Cancer experts outline critical challenges facing the new UK Government

Leading doctors and researchers have warned critical challenges in cancer care in the UK need to be urgently addressed by policymakers.

In a review published in The Lancet Oncology, a team of UK cancer care professionals has outlined ten time-critical issues impacting the delivery of cancer care services by the NHS.  

Among the issues highlighted are ongoing failures to reduce cancer survival inequalities and treatment delays, with authors noting the UK has one of the highest rates of cancer diagnoses following emergency admissions.  

Cancer is a complex disease. But the starting point to tackling our poor survival outcomes is simple: get a plan. Professor Pat Price added Department of Surgery & Cancer

In addition, they flag that focus on “novel solutions” such as new diagnostic tests and technology will not “address the fundamental issues of cancer as a systems problem”. 

They argue that the current focus on new technological solutions to improve cancer diagnosis risks overlooking improvements to fundamental services and care pathways, which could have significant impacts on patient outcomes, survival rates, and experience. 

The paper sets out several policy recommendations which help to understand the complexity of cancer services and wider health system to drive improvements in survival, quality of life, and experience for patients, and highlights the need for a dedicated national cancer care plan. 

“Cancer services are in crisis. The tragedy is that it doesn’t have to be this way,” said Professor Pat Price, Visiting Professor of oncology at Imperial College London, and study author.  

“Too often, policymakers focus on one aspect, like diagnosis, but that alone isn’t enough,” Professor Price explained. “If you boost diagnosis but don’t treat people on time, the newly diagnosed patients just end up stuck on long waiting lists.”  

To tackle the issues, the experts put forward several policy recommendations, including: 

• Creating a task force to help tackle the entrenched social inequalities in access and outcomes of cancer. 

• Reducing the cancer backlog and waiting times using modelling and governance to identify and better use NHS capacity. 

• Reducing variations in the quality of cancer care across the NHS by expanding national audits and researching how audit outcomes can drive change.  

• Ensure cancer research strategy avoids over-focus on biopharmaceuticals, and includes other key areas, such as surgery, radiotherapy, palliative care, as well as other methodological disciplines (for example, health economics). 

Changing cancer care

The recommendations are the latest in a series of policy papers aimed at addressing shortfalls and waiting times facing cancer patients. In a 2023, the team put forward a 10-point plan to serve as a blueprint for for a Cancer Care Strategy. It aimed to address gaps left by the integration of the Government’s proposed National Cancer Control Plan into a ‘Major Conditions Strategy’ in England and Wales.  

Professor Ajay Aggarwal, from the London School of Hygiene and Tropical Medicine, said: “Current plans for delivering sustainable improvements in cancer survival fail to consider the entrenched and complex system-level issues within the cancer service, which we highlight. We need to go well beyond new equipment, drugs, and other cancer technologies to deliver solutions to the substantial societal and system pressure points. While there is excellence in many areas of cancer care in the NHS, there remains substantial variation in quality and outcomes.” 

Professor Richard Sullivan, Institute of Cancer Policy, King’s College London, said: “A new national cancer control plan will need to take a whole-system approach integrating solutions for critical areas such as workforce, service quality, and societal equity.” 

Professor Price added: “Cancer is a complex disease. But the starting point to tackling our poor survival outcomes is simple: get a plan. Reverse the decision made by the last Government to scrap the national cancer control plan. All the international evidence shows that countries with national cancer plans have better survival. And make sure the plan is properly resourced and ensures we treat on time as well as diagnose early.” 

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‘NHS cancer services and systems—ten pressure points a UK cancer control plan needs to address’ by Ajay Aggarwal, Richard Simcock, Pat Price, et al. is published in The Lancet Oncology. DOI: https://doi.org/10.1016/S1470-2045(24)00345-0

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