Improvements needed in NHS cancer plan
Clear inequalities in cancer outcome remain between socioeconomic groups, with higher mortality rates in deprived areas and higher survival rates in London and the South.
This is a finding of a new report by the House of Commons Committee of
Public Accounts on the progress of the NHS cancer plan (PDF 830K).
The plan, published in 2000, established 34 cancer networks in England
which involve collaborative working between strategic health authorities,
acute and primary care trusts, the voluntary sector and local authorities,
to improve
provision of cancer services to patients.
However, the new report found that relationships between constituent
organisations can be difficult and that commissioning of cancer services
is not sufficiently joined up in some network areas.
It states that a third of cancer networks have, at best, an adequate
relationship with the primary care trusts that provide their funding,
and that the creation of NHS foundation trusts brings the risk of more
limited partnership working.
The report says that 30 per cent of networks visited by the National
Audit Office did not have comprehensive plans for providing cancer services
in their area.
Increased funding for cancer services is reaching the front line and
being spent directly on funding new drugs, staffing and new services,
although staffing of some posts is proving to be difficult. The report
states that 25 per cent of lead pharmacist positions that have been created
in cancer networks remain unfilled.
The report also highlights variations in the availability of cancer drugs.
It states that unacceptably wide variations in use of National Institute
for Health and Clinical Excellence approved cancer drugs persist between
different parts of the country. For example, the use of trastuzumab (Herceptin)
for metastatic breast cancer in eligible women ranged from 90 per cent
to fewer than ten per cent.
The report recommends better monitoring of performance against cancer
plan targets, and says that cancer networks should make clear in their
delivery plans how inequalities are being addressed. It recommends that
the cancer plan is updated to take into account the NHS structural changes
since it was published.
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Hospital Pharmacist