Cancer strategy: consultation analysis

Question 9

Under Timely access to care, we are considering:

• Screening (such as national programmes and genetics)
• Early detection and diagnosis (looking at genetic tests/molecular pathology; diagnostic tests (haematology, pathology, radiology, endoscopy); Detecting Cancer Early programmes; and Early Cancer Diagnostic Centres)
• Primary Care (including direct access to investigations, referrals and opinions; and education and engagement with communities)

Do you agree with these areas of focus?

There was a high level of support for the proposed areas of focus among respondents: 96% of respondents agreed with the areas of focus, while 4% did not agree. Respondents were also asked to provide any comments on their response, and the key themes raised in responses are covered below. There were two open-format questions on the areas of focus for timely access to care:

• 176 responses to the first question ("In your experience, what aims or actions would you like to see under any of these areas? Please focus your response on timely access to care."): 96 from individuals and 80 from organisations.
• 94 responses to the second question ("Please explain your answer and provide any additional suggestions."): 40 from individuals and 54 from organisations.

Timely detection, screening and testing

The most common theme focused on the importance of timing in detection, screening and testing. Respondents highlighted the importance of early detection, and they provided suggestions on screening, such us prioritising screening on patients with history or higher chance of incidence. Furthermore, they suggested screening to take place annually. Responses also recognised the role of Early Cancer Diagnostic Centres (ECDCs) on timely diagnosis, and they provided suggestions for improving it, e.g. upgrading their role, expanding their principles, being more evidence-based and moving from a pilot to routine care. Respondents also mentioned that screening should be facilitated and be up to date, and that high-tech treatments should be considered (e.g. AI for skin imaging).

"Early detection of a condition (e.g. cancer) through a healthy living test (e.g. blood sample taken at regular check-ups in the community). When detected the care coordinated locally, regionally or nationally as required." (Organisation response)

"The role of ECDCs expand and transition from pilot to routine care" (Organisation response)

Respondents also discussed the waiting times between having a test and knowing the diagnosis, timely access to care and services, as well as the acceleration of the patient pathway.

"Reduction in timescales between screening and more awareness of GPs of cancers that are uncommon within common groups eg: lobular breast cancer" (Individual response)

Service management

The second more frequent theme was about service management, raising issues around service delivery and distribution. Among others, respondents suggested considering the financial or wider costs of services, accessibility, sustainability, higher availability, innovation, primary or secondary care education, better integration and co-ordination between services.

"[...] It will also be important to focus on capacity within the service to deliver the required treatments after diagnosis. Delays downstream after diagnosis may counteract all or part of the benefit gained from earlier diagnosis. It would be good to include some ambitions for a more integrated cancer service across and within primary, secondary and tertiary care." (Organisation response)

Furthermore, some respondents highlighted concerns on age cohorts. For instance, they suggested wider age limits for screening.

"Lower age of breast screening to 40[.] As standard where under 50 or breast tissue is dense, ultrasound or MRI scans" (Individual response)

Information and financial support

The next theme was about information and financial support. Respondents underlined the necessity of adequate funding for services, investing in innovation, and raised issues around resource allocation.

"It needs to be properly funded so that there are sufficient staff and resources." (Individual response)

Responses focused on information suggested actions to increase patients' awareness of cancer symptoms, such as campaigns, consultations or the promotion of digitisation.

"GPs need to restart face to face consultations as telephone consultation do not allow them to really get to know their patients" (Individual response)

Workforce management

Responses under this theme considered issues such as the accountability, efficiency and awareness of GPs, the training and education of health professionals, as well as the development of a workforce strategy.

"There needs to be the workforce in place to respond!" (Individual response)

Broader comments

A few responses featured broader comments on the implementation of a timely access to care.

"It's all overdue" (Individual response)