Is it time to reform England’s “Inadequate” cancer services?

By Grace Duffy, a medical negligence expert at Irwin Mitchell

The Health and Social Care Committee’s Report, prepared by a politically impartial panel of experts, assessed five of the Government’s commitments regarding the NHS’ cancer service. The Report focused on four broad policy areas:

1. Workforce
2. Diagnostics
3. Living well with and beyond cancer; and
4. Innovation and technology

The expert panel ranked each policy area after considering whether the Government’s commitment was:

1. Met overall, or on track to be met
2. Effectively funded or resourced
3. Achieving a positive impact for service users
4. Appropriate

The expert panel’s overall rating was “Inadequate”, so what is preventing effective and efficient cancer service and is it in need of reform?

The panel’s findings

While the Government’s workforce growth target of 4,126 was exceeded by 226, cancer services remain inadequately staffed and under considerable pressure. The panel noted a lack of funding, staff shortages and an over-reliance on charity funded roles, resulting in unstable and fragmented care.

There was encouraging evidence regarding investment and funding of diagnostic equipment. However, the Government’s target of 75 per cent of patients being diagnosed within 28 days of a GP referral or after screening was not met. Furthermore, there remains a lack of trained staff to run the diagnostic machines, interpret screening results and deliver innovative treatments.

With regards to patients living with and beyond cancer, the latest National Cancer Patient Experience Survey (2019) highlighted that 50 per cent of patients had not received a care plan, and 20 per cent did not know, or could not remember, their care plan. 

The expert panel was concerned by the lack of criteria or benchmarks for personalised care packages and, once more, there was an over-reliance on the charity sector to provide this service.

In respect of innovation and technology, there was a ‘postcode lottery’ in terms of who could readily access innovative treatments. In addition to this, there was a decline in recruitment to clinical trials due to discrimination, mistrust, and perceived harm. Even where innovative treatment was available, there was a lack of investment in the workforce administering such treatment.

The expert panel noted an overarching theme of inequality across many dimensions including (but not limited to) ethnicity, sexual orientation, social class, and geography. There was a clear link between areas of deprivation, inadequate cancer services and poor outcomes for patients. 

The panel argued that workforce shortages played a major role, given the difficulty in recruiting and retaining staff in deprived areas. The expert panel accepted that tackling this issue goes well beyond the NHS, but explained that there needs to be greater education regarding red flag symptoms and access to care in deprived areas and within minority communities.

Conclusion

Ultimately, equal access and experience of cancer services hinges on the availability and capacity of trained staff. A properly resourced workforce is needed to provide personalised and timely care. 

Furthermore, greater accessibility and education is needed in deprived areas, with equal focus on all areas of cancer, including the rarer types. There is no doubt that the Covid-19 pandemic weakened the NHS, but these findings clarify that our cancer services were facing significant challenges before March 2020 and demand Government reform. 

Find out more about Irwin Mitchell's expertise in supporting patients and families affected by cancer care delays at our dedicated cancer claims section.

There was a clear link between areas of deprivation, inadequate cancer services and poor outcomes for patients. The panel argued that workforce shortages played a major role, given the difficulty in recruiting and retaining staff in deprived areas”