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04
Apr

Winter pressures compromise cancer patients


According to a survey by the Health Service Journal (HSJ) 530 cancer operations were cancelled by hospital Trusts in England between December and February 2018. 

 

The HSJ polled 81 acute Trusts and reports that 43 Trusts admitted having to cancel at least one operation. Extreme winter pressures causing high demand on services, leading to shortage of beds and other capacity, including intensive care, are cited as the main reasons for these cancellations. 

 

Earlier this year hospitals were advised to cancel routine appointments and non-urgent operations to help ease winter pressures, but time-critical procedures and cancer operations should go ahead as scheduled. However, one of England’s largest Trusts, Leeds Teaching Hospitals, said it had “no option” but to reschedule some cancer operations. Chief Medical Officer, Yverte Oade, said the 109 operations cancelled by the Trust amount to just over 1% of the operations it would have expected to carry out during the three-month period. 

 

Bed-blocking was given as a significant factor for cancellations at University Hospitals of Leicester as bed occupancy at its three sites was so high as to prevent patients ‘stepping down’ from the intensive care unit.

 

Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support described the situation as “unacceptable.” She added: “Ultimately it is down to the government, not hard-pushed NHS Trusts, to ensure there is sufficient funding and enough staff to provide prompt treatment.”

 

These results are published just days after Prime Minister Theresa May confirmed the need for a long-term plan for funding the NHS. She told a Liaison Committee meeting that: “The Government will provide a multi-year funding settlement in support of the plan, consistent with our fiscal rules and balanced approach, but ensuring that the NHS can cope with the rising demand ahead of the spending review.”

 

As a measure of the increased demand for cancer treatment, a spokesperson from NHS England is quoted in reports as saying NHS hospitals treated 2,615 more cancer patients this January than last – an increase of 5.7%.

 

 

One-stop-shops

 

Yesterday, (April 3), NHS England confirmed it was to roll out ‘one-stop-shops’ designed to speed up cancer diagnosis across the country. 

 

Rapid diagnostic and assessment centres are being piloted in ten areas as part of a drive to catch cancer early and help save lives. GPs or other healthcare professionals will be able to refer patients with vague, non-specific symptoms, such as unexplained weight loss, appetite loss or abdominal pain to one of the new centres where all the tests can be carried out under one roof. Under the present system it is not uncommon for patients to be referred multiple times to different centres for various tests before a diagnosis is possible.

 

NHS England says that some patients will receive a definitive diagnosis or an all-clear on the same day, whilst others will need to undergo further assessment but can generally expect a diagnosis within two weeks of their first appointment.

 

These initial ten centres are located at:

North Middlesex University Hospital

University College London Hospital

Southend University Hospital

Queens Hospital

Royal Free Hospital

St James University Hospital

Airedale General Hospital

University Hospital South Manchester

Royal Oldham Hospital

Churchill Hospital

 

Overall cancer survival rates across the UK are improving, although there is significant variation between different cancer types. Cancer Research UK reports that cancer survival in the UK has doubled in the last 40 years. However, the UK still lags behind other countries. 

 

Earlier this year the CONCORD-3 report compared the outcomes for cancer patients from 73 different countries between 2000 and 2014. (CONCORD is an international scientific collaboration led by the London School of Hygiene & Tropical Medicine). Out of 27 EU countries, the UK rates as follows:

Lung cancer – 21st  

Colon cancer – 17th

Cancer of the rectum – 12th

Prostate cancer – 16th

Breast cancer – 14th

Blood cancer – 14th

Pancreatic cancer – 20th

Brain cancer – 21st

Stomach cancer – 27th

 

Improving cancer treatment and survival rates was listed as a priority in the Five Year Forward View. The ‘Next Steps’ report, published this time last year, reiterated the commitment to improving cancer care with a focus on early diagnosis, new screening tests, faster access to tests, results and treatment together with a major radiotherapy upgrade programme.

 

 

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