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The NHS must continue to change to give cancer patients best chance says cancer tsar

DEPARTMENT OF HEALTH News Release (2007/0112) issued by The Government News Network on 14 May 2007

Report looking at the clinical case for change in cancer services published by National Cancer Director

The NHS must continue to change if it is to deliver better cancer care to patients says the National Cancer Director for England Professor Mike Richards.

The report by Mike Richards, Getting it right for people with cancer: the clinical case for change, highlights the many clear successes achieved in treating cancer with:

mortality rates in the under 75s falling by nearly 16 per cent;
a 49 per cent increase in cancer specialists;
£520m invested in new and replacement specialist equipment; and
triple the number of cancer patients entering clinical trials in recent years.

However, to meet greater future demand we need to push ahead with reforming the way cancer services are provided on the NHS. This should be through:

better coordination of patient care by ensuring a specialist team coordinates a patient's care so that they get the best treatment and support - putting the needs of patients ahead of the convenience of the NHS;

centralisation of complex services so staff develop expertise and experience to get the best results for patients;

moving simpler tests and treatments closer to patients so people are not forced to travel large distances if it is not necessary;

using staff more flexibly - focusing on skills not job titles, so doctors do what only they can do using hospital beds better - ensuring support is available so that people are not admitted to hospital when they don't need to be, and that they can come home from hospital when they no longer need to be there - resulting savings could be reinvested in others areas of cancer care.

Professor Mike Richards says:

"Cancer care has improved greatly since I first qualified in the 1970s. Re-organisation of services over recent years has played a key part in this and will continue to do so as the changes we are making are completed. It is important that we press on with these as cancer will become ever more common as more people live longer.

"My report shows that some treatment and care needs to be concentrated in specialist centres so that clinicians with the right skills, experience and equipment are available to treat patients with complex needs safely. This is what I would want for myself if I were a patient. I want people to understand that not all health services can be provided locally and that to truly receive expert care they may need to travel a bit further but should be reassured that the benefits they reap will be worth it.

"At the same time, medical technology is also making it possible to treat many patients closer to home, for example, simple chemotherapy is now given in district hospitals rather than specialist centres, and this is being taken one step further with some patients receiving simple chemotherapy from nurses in outreach clinics - meaning sick people don't have to travel for simple routine treatment."

Notes for Editors:

1. The report 'Getting it right for people with cancer: The clinical case for change' by Professor Mike Richards is available on the DH website http://www.dh.gov.uk

2. Improvements seen in cancer services:

Cancer mortality in those under 75 has fallen by nearly 16% in the last seven years.

For most cancers, survival has been improving steadily over the last 30 years. For example:

80% of women diagnosed with breast cancer today will now survive for at least five years compared to 50% in the 1970s.

50% of patients with colon (bowel) cancer today will survive for at least five years compared to 26% in the 1970s.

Improvements in survival are due to several factors such as screening, earlier diagnosis and better treatment but more needs to be done.

Better waiting times

Over 99% of people with suspected cancer are now seen by a specialist within two weeks of being urgently referred by their GP.

Over 99% of patients with cancer are receiving their first treatment within one month of diagnosis.

Over 96% of patients with cancer are receiving their first treatment within two months of being urgently referred by their GP.

More staff

Since 1997 there has been a 49% increase in the number of cancer specialists.

More equipment

Some £520 million of central funding has been invested in new and replacement equipment for the NHS since April 2000, for example:

158 new MRI scanners
231 CT scanners
144 Linear Accelerators (machines that give radiotherapy)
over 730 items of breast screening equipment.

This means that 82% of MRI scanners, 81% of CT scanners and 76% of linear accelerators now in use in the NHS are new since January 2000.

More opportunities to join clinical trials

In 2005/06 over 28,600 cancer patients in England entered clinical trials.
The number of cancer patients entering clinical trials in England has more than tripled in the last five years - this is the highest national per capita rate of cancer trial participation in the world.

3. Cancer in Numbers

There were over 233,600 new cases of cancer in England in 2004.
The four most common cancers - breast, lung, colorectal and prostate - accounted for just over half of these new cases of cancer (excluding non-melanoma skin cancer).

Breast cancer accounted for 32% of cancer cases among women.

Prostate cancer accounted for 25% of cancer cases among men.

Cancer is predominantly a disease of the elderly - only 0.5% of cases registered in 2004 were in children (aged under 15) and only 26% were in people aged under 60.

It is estimated that there will be a 16% increase in new cancer cases over the next 10 years - resulting in over 283,000 new cases of cancer per annum in England by 2016.

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