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The Cancer Control Programme in England

The Cancer Control Programme in England. Lindsay Wilkinson Head of Cancer Policy Team – Department of Health (England). Overview. The problem of cancer in England in the 1990s Developing the momentum for change Agreeing what needs to be done Making change happen Monitoring progress

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The Cancer Control Programme in England

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  1. The Cancer Control Programme in England Lindsay Wilkinson Head of Cancer Policy Team – Department of Health (England)

  2. Overview • The problem of cancer in England in the 1990s • Developing the momentum for change • Agreeing what needs to be done • Making change happen • Monitoring progress • Keeping abreast with developments in science and society

  3. The problem of cancer in England in the 1990s • High incidence/mortality • Poor survival rates compared with Western Europe (EUROCARE) • Inequalities (geographical and by socio-economic group) • Underfunding compared with Western Europe • Long waits • Fragmentation of services

  4. Developing the momentum for change • Evidence of the problems • Acceptance of the problems (winning hearts and minds) • Effective advocacy • The role of the media • Political will • Leadership

  5. Agreeing what needs to be done • Developing the NHS Caner plan relatively straightforward once the momentum for change had been built • Writing and publication took around 6 months

  6. Components of a Cancer Control Programme (1) Themes: • Prevention • Screening • Early diagnosis • Treatment • Information and support • Supportive and palliative care • Research and development

  7. Components of a Cancer Control Programme (2) Infrastructure • Service structure • Workforce • Facilities • Data systems and monitoring • Quality assurance and quality improvement processes • Funding

  8. NHS Cancer Plan: 4 Key Aims • Save lives • Improve patients’ experience of care • Reduce inequalities • Build for the future

  9. Making Change Happen (1) • Clear vision and consensus on the way forward (eg a National Cancer Plan) • Leadership at all levels • Continuing high levels of support (political, managerial, clinical & patient groups) • Clear commitments: targets and milestones • Funding arrangements

  10. Making Change Happen (2) • Delivery systems • National: cancer taskforce • Local: cancer networks • Guidance on service configuration (Improving outcomes guidance – NICE) • Quality Assurance (Standards and peer review) • Quality Improvement (Cancer Services Collaborative) • Information systems • Levers and sanctions for non-achievers

  11. Cancer Networks • Typically cover populations of 1 – 2 million • Partnership of organisations involved in commissioning and providing healthcare • Encompasses primary, secondary and tertiary care • Bring together all relevant clinicians, managers and patient representatives

  12. Monitoring Progress on Cancer in the UK • The National Audit Office (which is independent of government) conducted 3 reviews into progress on cancer in 2004/5 (links at end). • These reviews show that substantial progress has been made, but more needs to be done

  13. Cancer : Progress on Outcomes • Cancer mortality falling (14% in 7 years in people under 75) • Survival rates improving across a wide range of cancers • Experience of care has improved between 2000 and 2004 (surveys conducted by DH and NAO)

  14. Cancer : Progress on Specific Areas Prevention : Tobacco strategy Adult smoking prevalence 28%  25% Screening : Extension of breast screening 31% increase in cancers detected Waits : Progress towards targets Services : Establishment of MDTs Workforce : 1000 extra consultants More nurse specialists More radiographers being trained New ways of working Facilities : New CT and MRI scanners New Linacs Research : Accrual to clinical trials doubled

  15. Keeping abreast of developments Societal Changes • Obesity • Ageing population • Rising expectations Scientific Developments • New technologies (eg PET-CT) • New treatments

  16. Summary • Change is hard…….but possible • Cancer services in England are improving…….…but there is a long way to go

  17. Useful links Department of Health www.dh.gov.uk NHS Cancer Plan: www.dh.gov.uk/assetRoot/04/01/45/13/04014513.pdf NHS Cancer plan 3 year progress report www.dh.gov.uk/assetRoot/04/06/64/40/04066440.pdf Cancer plan and the new NHS (4th anniversary report) www.dh.gov.uk/assetRoot/04/09/25/37/04092537.pdf National Audit Office www.nao.org.uk NAO Reports (2004/2005): Tackling Cancer: Improving the Patient Journey www.nao.org.uk/publications/nao_reports/04-05/0405288.pdf NHS Cancer Plan: a Progress Report Tackling Cancer in England, Saving More Lives www.nao.org.uk/publications/nao_reports/03-04/0304364.pdf

  18. Lindsay Wilkinson Head of Cancer Policy Team – Department of Health (England) Lindsay.Wilkinson@dh.gsi.gov.uk

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