Is Your Access to New Cancer Treatments a Postcode Lottery?

Excessive bureaucracy in the NHS is hindering access to the latest cancer treatments for patients in England, according to senior cancer doctors. The Royal College of Radiologists (RCR) highlights the challenges faced by cancer centres in navigating funding applications, leading to a disparity in treatment availability across the country, often referred to as a postcode lottery.

Last updated: 10 October 2023 (BST)

Key Takeaways

• The RCR warns that NHS bureaucracy is stifling access to innovative cancer treatments.
• Some advanced treatments are only available in larger, better-funded centres, creating inequalities.
• Survival rates are improving, but delays in diagnosis and treatment persist.
• Patient experiences highlight the need for streamlined processes in accessing care.
• The government is expected to announce a new cancer strategy aimed at improving patient care.

The Impact of Bureaucracy on Cancer Care

In recent discussions, the RCR has expressed significant concern regarding the increasing red tape surrounding the approval and funding of advanced cancer treatments. Bureaucratic hurdles complicate the process for hospitals seeking to provide the latest therapies, which can lead to delays in patient care and treatment disparities across different regions. This situation is particularly concerning given the impressive advancements in cancer treatment technology, including immunotherapy and precision radiotherapy.

The Postcode Lottery Effect

The term "postcode lottery" is used to describe the inconsistency in healthcare access based on geographical location. In the context of cancer treatment, this means that patients in affluent areas with well-funded hospitals may have access to cutting-edge therapies, while those in less affluent regions may not. This disparity is particularly evident with therapies such as Stereotactic Ablative Body Radiotherapy (SABR), which, despite being a significant innovation in cancer treatment, is not uniformly available across all NHS trusts.

What is Stereotactic Ablative Body Radiotherapy (SABR)?

SABR is an advanced radiation therapy technique that delivers high doses of radiation precisely to tumours while sparing surrounding healthy tissue. This treatment is particularly effective for small tumours located in the lungs, liver, lymph nodes, and brain. However, the RCR indicates that hospitals often need to apply for funding from NHS England to use SABR, which contributes to the aforementioned postcode lottery.

The Call for Change

Dr Nicky Thorp, vice president for clinical oncology at the RCR, has voiced a strong call for reducing the bureaucratic barriers that prevent clinicians from accessing innovative treatments. She argues that the current system is not only inequitable but fundamentally incompatible with the principles of the NHS. The RCR and the Society of Radiographers have formally requested that the government simplify the funding process for SABR and other cutting-edge treatments, such as certain immunotherapy drugs and molecular radiotherapy.

Government Plans for Cancer Strategy

The government is preparing to unveil a new national cancer strategy, which is expected later this autumn. Officials have mentioned that the strategy will focus on putting the NHS back at the forefront of global cancer care. This has raised hopes among healthcare professionals that it will address the critical issue of treatment accessibility and the delays in diagnostics that have become prevalent in recent years.

Current State of Cancer Diagnostics

The diagnosis of cancer remains a critical area of concern. A recent report by Cancer Research UK (CRUK) revealed that only half of patients diagnosed with cancer following an urgent referral receive their diagnosis within the target timeframe of 28 days. This is particularly alarming for patients with specific cancers, such as bone, bladder, kidney, and head and neck cancers, where only about a third receive timely diagnoses.

Improving Diagnosis Timelines

While those without cancer are often informed of their results more quickly, with 75% receiving confirmation within the target time, the prolonged wait for cancer diagnoses can lead to significant delays in starting treatment. Jon Shelton, head of cancer intelligence at CRUK, emphasises the need for faster testing processes to ensure patients receive timely care. Delays in follow-up tests, particularly for complex cases, can exacerbate the situation, making it crucial for healthcare providers to streamline their diagnostic procedures.

Patient Experiences: A Personal Insight

Ray Bowen, a 76-year-old patient from Middlesbrough, shared his experience of cancer treatment, highlighting the significance of timely access to innovative therapies. After undergoing surgery for kidney cancer in 2019, Ray faced the return of the disease in his remaining kidney in 2022. With surgery deemed impossible, he was treated with SABR radiotherapy, which effectively targeted his cancer with high doses of radiation. Three years later, he expresses gratitude for this “magic treatment,” and underscores the necessity of making such options more widely available.

Government Initiatives and Progress

The NHS has reported that it is treating more cancer patients than ever, alongside initiatives aimed at early diagnosis, such as home testing and mobile scanning units. The Department of Health has described cancer care as an urgent priority, indicating that the forthcoming cancer strategy will focus on ensuring patients receive the most cutting-edge treatments available. They project that by mid-2025, 148,000 more individuals will have their cancer diagnoses processed within the target timeframe compared to the previous year.

What Lies Ahead?

As the government readies to release its cancer strategy, there is cautious optimism among healthcare professionals and patients alike that the new measures will address the issues of bureaucratic delays and treatment disparities. The rising survival rates for many cancers, driven by advancements in technology, provide hope for a brighter future in cancer care. However, without significant changes to the existing bureaucratic processes, many patients may still face barriers to accessing the treatments they need.

FAQs

What is the postcode lottery in cancer treatment?

The postcode lottery refers to the inconsistent availability of cancer treatments based on geographical location, with some patients being able to access advanced therapies while others may not, depending on the funding and resources of their local healthcare providers.

What is Stereotactic Ablative Body Radiotherapy (SABR)?

SABR is an advanced cancer treatment that delivers high doses of precisely targeted radiation to small tumours while minimising exposure to surrounding healthy tissue, making it an effective option for various cancers.

How does NHS bureaucracy affect cancer treatment access?

Bureaucratic processes can delay the approval and funding of innovative cancer treatments, leading to disparities in treatment availability across different hospitals and potentially affecting patient outcomes.

What is the expected impact of the new cancer strategy?

The new cancer strategy is anticipated to streamline processes, improve access to advanced treatments, and enhance early diagnosis, ultimately aiming to elevate the overall quality of cancer care in the NHS.

How long does it take to get a cancer diagnosis in England?

Currently, only about half of patients receive a cancer diagnosis within the target timeframe of 28 days following an urgent referral, with significant delays reported for certain types of cancer.

As the NHS evolves and adapts to new challenges in cancer care, one crucial question remains: Will the upcoming cancer strategy effectively address the systemic issues that currently hinder patient access to life-saving treatments? #CancerCare #NHS #HealthcareInnovation