Target waiting times are not being met, and not enough people are receiving radiotherapy treatment
The Public Accounts Committee (PAC) have today issued a damning report into the coalition’s record on cancer services. They accuse the Department of Health and NHS England of having ‘lost momentum’ on improving services, and the chair commented that although more and more people are being diagnosed with cancer, the resources available to support improvement have gone down.
In what it described as an ‘alarming’ development, the report said the NHS had failed to meet the 62-day targets for patients to start treatment for the first three quarters of the 2014. Between July and September 2014, around 5,500 patients had to wait longer than 62 days to start treatment. The PAC say that meeting the target has been challenging because the number of urgent GP referrals increased by 51 per cent between 2009/10 and 2013/14.
The report also highlighted discrepancies in access to treatment. Three-in-five cancers are diagnosed in people aged over 65, but older people are much less likely to receive treatment – for example, 70 per cent of patients aged 15 to 54 receive surgery for kidney cancer, compared to 36 per cent of patients aged 75 to 84.
The PAC say:
“It is unacceptable that NHS England does not understand the reasons why access to treatment and survival rates are considerably poorer for older people.”
There are also worrying – and unexplained – examples of clinical commissioning groups with very different levels of performance. For example in North East Lincolnshire, 98.5 per cent of patients were seen by a specialist within two weeks of an urgent GP referral, compared with only 87.1 per cent in Lincolnshire West.
There were also concerns about equipment. England currently has five radiotherapy machines for every one million people, fewer than most other high-income countries. The current stock of radiotherapy treatment machines is coming to the end of its life and will need to be replaced ‘in the near future’ The PAC find that:
“Although access to intensity modulated radiotherapy treatment, an advanced form of radiotherapy, has improved, the overall proportion of patients receiving radiotherapy has remained at around 35 per cent since 2009/10.
“This is some way below the estimated 40 per cent to 50 per cent of patients who could benefit from radiotherapy treatment at some time during their illness.”
It is clear from the report that the government’s reorganisation of the health service has contributed to some of the lack of efficiency:
“Following the reforms to the health system in 2013, the commissioning arrangements for cancer services are more complex and fragmented.
“Macmillan Cancer Support highlighted its recent research, which had found confusion among commissioners and healthcare professionals about responsibilities and accountabilities for planning and commissioning cancer services in the reformed NHS.
“In its view, there needs to be one body with oversight of the whole patient pathway.”
The PAC also say that strong national leadership has a crucial role to play in driving progress, but that this is now at risk after NHS England downgraded the position of national clinical director for cancer to only a part-time role. In addition, the National Cancer Action Team has been disbanded.
Responding to the report Andy Burnham, Labour’s shadow Health secretary, said:
“This slump in cancer standards is a scandal that needs to be stopped. The NHS as we know it can’t survive five more years of the Tories. Labour has a better plan to turn things around and improve early diagnosis of cancer.
“We will give people a new guarantee of tests and results within one week by investing in new diagnostic capacity, paid for by a levy on tobacco companies.”
Ruby Stockham is a staff writer at Left Foot Forward. Follow her on Twitter
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