Early diagnosis key to UK cancer ambition
pharmafile | February 8, 2011 | Feature | | Cancer, NHS, NICE
A series of quality standards on cancer care is to be drawn up by NICE as part of a new strategy to improve England’s cancer survival rates.
The government’s ‘Improving Outcomes – A Strategy for Cancer’ aims to save 5,000 lives a year by 2014/15 by improving the quality and efficiency of cancer services, and moving towards achieving outcomes to equal the best in Europe.
The strategy published in January carries with it more than £750 million of funding over four years, and includes recommendations on diagnosing cancer earlier, helping people to live healthier lives to reduce preventable cancers, introducing new screening programmes, and making sure that all patients have access to the best possible treatment, care and support.
At the core of the strategy is a greater emphasis on getting GPs to diagnose cancers, rather than referring suspected cases to consultants. Expensive new diagnostic procedures will be needed in primary care, and £450m has been set aside for chest X-rays, ultrasounds and MRI brain scans over the next four years.
Meanwhile, NICE quality standards will provide specific, concise statements to define and promote high quality clinically and cost-effective patient care. They aim to help healthcare practitioners and commissioners of care deliver excellence in services.
Quality standards will be developed for colorectal, lung, ovarian and prostate cancer – common cancers which could see survival rates improve. The government says good early progress has been made on key topics such as patient experience, end of life care and breast cancer. The breast cancer quality standard is expected in August this year.
The quality standards will be used to support the production of more detailed commissioning guidance, to which GP consortia must have regard when contracting for services.
NICE has also been asked to assess the suitability of developing a quality standard on chemotherapy. The need for further quality standards to support the development of cancer services is also being considered.
In the meantime, commissioners and providers can continue to draw on the clinical guidelines and Improving Outcomes guidance that NICE has already developed for cancer services. NICE guidance on the prevention of skin cancer will be published later this month, and local NHS bodies are being urged to implement it in tandem with national campaigns.
New surgery techniques
The strategy calls for the promotion of the latest surgical techniques to help cancer patients.
The government says variation in access to high quality surgery has held back progress.
In 2006, NICE recommended that laparoscopic colorectal resection should be offered to all suitable patients, but a shortage of trained surgeons meant the recommendation was waived by the government.
A national training programme (LAPCO) was established to accelerate adoption of this technique to help meet the shortfall, and now LAPCO has over 150 consultants on the programme, and as a result the waiver on the NICE technology appraisal has been lifted.
Professor Sir Mike Richards, England’s clinical director for cancer, said: “We know the main reason our survival rates lag behind other countries is because too many people are diagnosed late. This is why our strategy focuses on earlier diagnosis which we will achieve through raising the public’s awareness of the signs and symptoms of cancer and also providing better access to diagnostic tests.
“But improving outcomes for people with cancer isn’t just about improving survival rates. It is also about improving patients’ experience of care and the quality of life for cancer survivors, and our strategy also sets out how that will be tackled.”
Harpal Kumar, chief executive of Cancer Research UK, said: “Diagnosing cancer earlier will be the key driver in achieving these aims, and the additional investment made available for this is critical. The government now needs to ensure that this new investment flows through and is quickly taken up by frontline services.”
Andrew McConaghie
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