The cancer strategy is good news for people affected by breast cancer, but only if the Government commits to putting it into practice.
Yesterday (19 July 2015) was a big day for everyone in the cancer community: the Independent Cancer Taskforce published a new five-year strategy for cancer services in England.
The taskforce was set up by NHS England in January 2015 and includes health professionals and charity representatives. It’s independently chaired by Dr Harpal Kumar who some of you may recognise as the Chief Executive of Cancer Research UK.
The strategy sets out all the things that need to happen over the next five years to drive significant improvements in cancer outcomes. At the moment, more people are being diagnosed with cancer than ever before, our survival rates lag behind other countries of similar wealth and patient experience could be improved.
The taskforce has considered the whole “patient pathway” including the prevention of cancer, living with and beyond cancer and end-of-life care. A number of significant recommendations affect breast cancer, which we examine below.
Spotlight on secondary
Breast Cancer Now is determined to stop women dying from breast cancer – and this means that we need to tackle the secondary form of the disease (when cancer spreads from the breast to other parts of the body, at which point it becomes incurable).
Some 10,000 women die from breast cancer every year in England, the vast majority from secondary breast cancer, but to date the needs of this group have been seriously neglected.
Patients living with secondary breast cancer face a very different journey to those diagnosed with primary breast cancer, and have very different care and support needs.
Over the past few months we’ve brought this issue to the taskforce’s attention and are pleased that, as a result, secondary cancer features throughout the strategy. Patients with secondary cancer have been identified as a key target group and one of the seven ambitions outlined in the strategy focuses on improving long-term quality of life for people with cancer – including those who “are living with an advanced and incurable form of the disease”.
We also welcome that the strategy highlights the importance of “multi-disciplinary teams” (MDTs) in planning the care of people living with secondary cancer and ensuring it is more joined up. This will benefit people with secondary cancer who have more complex needs and who, at present, are looked after by a number of different parts of the NHS, often resulting in uncoordinated care and people left frustrated by being moved from pillar to post within the system.
Alongside this, there is an important recommendation around data collection for secondary cancer. This will be crucial in enabling us to understand more about secondary cancer and better assess the care being provided on the NHS for people living with them.
Good news all round
The strategy is good news for breast cancer patients more generally too, not just those with the secondary form of the disease. It contains some key recommendations related to the prevention of cancer, access to Clinical Nurse Specialists (CNSs) and improving care for older people.
We know that that up to four in 10 breast cancer cases could be prevented in the UK if women lead healthier lifestyles – for example, maintaining a healthy weight, reducing alcohol consumption and being physically active. We are therefore pleased that the strategy reflects our calls for a focus on the prevention of cancer and recommends a national action plan to address obesity. This could help reduce both primary breast cancer and the risk of recurrence.
It’s well known that the support of a CNS is the most important contributing factor to people’s positive experience of care. They play a crucial role in guiding patients though treatment and providing information and support. However, not everyone who should have access to a CNS does. Addressing this is one of the strategy’s top priorities with a lot of focus being put on increasing the number of CNS training positions.
Finally, the strategy has a strong and long overdue focus on older people. Like those with secondary cancer, older people often don’t receive the treatment and care they need or deserve. We’ve worked closely with the All-Party Parliamentary Group on Breast Cancer (APPGBC) on this issue in the past and called for the strategy to commit to ensuring that breast cancer treatment is based on clinical need and fitness for treatment, rather than age. We are therefore delighted to see that the taskforce has not only recommended this but has also set out an ambition to “reduce the survival deficit for older people”.
This is the key question that a lot of charities – not just Breast Cancer Now – are asking. We welcome the strategy and want to see it become a reality but, at the moment, it’s not clear if the Government and the seven bodies, such as NHS England, who would be charged with delivering it, feel the same way.
The Government aspires to lead the world in fighting cancer and has said that it wants to ensure that England ups its game on cancer outcomes. Because the NHS is a complicated beast with so many bodies responsible for delivering different aspects of care and for commissioning services, it is more important than ever that the strategy receives strong government backing.
Although it’s great that people are talking about how to achieve world-class cancer outcomes, this won’t mean anything unless patients actually notice the difference “on the ground”.
We worked hard to ensure that the strategy meets the needs of people affected by breast cancer. The first hurdle has been passed and we now stand ready to do our part to make sure that the strategy is implemented. But we expect the same from the Government. We urge it to show its strong commitment to putting this strategy into practice.
Amelia Chong is Breast Cancer Now's Policy and Public Affairs Officer