Many cancer networks are failing to improve services
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7535.193 (Published 26 January 2006) Cite this as: BMJ 2006;332:193Data supplement
Many cancer networks are failing to improve services in England
Susan Mayor
A high number of cancer networks—the groups set up to lead improvements in cancer services at a local level and to implement England’s national cancer plan—are failing in their role, warns a report published this week.
It found major variations in cancer mortality and in levels of access to newer drug treatments in different parts of England.
The report reviewed what had been achieved five years into the NHS cancer plan, a 10 year strategy to provide a comprehensive approach to improving cancer services across the country.
The House of Commons Committee of Public Accounts, which conducted the review as part of its role to examine public spending, found that 30% of networks it assessed had no comprehensive plans for providing cancer services in their area, even though the networks had been functioning for more than three years. It also found cancer networks to be inconsistent in monitoring their performance against the targets in the plan—with no monitoring at all taking place in five of the networks reviewed.
Edward Leigh MP, chairman of the committee, said: "It is hard to believe that nearly a third of the networks visited by the NAO [National Audit Office] had no comprehensive plans for providing cancer services in their locality. But that was what they were set up to do. Their effectiveness needs to be monitored closely and, where necessary, improved."
The committee recommends that strategic health authorities, which are now responsible for ensuring that networks operate effectively, should review the effectiveness of cancer networks in their locality and put cancer service plans in place where necessary.
All cancer networks should establish comprehensive arrangements to monitor progress against targets for which they are responsible, the report says. It also says that the national cancer director, Mike Richards, should identify and establish the most suitable monitoring framework.
The committee found that cancer mortality, particularly from lung cancer, was highest in the most deprived areas. Across the strategic health authorities the highest mortality from lung cancer was twice the lowest. The committee considered that the differences in mortality reflected lifestyles, particularly the prevalence of smoking, and the extent to which patients with symptoms had them addressed quickly, as well as the effectiveness of NHS cancer services.
The report recommends that all cancer networks should make clear in their delivery plans how they will reduce inequalities in cancer prevalence and mortality. The Department of Health should publish a progress report specifically on the results of actions to address inequalities, it advises.
The committee concluded that the cancer plan should be updated to take account of major NHS structural changes since it was published five years ago. It should include a more comprehensive set of targets and should reflect the estimate of the future burden of cancer that is currently being developed by the health department.
"The cancer plan must be comprehensively updated with fresh targets and complete clarity about whether they are being met," said Mr Leigh.
The NHS Cancer Plan: A Progress Report is accessible at www.parliament.co.uk .
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