Twelfth Report - Cancer services
Select Committee
Health and Social Care Committee
HC 551
5 April 2022
Recommendations
7 results
4
Accepted
Para 52
The Government should implement the recommendations of Professor Sir Mike Richards’ review of cancer screening...
Recommendation
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 Summary
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.
Department of Health and Social Care
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13
Accepted
Para 87
The Department of Health and Social Care and NHS England must publish a detailed analysis...
Recommendation
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 …
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Government Response Summary
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.
Department of Health and Social Care
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16
Accepted
Para 96
As part of its new cancer plan, the Government should include a plan for how...
Recommendation
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 …
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Government Response Summary
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.
Department of Health and Social Care
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21
Accepted
As part of the long-term plan for the cancer workforce, the Government and NHS England...
Recommendation
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) …
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Government Response Summary
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.
Department of Health and Social Care
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24
Accepted
Para 129
Cancer Alliances must reflect on new data provided to them by NHS England and the...
Recommendation
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 …
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Government Response Summary
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.
Department of Health and Social Care
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29
Accepted
Para 148
The Government should set out how it will build on the lessons learnt during the...
Recommendation
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 …
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Government Response Summary
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.
Department of Health and Social Care
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30
Accepted
The Government should also establish a ring-fenced fund for cancer research infrastructure targeted at NHS...
Recommendation
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 Summary
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.
Department of Health and Social Care
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Conclusions (10) Observations and findings — click to expand
1
Conclusion
Accepted
Para 43
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 of the Covid-19 pandemic on the development of Rapid Diagnostic …
Government Response Summary
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.
3
Conclusion
Accepted
Para 51
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 programmes like the Lung Health Check programme offer some reason …
Government Response Summary
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.
6
Conclusion
Accepted
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 yield and whether it will allow England to catch up …
Government Response Summary
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.
10
Conclusion
Accepted
Para 71
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 set by the Government. It is clear that there is …
Government Response Summary
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.
12
Conclusion
Accepted
Para 86
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 treatment or offer alternative treatment options. Nonetheless, we remain extremely …
Government Response Summary
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.
17
Conclusion
Accepted
Para 101
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 London. However, it is clear that there are still significant …
Government Response Summary
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.
18
Conclusion
Accepted
Para 102
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 modern radiotherapy techniques and remove perverse incentives.
Government Response Summary
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.
22
Conclusion
Accepted
Para 127
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 regions in England and that the ability of Cancer Alliances …
Government Response Summary
The government states that Cancer Alliances already lead the planning and delivery of cancer services and their improvement across their local systems.
23
Conclusion
Accepted
Para 128
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 also be Ofsted-rated by Integrated Care Boards as a sub- …
Government Response Summary
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.
28
Conclusion
Accepted
Para 147
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 hospitals, to bring greater benefits to patients.
Government Response Summary
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.