Asked by: Baroness Merron (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to improve the collection and reporting of ethnicity data for breast cancer patients to support understanding of variations in outcomes and patient experience of NHS care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
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.
Asked by: Lord Kempsell (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they will take to ensure equity and quality in care and support across the entire cancer pathway, including (1) fairness and equity in diagnostics, (2) on time treatment, and (3) patients being offered conversations about the additional care and support they may need.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is taking steps to ensure equity and quality in care and support for patients is available across the entire cancer pathway. Reducing inequalities and variation in cancer diagnosis and treatment are a priority for the Government, as is increasing early cancer diagnosis, as this is a key contributor to reducing cancer health inequalities. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity. As part of this, we are increasing diagnostic capacity by rolling out community diagnostic centres across England, with capacity prioritised for cancer checks. Additionally, and as outlined in the 2024/25 NHS England Planning Guidance, NHS England is providing over £266 million in cancer service development funding to Cancer Alliances, to support delivery of the operational priorities for cancer.
The Department's ministers and officials frequently meet with key stakeholders within the cancer community, including discussions on support for patients and their families. The National Health Service provides personalised cancer care and support plans, to support both patients and their families at all stages of their cancer journey. This is being delivered in line with the NHS Comprehensive Model for Personalised Care, empowering people to manage their care and the impact of their cancer, and maximise the potential of digital and community-based support.
General practice surgeries also conduct cancer care reviews at regular intervals after cancer diagnosis, to offer support with any needs patients may have. This includes providing access to other specialist-led services who work alongside patients’ medical teams, to support patients and their families, such as counsellors, rehabilitation specialists, or social prescribers, who can connect you to community groups or services for more support.
NHS England and the integrated care boards are responsible for commissioning and ensuring the healthcare needs of local communities in England are met, including for cancer patients. NHS England provides access to a personal health budget, which is an amount of NHS money that is allocated to support the health and wellbeing needs of a patient, if eligible.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what progress they have made towards ensuring that people with cancer who require radiotherapy treatment can start treatment within their target of 31 days.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
We are seeing continued high levels of urgent cancer referrals, with over 12,000 urgent referrals seen for suspected cancer per working day in March 2024, compared to approximately 9,000 in March 2019. In March 2023, 89.7% of patients received a first or subsequent radiotherapy treatment within 31 days of a decision to treat, which is 0.6% higher than last year. From March 2023/24, 127,336 people received a first or subsequent radiotherapy treatment, which is 1,359 more than the previous year.
The Government continues to work with NHS England on implementing the Delivery plan for tackling the COVID-19 backlog of elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.
We are building our cancer workforce. In January 2024 there were over 35,200 full-time equivalent (FTE) staff in the cancer workforce, an increase of over 13,300, or 60.7% since January 2010. This includes over 8,100 FTE consultants in January 2024, an increase of over 3,300, or 69.6% since January 2010.
Since 2016, the Department has invested £162 million into cutting-edge radiotherapy equipment to replace or upgrade more than 100 radiotherapy treatment machines, so we can deliver the best possible outcomes for patients. From April 2022, the responsibility for investing in new radiotherapy machines sits with local systems.
Mentions:
1: Laurence Robertson (Con - Tewkesbury) The heartbreaking job of giving a terminal illness diagnosis falls to health professionals. - Speech Link
2: Angela Eagle (Lab - Wallasey) Such a diagnosis brings with it a slew a challenges and difficult decisions.As the hon. - Speech Link
3: Mims Davies (Con - Mid Sussex) by excellent key charities, such as Marie Curie, the Motor Neurone Disease Association and Macmillan Cancer - Speech Link
Mentions:
1: Andrew Rosindell (Con - Romford) diagnosed with dementia and dying than is the case with other conditions, such as heart disease and cancer - Speech Link
2: Andrew Rosindell (Con - Romford) At the moment, on average it takes over 16 weeks to get a diagnosis. - Speech Link
3: Maria Caulfield (Con - Lewes) Dementia is one of the six conditions covered by the strategy, alongside cancer, cardiovascular disease - Speech Link
4: Maria Caulfield (Con - Lewes) We know that we have work to do on improving diagnosis rates. - Speech Link
Mentions:
1: Peter Dowd (Lab - Bootle) It says:“Research has shown a link between mental illnesses and certain physical illnesses”such as cancer - Speech Link
2: Liz Twist (Lab - Blaydon) experiences reflect a number of challenges, including a lack of clinician awareness, long delays in diagnosis - Speech Link
3: Maria Caulfield (Con - Lewes) suffer with mental illness have significantly poorer health outcomes for major conditions including cancer - Speech Link
Mentions:
1: Baroness Browning (Con - Life peer) We have heard that even children and young people starting cancer treatment can wait in excess of 20 - Speech Link
2: Baroness Brinton (LD - Life peer) Why is there a three-month waiting period after diagnosis with cancer before applications can even be - Speech Link
3: Lord Addington (LD - Excepted Hereditary) Will we get better support for those who have not had that official diagnosis? - Speech Link
4: Viscount Younger of Leckie (Con - Excepted Hereditary) refreshed national autism strategy in July 2021, which aims to improve understanding in society, reduce diagnosis - Speech Link
Mentions:
1: Hannah Bardell (SNP - Livingston) Unfortunately, she also lives with a diagnosis of Fuchs’ corneal dystrophy. - Speech Link
2: John McNally (SNP - Falkirk) here and in Scotland—and in 2019, they published a calendar, from which all proceeds went to Breast Cancer - Speech Link
3: Alan Brown (SNP - Kilmarnock and Loudoun) survive.Lesley, who has sometimes worked three jobs to make ends meet, was a carer for her partner when he had cancer - Speech Link
Asked by: John McDonnell (Labour - Hayes and Harlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she has made an assessment of the potential merits of expanding the holistic care approach for cancer (a) care and (b) delivery to (i) prosthetic infection and (ii) other clinical conditions.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department has not made a formal assessment of the merits of expanding the holistic approach, used for cancer, to prosthetic infection and other clinical conditions, however the National Health Service is working towards a holistic approach in infection prevention and control, and in long-term conditions. This includes improving perioperative care for surgical clinical care pathways, including for prosthetic infections, whereby patients receive proactive, personalised support to optimise their health before surgery.
The NHS works hard to deliver care to meet people’s needs as far as possible, given this can have a significant impact on their experience and quality of life. Cancer Alliances across England are working to ensure that every person receives personalised care and support from cancer diagnosis onwards. This involves holistic need assessments to ensure people's physical, practical, emotional, and social needs are identified and addressed at the earliest opportunity. It also involves accessible information about emotional support, coping with side effects, financial advice, getting back to work, and making healthy lifestyle choices, before, during, and after treatment.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department is taking steps to assess the level of regional variation in the detection of lung cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Targeted Lung Health Checks have been implemented in the most deprived areas of England, where people are four times more likely to smoke and are therefore at higher risk of lung cancer. This has resulted in greater numbers of lung cancer being detected in these areas than previously. The programme will be converted to a Targeted Lung Cancer Screening Programme and fully rolled out in all regions by 2030.