Cancer services

Health and Social Care Committee Closed Inquiry
Opened: 6 Jul 2021 Closed: 1 Aug 2022 Parliament page
This inquiry will ask why cancer outcomes in England continue to lag behind comparable countries internationally and examine evidence relating to the underlying causes of these differences. We will also consider what impact disruption to cancer services during the covid-19 pandemic will have on efforts to catch up, and ask … Read more
15 Recommendations
15 Conclusions
1 Report
5 Oral sessions
3 Letters
5 Events
Activity timeline 15 events
13 Jun
2022
Report published
5 Apr
2022
Report published
29 Mar
2022
Correspondence
25 Jan
2022
Correspondence
20 Jan
2022
Oral evidence
20 Jan
2022
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
9 Nov
2021
Oral evidence
9 Nov
2021
Formal meeting (oral evidence session) · Room 8, Palace of Westminster
26 Oct
2021
Oral evidence
26 Oct
2021
Formal meeting (oral evidence session) · Room 5, Palace of Westminster
19 Oct
2021
Correspondence
14 Sep
2021
Oral evidence
Oral evidence sessions 5 sessions
20 Jan 2022
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Dame Cally Palmer · NHS England Judith Neptial, cancer patient Maria Caulfield · Department of Health and Social Care Mark Foulkes · Royal Berkshire NHS Foundation Trust Professor Peter Johnson · NHS England William Vineall · Department of Health and Social Care
9 Nov 2021
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Anna Jewell · Less Survivable Cancers Taskforce Ian Vousden · Kent and Medway Cancer Alliance Jane Lyons · Cancer52 Katy Hall, Expert by experience Professor David Baldwin · School of Medicine (University of Nottingham) Professor David Shackley · Greater Manchester Cancer Sarah Stevens · National Disease Registration Service, NHS Digital
26 Oct 2021
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Baroness Delyth Morgan · Breast Cancer Now David Watson · The Association of the British Pharmaceutical Industry (ABPI) Dr Philippa Hetherington, Expert by experience Professor David Cunningham · Association of Cancer Physicians Professor Mike Griffin · Royal College of Surgeons of Edinburgh Professor Nick James · Institute of Cancer Research Professor Pat Price · Action Radiotherapy
14 Sep 2021
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Andrea Brady, person with lived experience Dr Andrew Millar · North Central London Cancer Alliance Dr Jeanette Dickson · Council of the Academy of Medical Royal Colleges Dr Richard Roope · Royal College of General Practitioners Michelle Mitchell · Cancer Research UK Professor Peter Sasieni · King's College London, Clinical Trials Unit Sir Harpal Kumar · GRAIL Europe
13 Jul 2021
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Dame Cally Palmer · NHS England John Butler · International Cancer Benchmarking Partnership Prof Jon Emery · University of Melbourne Prof Peter Johnson · NHS England Prof Sir Mike Richards, Former National Cancer Director
Title HC No. Published Items Response
Twelfth Report - Cancer services HC 551 5 Apr 2022 30 Responded
Recommendations & Conclusions
30 results
1 Conclusion Accepted
Twelfth Report - Cancer services
We welcome the development of Rapid Diagnostic Centres and Community Diagnostic Centres, particularly in giving...
We welcome the development of Rapid Diagnostic Centres and Community Diagnostic Centres, particularly in giving GPs more effective referral routes for possible cancer symptoms, especially those which are non-specific but concerning. However, we have heard differing accounts about the impact … Read more
Government Response
The government states there are already 84 pathways live transforming the way that people with symptoms not specific to one cancer are diagnosed or have cancer ruled out, and have set expectations in the NHS Operational Planning Guidance for 2022/23 to extend coverage.
Department of Health and Social Care
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2 Recommendation Accepted in Part
Twelfth Report - Cancer services
NHS England has been focusing on encouraging people to come forward with cancer symptoms during...
NHS England has been focusing on encouraging people to come forward with cancer symptoms during the pandemic, which is welcome, and has recently launched a marketing campaign to encourage people to overcome their reluctance to visit their GP to discuss … Read more
Government Response
NHS England will extend coverage of non-specific symptom pathways to at least 75% population coverage by March 2023, ensuring at least 65% of urgent cancer referrals meet the Faster Diagnosis Standard and will trial new approaches to prostate cancer and expanding routes into the system across primary care community.
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3 Conclusion Accepted
Twelfth Report - Cancer services
Cancer screening is a vital tool for early diagnosis, but even before the pandemic there...
Cancer screening is a vital tool for early diagnosis, but even before the pandemic there were serious concerns about the effectiveness of national cancer screening services, particularly over IT systems and the speed at which innovations have been implemented. New … Read more
Government Response
The government describes the existing cancer screening programmes, including the introduction of primary Human Papilloma Virus (HPV) screening in cervical screening in 2019, continued work to evaluate self-sampling for HPV, expansion of the home testing programme, and progress in tackling the backlog of invitations caused by the pandemic.
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4 Recommendation Accepted
Twelfth Report - Cancer services
The Government should implement the recommendations of Professor Sir Mike Richards’ review of cancer screening...
The Government should implement the recommendations of Professor Sir Mike Richards’ review of cancer screening as a priority and ensure that there is a clear plan in place to rapidly conduct appointments missed during the pandemic.
Government Response
The government states that through NHS screening programmes they are able to reduce mortality and morbidity and there have been important changes in screening programmes in recent years.
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5 Conclusion Acknowledged
Twelfth Report - Cancer services
We understand the rationale for simplifying the Cancer Waiting Times standards.
We understand the rationale for simplifying the Cancer Waiting Times standards. It is important that NHS cancer services are given a clear set of targets to achieve and that these targets are the ones that are most important to patients. … Read more
Government Response
The government acknowledged the importance of a quick cancer diagnosis, referring to the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care and investment in Community Diagnostic Centres to increase diagnostic capacity and reduce waiting times.
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6 Conclusion Accepted
Twelfth Report - Cancer services
The Government’s recent announcement of a £2.3 billion investment in 100 new Community Diagnostic Centres...
The Government’s recent announcement of a £2.3 billion investment in 100 new Community Diagnostic Centres is welcome and could provide a significant increase in physical diagnostic capacity. However, it is not yet clear how much additional capacity this investment will … Read more
Government Response
The government announced a £2.3 billion investment to increase the volume of diagnostic activity and to roll out up to 160 community diagnostic centres (CDCs) by March 2025 and outlined workforce planning measures including expanding training places, streamlining training routes, optimising the use of existing cross-professional workforce good practices to free up capacity and improving workforce productivity through digital diagnostic investment.
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7 Recommendation Acknowledged
Twelfth Report - Cancer services
The Government and NHS England must set out detailed plans for how the £2.3 billion...
The Government and NHS England must set out detailed plans for how the £2.3 billion investment in Community Diagnostic Centres will be utilised, in particular detailing how many additional CT, MRI and PET-CT scanners and endoscopy suites the investment will … Read more
Government Response
The government acknowledges the recommendation by referencing the Delivery Plan for Tackling the COVID-19 Backlog of Elective Care and stating CDCs delivered over 880,000 diagnostic tests in 2021/22, projecting 17 million more tests over the next three years, increasing annual capacity by 9 million tests by March 2025, but does not give detail regarding additional scanners etc.
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8 Recommendation Acknowledged
Twelfth Report - Cancer services
The Government and NHS England must also develop a specific plan to address gaps in...
The Government and NHS England must also develop a specific plan to address gaps in the diagnostic workforce, setting out how it will address both short-term and long- term shortages in key professions, and particularly what investment will be required … Read more
Government Response
Health Education England invested £52 million in 2021/22 in the cancer and diagnostics workforce and the Government's forthcoming 10 Year Cancer Plan will set a new vision for cancer care, and the Department commissioned HEE to review long term strategic trends for the health workforce.
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9 Conclusion Acknowledged
Twelfth Report - Cancer services
There is huge potential in NHS cancer data, and a large amount of data from...
There is huge potential in NHS cancer data, and a large amount of data from NHS cancer services is already collected and reported. However, there is significant room for improvement, particularly in reducing the two years it takes to collect … Read more
Government Response
The government welcomes the committee's recognition of work underway to diagnose 75% of cancers by 2028, highlighting six priorities to increase early diagnosis and stating it is premature to suggest progress is off track.
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10 Conclusion Accepted
Twelfth Report - Cancer services
Notwithstanding the lag on published data, on the basis of evidence supplied by the Government...
Notwithstanding the lag on published data, on the basis of evidence supplied by the Government and the NHS, and Cancer Research UK’s analysis, we do not believe that the NHS is on track to meet the 75% early diagnosis ambition … Read more
Government Response
The Government welcomes the Committee's recognition of the work that is already under way to deliver on the ambition to diagnose 75% of cancers by 2028 and describes programmes already underway.
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11 Recommendation Acknowledged
Twelfth Report - Cancer services
The static trajectory in early diagnosis demands that the Government’s new plan for cancer services...
The static trajectory in early diagnosis demands that the Government’s new plan for cancer services must include a clear action plan for achieving the 75% early diagnosis ambition which goes beyond current plans and considers much more radical proposals to … Read more
Government Response
The government welcomes the recognition of its work to diagnose 75% of cancers by 2028 and lists existing priorities, but doesn't commit to any new or radical action to achieve the target.
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12 Conclusion Accepted
Twelfth Report - Cancer services
We recognise that the disruption to cancer services during the pandemic was primarily driven by...
We recognise that the disruption to cancer services during the pandemic was primarily driven by the need to mitigate the risk posed by Covid-19 to patients undergoing cancer treatment. We also recognise the efforts made by the NHS to maintain … Read more
Government Response
Cancer diagnosis and treatment has remained a top priority and there were over 4.9 million urgent referrals and over 600,000 people started cancer treatment between March 2020 and March 2022 and describes existing NHS Long Term Plan ambitions on early cancer diagnosis and actions local systems are required to take.
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13 Recommendation Accepted
Twelfth Report - Cancer services
The Department of Health and Social Care and NHS England must publish a detailed analysis...
The Department of Health and Social Care and NHS England must publish a detailed analysis of the extent of the cancer backlog to support the delivery of the elective care recovery plan. The Department should work with NHS England to … Read more
Government Response
The government stated cancer diagnosis and treatment has remained a top priority throughout the pandemic with substantial funding and targets being set for local systems to reduce cancer diagnosis times and to reduce the shortfall in the number of first treatments.
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14 Recommendation Acknowledged
Twelfth Report - Cancer services
Based on these estimates the Department of Health and Social Care and NHS England should...
Based on these estimates the Department of Health and Social Care and NHS England should set out: a) an estimate of what level of additional capacity in NHS cancer services will be needed to address the backlog in cancer services … Read more
Government Response
Cancer diagnosis and treatment has remained a top priority and there were over 4.9 million urgent referrals and over 600,000 people started cancer treatment between March 2020 and March 2022 and describes existing NHS Long Term Plan ambitions on early cancer diagnosis and actions local systems are required to take.
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15 Conclusion Acknowledged
Twelfth Report - Cancer services
For patients with limited treatment options the approval of a new drug or therapy can...
For patients with limited treatment options the approval of a new drug or therapy can make a significant difference even when the survival benefit is only months. Despite the effectiveness of the Medicines and Healthcare products Regulatory Agency’s regulatory process, … Read more
Government Response
The government acknowledges that the drug approval process is too slow but states that NICE is committed to publishing guidance around the time of licensing and has consistently delivered on this commitment in the majority of cases.
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16 Recommendation Accepted
Twelfth Report - Cancer services
As part of its new cancer plan, the Government should include a plan for how...
As part of its new cancer plan, the Government should include a plan for how to better align the technology appraisals carried out by NICE with the regulatory process applied by the MHRA, in order to reduce the delay between … Read more
Government Response
The government states that NICE is committed to publishing guidance around the time of licensing and has consistently delivered on this commitment in the majority of cases, with measures in place for funding ahead of NICE guidance and collaboration between MHRA, NICE, and NHSE&I.
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17 Conclusion Accepted
Twelfth Report - Cancer services
The Government and the NHS have recognised some of the issues with radiotherapy delivery in...
The Government and the NHS have recognised some of the issues with radiotherapy delivery in the NHS and have made welcome commitments to resolve these, such as investing in new radiotherapy machines and the proton beam centres in Manchester and … Read more
Government Response
The government claims to be already addressing concerns about radiotherapy services by investing in new equipment and supporting optimal machine utilisation, staff training, and technology.
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18 Conclusion Accepted
Twelfth Report - Cancer services
The Government’s new cancer plan should provide an update to the 2014 radiotherapy vision which...
The Government’s new cancer plan should provide an update to the 2014 radiotherapy vision which should include a long-term rolling investment programme for outdated radiotherapy equipment as well as changes to the national radiotherapy tariff to incentivise the delivery of … Read more
Government Response
The government stated that until the 2021 Spending Review, replacing equipment resided with NHS Trusts, but since 2016 NHS England has taken steps to ensure every NHS Trust has access to modern equipment and has invested £162m to replace or upgrade over 100 radiotherapy treatment machines.
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19 Conclusion Deferred
Twelfth Report - Cancer services
Major specialist cancer hospitals have better access to staff, expertise and technology, and patients referred...
Major specialist cancer hospitals have better access to staff, expertise and technology, and patients referred to these sites are more likely to be offered potentially life- saving surgery. During the pandemic, these hospitals were the ones most likely to be … Read more
Government Response
The government's response states the Cancer Call for Evidence has closed, and the responses are being analysed alongside wider evidence for a new vision for cancer care in their 10-Year Cancer Plan.
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20 Recommendation Deferred
Twelfth Report - Cancer services
As part of the Government’s new cancer plan, the Government and NHS England should review...
As part of the Government’s new cancer plan, the Government and NHS England should review the organisation of cancer surgery with a specific focus on whether more specialist hospitals should be established to ensure that more cancer surgery is carried … Read more
Government Response
The government deferred action, stating that the Cancer Call for Evidence is being analysed and the 10-Year Cancer Plan will address the organisation of cancer surgery.
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21 Recommendation Accepted
Twelfth Report - Cancer services
As part of the long-term plan for the cancer workforce, the Government and NHS England...
As part of the long-term plan for the cancer workforce, the Government and NHS England should develop specific proposals for improving the retention of experienced cancer staff, including targeting burnout and improving the day-to-day working conditions of staff. (Paragraph 115) … Read more
Government Response
The government states that the forthcoming 10 Year Cancer Plan, NHS People Plan and 22/23 NHS priorities address workforce wellbeing, including staff mental health hubs and a retention programme.
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22 Conclusion Accepted
Twelfth Report - Cancer services
Cancer Alliances have had a positive impact on transforming cancer services and sharing best practice,...
Cancer Alliances have had a positive impact on transforming cancer services and sharing best practice, and enjoy strong support from the sector. However, it is clear that while they are having some success, there is still significant unwarranted variation across … Read more
Government Response
The government states that Cancer Alliances already lead the planning and delivery of cancer services and their improvement across their local systems.
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23 Conclusion Accepted
Twelfth Report - Cancer services
To support Cancer Alliances to embed transformation into local cancer services, new Integrated Care Systems...
To support Cancer Alliances to embed transformation into local cancer services, new Integrated Care Systems must be required to appoint cancer leads, with responsibility for working directly with Alliances to embed best practice into their own systems. Cancer performance should … Read more
Government Response
The government states that Cancer Alliances already lead the planning and delivery of cancer services, and the ICS Design Framework has made clear that Integrated Care Boards (ICBs) will look to the Cancer Alliances to continue to undertake these roles from July 2022.
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24 Recommendation Accepted
Twelfth Report - Cancer services
Cancer Alliances must reflect on new data provided to them by NHS England and the...
Cancer Alliances must reflect on new data provided to them by NHS England and the Department of Health and Social Care about cancer outcomes by ethnicity in their areas. In particular they should review the care provided to people from … Read more
Government Response
The government states that tackling inequalities is a key focus of the NHS Long-Term Plan and 22/23 Planning Guidance, with actions in place to increase accessibility of surveys, target lung health checks, and target messaging in campaigns to minority audiences.
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25 Recommendation Acknowledged
Twelfth Report - Cancer services
The new Office for Health Improvement and Disparities should review the drivers of disparities in...
The new Office for Health Improvement and Disparities should review the drivers of disparities in cancer outcomes and develop a joint strategy with NHS England to address these disparities.
Government Response
The government states they remain committed to levelling up outcomes across the UK and are planning on publishing the Health Disparities White Paper later this year to break the link between people’s backgrounds and their prospects for a healthy life.
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26 Conclusion Deferred
Twelfth Report - Cancer services
There are specific challenges facing people with rare and less common and less survivable cancers,...
There are specific challenges facing people with rare and less common and less survivable cancers, including that they are often harder to diagnose and that issues with spreading best practice for treating less common cancers are more pronounced. Despite some … Read more
Government Response
The government is analysing responses to the Cancer Call for Evidence to develop the 10 Year Cancer Plan, which will address all cancer types, including rare and less survivable cancers.
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27 Recommendation Deferred
Twelfth Report - Cancer services
The Government must consider rare, less common and less survivable cancers specifically as part of...
The Government must consider rare, less common and less survivable cancers specifically as part of its new cancer plan. NHS England should also produce an action plan for rare, less common and less survivable cancers, containing clear commitments to address … Read more
Government Response
The government deferred action, stating that it is analysing responses to the Cancer Call for Evidence and that the 10 Year Cancer Plan will address all cancer types, including rare and less survivable cancers.
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28 Conclusion Accepted
Twelfth Report - Cancer services
The impact of Covid-19 on cancer research was significant and it is concerning that trial...
The impact of Covid-19 on cancer research was significant and it is concerning that trial recruitment has not yet reached pre-pandemic levels. However, the pandemic has provided a model for how cancer research can be conducted more efficiently, in more … Read more
Government Response
The government describes the multi-year Vision for the Future of UK Clinical Research Delivery, how it will build on the lessons learnt during the pandemic, and sets out the ambition to create a patient-centred, pro-innovation and digitally enabled clinical research environment.
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29 Recommendation Accepted
Twelfth Report - Cancer services
The Government should set out how it will build on the lessons learnt during the...
The Government should set out how it will build on the lessons learnt during the pandemic by making it easier for researchers to: a) access vital patient data; b) access staff needed for their studies, by providing more protected time … Read more
Government Response
The government outlines actions to improve data access, staff access for studies and streamlining of approval processes, referencing the Vision for the Future of UK Clinical Research Delivery, investment in Trusted Research Environments, a single front door for study approvals, and the Innovative Licensing and Access Pathway.
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30 Recommendation Accepted
Twelfth Report - Cancer services
The Government should also establish a ring-fenced fund for cancer research infrastructure targeted at NHS...
The Government should also establish a ring-fenced fund for cancer research infrastructure targeted at NHS trusts which have historically low levels of research activity. (Paragraph 149) 46 Cancer services
Government Response
The Department provides sustained investment in research expertise, specialist facilities, a research delivery workforce and support services through the NIHR Infrastructure including Experimental Cancer Medicine Centres (ECMCs) and NIHR Biomedical Research Centre at the Royal Marsden BRC.
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Government Response AI assessment · 30 of 15 classified
Accepted 17
Accepted in Part 1
Acknowledged 8
Deferred 4
Total 15 recs + 15 conclusions
Correspondence 3 letters
29 Mar 2022 Corresondence from the National Cancer Director on the Cancer services inquiry
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25 Jan 2022 To committee Letter from the National Cancer Director and National Clinical Director on Cancer services dated 17.01.22
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19 Oct 2021 To committee Letter from Jeanette Dickson providing further information requested by the Committee on Cancer services dated 28.09.21
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