John Baron is MP for Basildon and Billericay, a former Shadow Health Minister, and the Chairman of the All-Party Parliamentary Group on Cancer.
Very occasionally, Government makes decisions which can genuinely be described as ‘transformational’. However, just such a decision was announced earlier this week by the Chief Executive of NHS England, Simon Stevens, when addressing the ‘Britain Against Cancer’ conference – the UK’s largest cancer conference of its type, organised annually by the All-Party Parliamentary Group on Cancer.
Simon announced that, from April 2015, one-year cancer survival rates, broken down by Clinical Commissioning Group (CCG), will be included in the Delivery Dashboard of the NHS’ Assurance Framework – this sits at the top of the NHS accountability tree. This oversees the operation of CCGs, and holds them individually accountable against a range of operational measures. However, the one-year survival rates will be the only disease-specific outcome measure in the Delivery Dashboard, emphasising how important they are in saving lives.
Persuading the top tiers of the NHS to include survival rates in the Delivery Dashboard – which has been the APPGC’s major call this year – comes as the culmination of many years’ hard campaigning. In 2009 the APPGC published its report into cancer inequalities, which also found that those NHS cancer patients reaching the one-year survival mark stood as much chance of reaching the five-year mark as any other patient in Europe.
However, where the NHS falls down badly is in getting patients to the one-year mark in the first place. In other words, the NHS is as good as any other health system at treating cancer, but is well behind when it comes to detecting it. This is why European and international survival rates are considerably ahead of ours.
The figures show that we could save an additional 5,000 lives a year if we matched European survival rate averages. The OECD believes as many as 10,000 lives could be saved if we matched international averages. One in five cancers are first diagnosed as late as A&E. To put this into context, on average around 69 per cent of cancer patients in the UK survive one year after diagnosis – in Sweden, the figure is 82 per cent.
As a result, the APPGC, together with the wider cancer community, campaigned for the inclusion of one-year cancer survival rates into the NHS Outcomes Framework and the Clinical Commissioning Group Outcomes Indicator Set (CCG OIS). The logic is simple. As late diagnosis makes for poor survival rates, putting the one-year figures up in lights at a CCG level should encourage the local NHS to adopt initiatives promoting earlier diagnosis. These initiatives could include better screening, better awareness campaigns, further GP training or increased referral rates.
The NHS agreed to include the one-year survival rates into the NHS Outcomes Framework and CCG OIS at the beginning of 2013, with the first CCG figures coming on-stream this summer. In July, the APPGC hosted a summer reception in Parliament to mark this important milestone, addressed by the Minister for Cancer, Jane Ellison MP, and the National Clinical Director for Cancer, Sean Duffy.
However, the cancer community was understandably dismayed when, out of the blue, NHS England introduced a fresh tier of accountability above the CCG OIS, in the form of the Delivery Dashboard. This emerged earlier this year, and initial feedback to the APPGC from CCG Chief Officers was that they were paying more attention to the Dashboard than to the CCG OIS, principally because it, unlike the latter, has ‘teeth’ if performance does not meet its strictures.
My fellow APPGC Officers and I raised this issue in Parliament, both in Health Questions and during back bench and Westminster Hall debates, and followed this up with meetings with NHS officials. Consequently, Simon Steven’s announcement on Tuesday was met with spontaneous applause from the 500 delegates attending ‘Britain Against Cancer’. The decision to include survival rates should be transformational in terms of improving cancer survival, and will help many families avoid the anguish of losing a much-loved relative before their time.
I would like to take this opportunity to thank Simon Stevens and his team for listening to the assembled voices of the cancer community. I would also like to thank the Secretary of State for Health and the Shadow Secretary of State for Health for confirming their support for this initiative whilst speaking at the conference.
Now the survival rates are set for inclusion, it will become incumbent upon all of us to use the ‘tools in the toolbox’ and ensure that our CCGs are held to account by Parliamentarians, the cancer community and the general public. Provided the levers of accountability are working, something the APPGC will be monitoring, this announcement means the odds in our favour in battling cancer have markedly improved.