Cancer treatment on NHS should get radical overhaul to save 30,000 lives a year

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A radical overhaul of how the NHS diagnoses and treats cancer would save the lives of thousands each year, an independent task force has said, recommending a stringent new target for patients to get their test results within four weeks.

Leading cancer experts said that doctors needed to undergo “a change of mindset” and be more willing to refer patients for tests.

The new measures set out by the task force – chaired by Harpal Kumar, chief executive of Cancer Research UK – which includes a new target of 95 per cent of patients referred for cancer tests to have a definitive diagnosis or have cancer ruled out within four weeks, could by 2020 lead to 30,000 more people surviving cancer for 10 years or more, experts estimated.

The UK’s cancer survival rates, while at their highest level ever – with more than half of people diagnosed today living for more than 10 years – lag behind, with around 10,000 more cancer deaths each year than in similar European countries.

Failure to diagnose cancer before symptoms progress and become more difficult to treat has been identified as one of the key reasons for the gap, and is the main focus of the task force’s report, which has been endorsed by the NHS. Mr Kumar said the measures could lead to an 80 per cent increase in the number of cancer tests.

GPs will be given direct access to a range of tests, including, X-ray, MRI, CT scans and ultrasound, in some cases bypassing specialist referrals in order to speed up the process. In areas where GP access is poor, patients with certain symptoms will be able to bypass their GP and refer themselves via a telephone triage system.

“We need to have a shift in mindset,” said Mr Kumar. “If a patient is presenting to their GP with symptoms, it is because they are concerned about something … therefore, there is a need to think hard about whether we are doing enough testing to see what might be underlying those symptoms.

“Our rates of investigative testing in England are way below those in other countries. If we don’t address this, we’ll see a continuation of what we’re seeing now, which is around a fifth of all patients being diagnosed as a result of an emergency presentation at hospital. That’s not the best for patients and it’s absolutely not the best for the health service.”

The recommendations follow new guidance from the National Institute of Health and Care Excellence (Nice), for doctors to extend cancer tests to half a million more people each year.

The task force’s report also sets out measures to improve cancer prevention – with a target to reduce smoking rates from today’s 18 per cent to less than 13 per cent by 2020, to improve patient experience of cancer treatment, provide better support for people living long-term with cancer, and to invest heavily in cancer care staff and infrastructure.

This will include the replacement of half of the country’s ageing stock of radiotherapy machines. More than 120 machines will require replacing over the next two years, at a cost of £2m each.

Overall, the measures will cost the NHS an additional £400m a year, which will include increases in the radiology and radiography workforce. Some of this increase has already been factored into the budget increases planned up to 2020. It is hoped that by catching more cancers early, the cost of treatment will fall, creating savings for the NHS in excess of £400m.

Simon Stevens, chief executive of NHS England, said: “One in two of us will get cancer at some point in our lives, and the good news is that survival rates are their highest ever. But two-fifths of cancers are preventable, and half of patients are currently diagnosed when their cancers are advanced. That’s why the NHS will be backing this groundbreaking route map for prevention, earlier diagnosis, modern treatments and compassionate care, which the task force estimates could save 30,000 lives a year.”

The Department of Health said that it would respond in full to the report later in the year. The Health Secretary, Jeremy Hunt, said the Government’s ambition was for the NHS to become “the best in the world for cancer care”.

“Cancer is no longer the death sentence it once was. Survival rates are at a record high, but we know there is more work to do,” he said.

Currently, the NHS has a target for patients to be seen by a specialist within two weeks of referral for suspected cancer, but there is no target for when they should get their test results.

There is also a waiting-time target for 85 per cent of cancer patients to wait no longer than two months from their original GP referral to beginning their treatment – a target that has been repeatedly missed in the past year.

Andrew Gwynne, a shadow health minister, said: “Labour welcomes this report by the independent Cancer Task Force, which highlights important priorities for improving cancer care that are desperately needed.

“The last Labour government made huge progress on improving cancer care, but sadly that progress has stalled in recent years.”

Dr Maureen Baker, chair of the Royal College of General Practitioners, said GPs wanted to play their part in improving cancer diagnosis rates, but would need extra resources.

“GPs are already doing a very good job of appropriately referring our patients who we suspect of having cancer, considering the relative rarity of presentations – an average GP might see eight new cases of cancer for every 8,000 patient consultations – and the limited resources available to us,” she said.

“We have a severe shortage of family doctors and the access we currently have to diagnostic tools is completely inadequate, so we particularly welcome the drive to give GPs better access to relevant scanners – something that the Royal College of General Practitioners, has long been calling for.”