The Health and Social Care Secretary, Sajid Javid today launched a call for evidence to underpin an ambitious 10-Year Cancer Plan for England to coincide with World Cancer Day. For Chamber’s Innovating Healthcare World Cancer Day Special, Chris Bryant MP and a panel of leaders gave their thoughts to the future of cancer care.
At lunchtime, Sajid Javid declared a “war” on cancer, launching a call for evidence to underpin a 10-Year Cancer Plan for England. Javid set out his vision to make England a world-leader in cancer care as we learn to live COVID-19 – with renewed attention paid to innovative treatment and early diagnosis to radically improve outcomes for cancer patients.
Speaking from his personal loss because of cancer, the Secretary of State explained how he lost his father to cancer highlighting that by the time he was diagnosed it was too late. Writing in the Daily Mail, said his father died of colon cancer following a late diagnosis. Speaking of the care that his father received, he said “I will be eternally grateful for the support Macmillan gave to him.”
A renewed focus on prevention
First, the Government is clear that people must be prevented from getting cancer in the first place. The Secretary of State singled out smoking where a quarter of deaths in 2019 were attributed. With six million people still smoking regularly in England, the Secretary of State outlined his ambition for England to be smoke free by 2030. Former CEO of Barnardo’s, Javid Khan will lead an independent review to identify ways to reduce smoking.
On Innovating Healthcare, the session chair and Director of Advocacy at Macmillan, Eve Byrne set the scene for the challenges ahead. The pandemic has made a huge impact on people coming forwards to seek a diagnosis or treatment for cancer. Labour MP and cancer survivor, Chris Bryant explained that with his personal experience, early detection saves lives. Citing the example of bowel cancer, men in particular present far too late.
Javid also emphasised how obesity is also a major risk factor and the Government’s aim is to halve childhood obesity by 2030. He also said that specialist alcohol consumption care teams are being rolled out across England, preventing 50,000 admissions over the next five years.
With stark disparities on cancer outcomes based on income, the Secretary of State announced that the Government will publish a White Paper next week.
Retaining and recruiting the workforce
Explaining the size of the problem, Chris Bryant told Innovating Healthcare that “we aren’t training enough pathologists this year [to replace those] that are leaving.” In a worrying trend, Scientific Committee Member of the European Cancer Patient Coalition, Professor Mark Lawler cited a survey of the European cancer workforce, which showed that three in ten workers are facing clinical depression. Representing radiologists across the UK, the President of the Royal College of Radiologists, Dr Jeanette Dickson said that to retain the workforce, “we need to make them feel more valued” and called for the system to be flexible. Highlighting the pressures across the whole workforce, she said that we need to think as much about nurses, radiographers and pharmacists as we about doctors.
How will patients face cancer in 2032?
Speaking at the Francis Crick Institute in Central London, Health and Social Care Secretary Sajid Javid said:
“Let this be the day where we declare a national war on cancer. We have published the call for evidence for a new 10 Year Cancer Plan for England, a searching new vision for how we will lead the world in cancer care.
“This Plan will show how we are learning the lessons from the pandemic and apply them to improving cancer services over the next decade.
“It will take a far-reaching look at how we want cancer care to be in 2032 – ten years from now. Looking at all stages, from prevention, to diagnosis, to treatment and vaccines.
“We want to hear views from far and wide to help us shape this work. Please join us in this effort, so fewer people face the heartache of losing a loved one to this wretched disease.”
The Secretary of State highlighted the huge strides in cancer care have been made in recent years – in the last 15 years, one-year survival has increased by more than 10% and for patients diagnosed in 2015, their survival rate was 72% after one year.
Speaking to Innovating Healthcare, commenting on the Secretary of State’s choice of language, Labour MP Chris Bryant said, “I hate this language of ‘war’ on cancer.” Calling for a change in language, Macmillan surveys have shown that patients think this choice of phrase is outdated and counterproductive. Pointedly, Professor Lawler said, “the last person to declare a war on cancer was Richard Nixon in 1971 and look what happened to him.”
However, the Covid-19 pandemic has undoubtedly had an impact. While dedicated NHS staff ensured cancer treatment was maintained at 94% of pre-pandemic levels and 95% of people starting treatment did so within a month, there were nearly 50,000 fewer cancer diagnoses across the UK during the pandemic, including 34,000 in England (March 2020 to November 2021).
The Health and Social Care Secretary today set out his determination to go further, building on the progress of the NHS Long Term Plan with a set of new and strengthened priorities, which include:
• increasing the number of people diagnosed at an early stage, where treatment can prove much more effective
• boosting the cancer workforce
• tackling disparities and inequalities, including in cancer diagnosis times and ensuring recovery from the pandemic is delivered in a fair way. For instance, the ‘Help Us Help You’ cancer awareness campaign will be directed towards people from more deprived groups and ethnic minorities; and
• intensifying research on mRNA vaccines and therapeutics for cancer – this will be achieved through the UK’s global leadership and supporting industry to develop new cancer treatments by combining expertise in cancer immunotherapy treatment and the vaccine capabilities developed throughout the pandemic
• intensifying research on new early diagnostic tools to catch cancer at an earlier stage.
• improving prevention of cancer through tackling the big known risk factors such as smoking
Commenting on the plan, Minister for Primary Care, Maria Caulfield, said:
“Half of us will have cancer at some point in our lives, and many more will have to support someone close to them who has it.
“We want to have the best cancer care in Europe and this call to evidence will help us develop a plan to achieve this. We want to hear from you – cancer patients, relatives and NHS staff – to see how we can best move forward to deliver better care and treatment.”
Improving community diagnostics
A key part of the strategy will be building on the latest scientific advances and partnering with the country’s technology pioneers. The NHS-Galleri trial is evaluating a new test that looks for distinct markers in blood to identify cancer risk and has already shown how technology can transform the way cancer is detected. The test is being trialled across England, with thousands of people already recruited.
The Government wants similar technologies to help form new partnerships and give the NHS early, cost effective access to new diagnostics. Artificial intelligence and machine learning technologies, for example, have the potential to help the health service radically improve its assessment of cancer risk.
The Government is spending billions to tackle the COVID-19 backlog, diagnostics and technology over the next three years to provide earlier diagnosis and treatment. It is also aiming to build a world class cancer workforce to help the NHS’ recovery by developing new roles along with training and upskilling the current workforce.
Chief Executive of the Royal Marsden and National Cancer Director for the NHS, Dame Cally Palmer said:
“The NHS is committed to saving more lives from cancer by finding more cases at an earlier stage when they are easier to treat in line with our ambitions set out in the NHS Long Term Plan – it is this action that will ultimately help us to save thousands of lives sadly lost to cancer every year.
“Despite the pandemic and thanks to the huge efforts of our staff, cancer services have remained a priority with well over two million checks in the last year alone and tens of thousands of people starting lifesaving treatment every month.
“From one stop shops for vital checks and revolutionary treatment options like proton beam therapy – we will continue to go further and faster in our mission to save more lives and ensure England is world leading in cancer care.”
The Government has also invested £2.3 billion to roll out Community Diagnostic Centres, which offer patients rapid access to clinical tests and lifesaving checks close to their home. In their first full year of operation, they will deliver up to 2.8 million scans. By 2025, the NHS will be able to carry out 4.5 million additional scans. This will also help reduce waiting times by diverting patients away from hospitals, allowing them to treat urgent patients, while the Community Diagnostic Centres focus on tackling the COVID-19 backlog.
Last year, the government offered free lung health checks at 23 locations across the country – with a further 20 new centres confirmed for 2022/23. The Faster Diagnosis Standard – 28 days from GP referral to diagnosis or all-clear – has also been implemented within NHS Trusts.
The impact of the pandemic
During the COVID-19 pandemic, the Government focused on recovering services that had been hit hardest. This included the rollout of nearly 160 Faster Diagnosis Pathways (previously known as Rapid Diagnostic Centres), which aim to speed up diagnosis for cancer without the need for repeat diagnostic checks and ensure patients with worrying symptoms can be quickly assessed by a GP. By 2024, the programme will be available across England for patients who display symptoms that could indicate cancer but don’t align to specific cancers, such as unexplained weight loss, fatigue, or vague abdominal pain.
Improving clinical trials
On clinical trials, people from a range of backgrounds must be enrolled to better discover cures and treatments for cancer. Evidence shows that some communities are underrepresented. The targeted lung health checks programme is a good example of success – taking mobile trucks into the heart of diverse communities. The Secretary of State was quick to champion that within this programme, 80% of lung cancers are being diagnosed compared with 30% before.
The Secretary of State wants to look at how more targeted measures can be rolled out to “level-up on cancer care.”
Programme Director at DATA-CAN and Cancer Data Network Lead at IQVIA, Yoshiko Cook told Innovating Healthcare that real world data has a beneficial role to play, stressing that “we need to take the latest data to inform decision making.”
Trials are incredibly important to getting innovative treatments and therapies to patients. The UK has had a faster uptake during the pandemic and there were several barriers that were overcome.
As a sector there are some very big challenges, but DATA-CAN is a great example where different organisations can come together to work out how we can build solutions. She emphasized that “the patient voice is incredibly important.”
Backing the benefits that trials can bring to patient care, Dr Dickson said “Trials provide a great route for people to get access to new treatments. If you expand trials, you improve access and patient care.”
Recognising that the level of collaboration across different sectors has increased over the period of Covid-19, Director of Oncology at MSD in the UK, David Long pointed out there is work that industry can do to share best practice. Applauding the role of The National Institute for Health and Clinical Excellence (NICE), he said the speed of their work during the pandemic was exemplary.
To get involved
Today’s new call for evidence is seeking input from cancer patients, relatives and NHS staff to gain the deepest understanding of the issue possible and provide the best future for the country’s cancer care. The easiest way to participate is by visiting gov.uk/dhsc.
The call for evidence will run for 8 weeks, after which the government will factor in responses into its new 10-Year Cancer Plan which is expected to be set out in summer.