440.pdf

Cancer plan and the new NHS (4th anniversary report)www.dh.gov.uk/assetRoot/04/09/25/37/04092537.pdf

National Audit Office www.nao.org.uk

NAO Reports (2004/2005): Tackling Cancer: Improving the Patient Journeywww.nao.org.uk/publications/nao_reports/04-05/0405288.pdfNHS Cancer Plan: a Progress Report

Tackling Cancer in England, Saving More Lives

www.nao.org.uk/publications/nao_reports/03-04/0304364.pdf

Lindsay Wilkinson

Head of Cancer Policy Team – Department of Health (England)

Lindsay.Wilkinson@dh.gsi.gov.uk