The Cancer Reform Strategy
The Cancer Reform Strategy will:
- Build on progress made on cancer in England since the publication of the NHS Cancer Plan
- Take account of the new challenges and opportunities in cancer, including the predicted rise in incidence (up 30% by 2020) and the likely availability of new technologies
- Focus on choice, quality and equality (including gender, race and sexuality) for cancer patients and value for money in cancer services
- Focus on reform – to release resources from areas where they are not delivering benefit and redirect to areas where need is greatest
- Consider where care can be shifted from hospitals to community and inpatient to walk-in care
- Consider how to maximise the opportunities for prevention and early diagnosis
- Make recommendations on how the new levers in the health reform agenda can be used to drive up quality and value for money
- The Cancer Reform Strategy will build on progress made through the implementation of the NHS Cancer Plan and NICE guidance. It will set the direction of travel for cancer service delivery in England for the next 5-10 years.
Key aims of the Cancer Reform Strategy are to:
- Promote choice, quality, equity and value for money
- Put greater emphasis on prevention and early detection
- Shift work from hospital to community
- Use the new levers of the healthcare reform agenda to drive change. These include stronger commissioning, plurality of providers, tariffs, standards and regulation
The Breast Cancer Working Group is being established to make recommendations to the Cancer Reform Strategy Advisory Board. It is anticipated that a final report will be prepared for the Advisory Board’s meeting in June 2007.
Key questions to be considered include:
- Epidemiology: How is the overall number of new cases of breast cancer likely to have changed by 2012, taking account of current trends, potential impact of screening and usage of HRT etc.
- Prevention: Will there have been any significant developments in chemo prevention by 2012?
- Screening: What age range? What interval? What technology?
- Public awareness: What change in knowledge about symptoms, impact of age on risk etc.
- Genetic risk: How might services best be developed for healthy people who are worried about their risk of developing cancer? What services should be available for people found to be at moderate/high risk?
- Initial assessment of symptomatic patients: Will/should patients still be presenting initially to their GP? Is there a role for initial assessment (e.g. by nurse practitioners) in large community health centres (polyclinics)? If so for which groups of patients?
- Diagnosis and staging: What will have changed?
- Treatment: What will have changed regarding surgery, radiotherapy, chemotherapy, novel therapies? What will the impact be on hospital bed utilisation?
- Follow up: How should this be delivered?
- Survivorship: what should we be doing to help patients get back to as normal a life as possible after cancer?
- Information and support: Where should we be? How can we improve service provision?
- Clinical outcomes data: How can we make collection of high quality data on all breast cancer patients by clinical teams a reality?
- Service delivery models: What services should be provided at different levels e.g. home, GP surgery, large community health facility, DGH, major centre.
The Group is chaired by Jeremy Hughes, Chief Executive of Breakthrough Breast Cancer. Group members include our own Erika Denton, Mike Michell and Dorothy Goddard