Top cancer doctors call for UK-wide improvements in care

Leading cancer doctors have called for a “fundamental reset” of cancer care in the UK in a bid to improve outcomes for those with the disease.

A policy review, published in The Lancet Oncology, said survival rates “remain unacceptably poor for many cancers” at a time when care “has become increasingly complex, specialised and expensive”.

The paper outlines a 10-point plan to improve cancer care, and calls for the creation of a UK-wide national cancer control plan, along with a prevention programme for smoking, obesity and alcohol consumption.

Experts said the current crisis has “deep historic roots” and a “fundamental reset is required” to reverse the problem.

It comes after the Government revealed plans to integrate its national cancer control plan into the Major Conditions Strategy, which was launched in January 2023.

The blueprint will aim to improve health outcomes over the next five years and will cover cancer, heart disease, musculoskeletal disorders, poor mental health, dementia and respiratory diseases.

It is expected to be published early next year.

Co-author of the paper, Mark Lawler, who is a professor of digital health at Queen’s University Belfast and chairman of the International Cancer Benchmarking Partnership, said “abandoning” a national cancer plan for the Major Conditions Strategy is “an incomprehensible decision not in the best interests of people with cancer”.

Professor Richard Sullivan, joint senior author and director of the Institute of Cancer Policy at King’s College London, added: “Cancer needs to be a top political priority for the whole of the UK.

“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.”

The authors estimate there will be between 457,000 and 564,000 cancer patients each year in the UK by 2040, a 30% increase from today.

They also want to see primary care strengthened, with hospice care integrated within the NHS.

Ruth Driscoll, associate director of policy and public affairs at the end of life charity Marie Curie, called for “more and better funding” for hospices to work with the NHS to meet rising demand and “end the postcode lottery in access”.

She added: “Some people with cancer will die with the disease. We can’t shy away from that.

“The Government must ensure that all dying people have the care and support they need, including people dying from cancer and other conditions such as dementia.”

Professor Lawler also called the decision to dismantle the National Cancer Research Institute, which was announced in June, a “big mistake”.

The paper calls for it to be re-established, along with the broadening of the strategic agenda on cancer research.

Earlier this month, data published by NHS England showed there had been 257,702 urgent cancer referrals by GPs in September, down 4% on 267,555 in August but up 1% year-on-year from 254,455 in September 2022.

However, the proportion of people seeing a specialist within two weeks of an urgent referral fell from 74.8% to 74.0%, remaining below the target of 93%.

Of the cancer patients who had their first treatment in September after an urgent GP referral, 59.3% had waited less than two months, down from 62.8% in August and behind the 85% target.

Pat Price, visiting professor at Imperial College London and joint senior author, said cancer care is “fast becoming a monumental crisis” with “no realistic plan”.

She added: “A cancer plan is not just a strategy, it is a lifeline for the one in two 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.”

In August, the Government and NHS England confirmed plans to streamline cancer waiting time targets.

Officials said the new standard, implemented in October, will move away from the “outdated” two-week wait target and be replaced by the Faster Diagnosis Standard.

The 10 previous targets will be consolidated into three, with patients with suspected cancer expected to have the disease diagnosed or ruled out within 28 days.

Elsewhere, the 62-day referral to treatment will ensure patients who have been referred and diagnosed with cancer should start treatment within that timeframe, while patients with a diagnosis who have had a decision made on their first or subsequent treatment, should start it within 31 days.

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said the paper is a “welcome spotlight on what is desperately needed to ensure cancer services meet the needs of people affected by cancer now and in the long-term”.

A Department of Health and Social Care spokesperson said: “Cancer is being diagnosed at an earlier stage more often with survival rates improving across almost all types of cancer and the NHS has seen and treated record numbers of cancer patients over the last two years.

“We have opened 127 community diagnostic centres offering over five million additional tests, are training hundreds of thousands more staff through our NHS Long-Term Workforce Plan and are committed to improving cancer prevention, diagnosis and treatment through our Major Conditions Strategy.

“We have also invested £162 million to ensure every radiotherapy provider has access to modern, cutting-edge equipment, along with £50 million to expand the cancer and diagnostics workforce.”