Cancer Strategy

Colleen Fletcher Excerpts

Thursday 22nd February 2018 Commons Chamber

[Colleen Fletcher (Coventry North East) (Lab)]

It is a pleasure to follow the hon. Member for Bosworth (David Tredinnick), who made an interesting speech. I also thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this important debate.

We all know someone who has had, or has been affected by, cancer. My family is no exception: both my parents had cancer and my husband lives with cancer every day of his life, and I could talk about cancer forever—but, Madam Deputy Speaker, I will try to limit myself to the recommended time.

The cancer strategy sets out strategic priorities and recommendations that aim to improve radically the outcomes that the NHS delivers for people affected by cancer, yet we also know that the specific needs of blood cancer patients are not being fully met by the cancer strategy. That is primarily because the experience of blood cancer patients is different from that of solid tumour cancer patients, so general cancer services are not always effective in meeting their needs.

These unmet needs occur in a number of priority areas identified in the cancer strategy, including awareness and early diagnosis, patient experience, living with and beyond cancer, access to new treatments and research, and NHS commissioning. Today, I want to focus on one particular issue: the need to improve post stem cell transplant care for blood cancer patients. This issue overlaps with a number of the aforementioned priority areas: patient experience, living with and beyond cancer, and NHS commissioning.

It is estimated that by 2020 there will be more than 16,000 people in the UK living post transplant, many of whom will be experiencing both physical and psychological side-effects from their treatment which can last for months or even years. The side-effects can include graft versus host disease, second cancers, infertility, depression, isolation and post-traumatic stress disorder.

Unfortunately, we know that there are worrying gaps in the care and support available to stem cell transplant patients after treatment. It is particularly concerning that only half of those who need psychological support actually receive it. The same is true for practical support: one in five are not offered any specialist care to help with elements of their physical recovery. These statistics are reflected in the experiences of many blood cancer patients, who feel that the level of support available to them falls away when they are sent home after their transplant. They feel that they have no one to talk to about the effects of the transplant, the challenges of late complications, the psychological burden of living with and beyond cancer and its treatment, their dietary needs, their infertility problems or practical issues such as when they can start to resume the everyday activities that they enjoyed before their treatment started.

This is happening because the commissioning of post transplant services is simply not working for every patient. After 100 days, responsibility transfers from NHS England to the clinical commissioning groups, but evidence suggests that this arbitrary cut-off can lead to fragmentation and gaps in the care and support offered to patients. To remedy this situation, there must be a review of the 100-day cut-off, as well as of the care currently provided to patients after a stem cell transplant, to ensure that all patients can access the support they need. This includes ensuring that all patients have access to appropriate emotional and psychological support services and to a clinical nurse specialist or the equivalent model of support, both of which are pledges in the cancer strategy.

This issue very much ties into what the cancer strategy says about the commissioning of cancer services being “highly fragmented”. The strategy recommended

“setting clearer expectations, by the end of 2015, for how cancer services should be commissioned”,

and as we head rapidly towards 2020, it is important that we continue to work hard to resolve the confusion that still exists. I hope that the Minister will be able to update us on how work in that area is progressing. I have outlined just a few of the priority areas where much more needs to be done to ensure that blood cancers and the needs of blood cancer patients are appropriately addressed by the cancer strategy. I believe that thorough and robust action in these and a number of other key areas will have a significant impact on outcomes for blood cancer patients, improving care on their journey from diagnosis to treatment and through to recovery.