The Cancer Reform Strategy
3 August 2010
The Cancer Reform Strategy which has been in place since 2007 is being reviewed as a part of the White Paper “ Liberating the NHS ” produced very recently by the Coalition government. The review is being led by the Cancer Czar, Sir Mike Richards and he is due to report back to the government in about 6 months. This review is important because it is set against a backdrop of economic austerity and will set the direction for the next 5 years.I represented the James Whale Fund at the meeting of the Cancer Campaigning Group who bring together all the cancer charities to influence policy in the NHS. At that meeting Sir Mike Richards presented an outline of the review and highlighted the key questions facing the Coalition government about cancer care. The flavour of the presentation was one of genuine consultation –some of us may be sceptical at this point – and the bottom line was he was asking for our views and opinions before a word of the review was written. The link for your opportunity to state your views is
crsreview2010@dh.gsi.gov.uk
I will outline his main themes :
- The new mantra is “ no decision about me, without me ” which runs through the whole discussion. This implies informed patients aware of their options and able to shape their own treatment plan.
- The new focus in cancer care is on outcomes which means improved survival rates, improved patient experience and improved quality. This is very broad brush stuff but does indicate an opportunity for JWF to focus on the benefits to patients of better drug availability.
- The Cancer Drug Fund is planned to be £ 50 million in this financial year and £ 200 million in 2011/2 . Sir Mike indicated how the fund may operate but this is far from certain. He said that the consultant would be able to recommend drugs not approved by NICE if in his opinion they were clinically suitable . The funding for this recommendation would come from the new Cancer Drug Fund but it was still unclear as to the decision process. I asked about Priorities Forums and the PCT role in this process and was re-assured by Sir Mike that it would not be another bureaucratic paper chase whilst patients waited and suffered. However I did not get an answer and I remain sceptical about the mechanisms.
- The theme of “ value –based pricing ” for drug pricing policy is the new phrase. Clive Stone and I heard this phrase from David Cameron nearly 2 years ago. It will be a revolution in the current NHS buying policy if drug companies are paid on outcomes rather than the drug costs. I suggest this is along term strategy and we need to monitor developments.
- The strategy of GP led commissioning was discussed with some concern raised about the abilities of GP’s to manage cancer pathways in particular and to be accountants as well as doctors. Sir Mike talked about GP consortia and the existing PCT’s transitioning to the new structure over time. This is very definitely work in progress.
- The NHS is looking for £20 million per annum of efficiency savings and Sir Mike is looking for ideas on both saving money based on evidence of best practice. He emphasised the importance of new technology such as laparascopic surgery to reduce time in hospital and the vital importance of early diagnosis. He was clear that we should be realistic and to look for money saving as well as new investment though new investment could be the way to save money.
The lessons for the JWF are quite clear:
- The new drug availability process and new policies are attractive but not clearly developed. We should aim to find out precisely how the Cancer Drug Fund will be administered and who will decide on what criteria.
- The survival rates for Kidney Cancer are poor and this is our lever to press our case at government level for Kidney Cancer drugs and treatments to be given high priority. I will be attending the NICE technology appraisal for the next anti kidney cancer drug called Pazopanib in October and I will use this argument in my submission.
- We are invited to respond to the Cancer Review. This is our opportunity to have our voice heard. The link is crsreview2010@dh.gsi.gov.uk I am normally sceptical about these consultations but this time, I think they are more open to new ideas.
