Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress they have made in reducing inequalities in outcomes for breast cancer patients from black and minority ethnic backgrounds over the past (1) 10 years, (2) five years, and (3) two years.

Reducing inequalities and improving breast cancer outcomes for ethnic minority women is a priority for the Government. To support this work, NHS England has commissioned six new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments, and help stimulate improvements in cancer treatments and outcomes for patients, including for breast cancer. The Royal College of Surgeons began work on this audit in October 2022, and the first outcomes are expected in September 2024.

NHS England is also leading a programme of work to tackle healthcare inequalities centred around five clear priorities, which are set out in the operational planning guidance for the health system. The Core20PLUS5 approach proactively targets groups that are less likely to engage with services in the most deprived quintile of the population, along with ethnic minority communities and inclusion health groups, across five clinical areas which includes early cancer diagnosis, specifically screening and early referral.

The issue of improving equality monitoring, by reference to ethnicity and the other eight protected characteristics, is being considered at a national level under the programme called the Unified Information Standard for Protected Characteristics (UISPC). Evaluating the use of the 2021 ethnicity census categories is part of this programme. The UISPC Publication Steering Group is reporting to NHS England and the Department this year, which will inform a view on the next steps, including any plans for publication and consultation, and an implementation timetable. Preparatory work has been undertaken by NHS England that would facilitate the introduction of the 2021 ethnicity codes, should a decision be made to adopt the 2021 ethnicity census codes, or to implement an alternative approach to ethnicity, if recommended.

NHS England’s operational planning guidance recognises the importance of improving the quality of data for patient characteristics. This is one of the five strategic priorities in their drive to reduce healthcare inequalities, as improved data quality will help to reveal health inequalities and inform action to address them. NHS England has therefore asked systems to continue to improve the collection and recording of ethnicity data across primary care, outpatients, accident and emergency, mental health, community services, and specialised commissioning.

NHS England’s National Disease Registration Service (NDRS) collects ethnicity data for all cancer patients through a variety of routine, national data feeds, including the Cancer Outcomes and Services Dataset, Hospital Episode Statistics data, and Patient Administration System data. The NDRS publishes key performance indicator data on the national registration statistics for England. The latest published indicator data, for invasive cancer cases excluding non-melanoma skin cancers, diagnosed in 2020, shows that ethnicity data is complete for 94.9% of cases.