Very occasionally, Government makes decisions which can genuinely be described as ‘transformational’. However, just such a decision was announced in December by the Chief Executive of NHS England, Simon Stevens, when addressing the ‘Britain Against Cancer’ conference – the UK’s largest cancer conference of its type, organised annually by the All-Party Parliamentary Group on Cancer (APPGC).
Simon Stevens announced that, from April, one-year cancer survival rates, broken down by Clinical Commissioning Group (CCG), will be included in the Delivery Dashboard of the NHS’ Assurance Framework – this sits at the top of the NHS accountability tree. This oversees the operation of CCGs, and holds them individually accountable against a range of operational measures. However, the one-year survival rates will be the only disease-specific outcome measure in the Delivery Dashboard, emphasising how important they are in saving lives.
Persuading the top tiers of the NHS to include survival rates in the Delivery Dashboard comes as the culmination of many years’ hard campaigning. In 2009 the APPGC published its report into cancer inequalities, which also found that those NHS cancer patients reaching the one-year survival mark stood as much chance of reaching the five-year mark as any other patient in Europe.
However, where the NHS falls down badly is in getting patients to the one-year mark in the first place. In other words, the NHS is as good as any other health system at treating cancer, but is well behind when it comes to detecting it. This is why European and international survival rates are considerably ahead of ours.
The figures show that we could save an additional 5,000 lives a year if we matched European survival rate averages. The OECD believes as many as 10,000 lives could be saved if we matched international averages. One in five cancers are first diagnosed as late as A&E. To put this into context, on average around 69% of cancer patients in the UK survive one year after diagnosis – in Sweden, the figure is 81%.
Now the survival rates are set for inclusion, the challenge will be to ensure CCGs are indeed held to account. Underperforming CCGs will have to be compelled to work harder in promoting early diagnosis through whichever initiatives they deem most suitable for their populations – these could include better screening programmes, further cancer awareness campaigns, improved access to diagnostic tools at Primary Care, and so on.
In the debate, whilst congratulating the Minister for playing her role in persuading NHS England to include the survival rates, I will be asking what steps the Government will be taking to ensure NHS England pursues underperforming CCGs – which includes those ‘coasting’ along on middle figures.
Provided the levers of accountability are working, something Government, the APPGC and the ‘cancer community’ will be monitoring, the inclusion of one-year survival rates means the odds in our favour in battling cancer have markedly improved.