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15 November 2023

Leading cancer doctors raise the alarm about “serious missteps” on cancer policy

The loss of a dedicated National Cancer Control Plan in England and Wales 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, caution leading cancer experts in a Policy Review published in The Lancet Oncology.

A patient lies in a hospital bed, their head is out of frame

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 by 2040.

The authors draw attention to the UK’s poor performance compared to other countries, stating that our approach to cancer care contradicts “international consensus”.

Leading oncologist authors 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.

Cancer needs to be a top political priority for the whole of the UK. The awful statistic that 1 in 2 of us will develop cancer should be justification enough. We need care that is clinically led and truly personalised. 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 Richard Sullivan, joint senior author and Director of the Institute of Cancer Policy

The ten-point plan to improve cancer care includes:

  1. 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.
  2. Re-establish a strengthened and more comprehensive National Cancer Research Institute and broaden cancer research strategic agenda and funding.
  3. 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.
  4. 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.
  5. Properly fund a UK-wide evidence-driven prevention programme particularly for tobacco control, alcohol, and obesity
  6. Integrate hospice care within the NHS and increase support for psychosocial and survivorship, keeping patients and those living with cancer out of hospitals.
  7. 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.
  8. 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.
  9. 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.
  10. 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.

Professor Pat Price, joint senior author, leading oncologist and Visiting Professor Imperial College London said: “The dangerous reality is that cancer care in this country is fast becoming a monumental crisis and there appears to be no realistic plan. Today we face record cancer treatment waiting times with an expected increase of 2,000 extra cancer patients a week by 2040. A cancer plan is not just a strategy, it is a lifeline for the 1 in 2 of us that will get cancer. Cancer patients are consistently being failed, with UK cancer survival outcomes remaining near the bottom of cancer league tables. 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 Mark Lawler, Professor of Digital Health at Queen's University Belfast, chair of the International Cancer Benchmarking Partnership and co-author on the paper said: "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 (published in Lancet Oncology) 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 report will be launched at an event in Parliament on 15 November 2023 and outlines a blueprint to tackle the cancer crisis. It highlights the action needed to tackle record cancer treatment waiting times, workforce shortages, and the lingering impact of the COVID-19 pandemic.

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Director, Institute of Cancer Policy and Co-Director of the Centre for Conflict & Health Research