Cancer strategy: consultation analysis

Question 3

Our proposed Vision is: "A compassionate and consistent cancer service, that provides improved support, outcomes and survival for people at risk of, and affected by, cancer in Scotland"

Do you agree with this vision?

There was a high level of support for the proposed vision amongst among respondents. 85% of respondents agreed with the vision, while 15% 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 186 responses to the open-format question (106 were from individuals and 80 from organisations).

Support and outcomes

A great number of respondents offered suggestions regarding the improvement of support offered to cancer patients and its subsequent outcomes. In general, respondents felt that the Vision should focus on a patient-centred approach and promote psychological support, wellbeing and wider societal benefits. Financial support of patients and investment in cancer strategies were also raised as a crucial target by respondents.

"The vision is fine, compassion and consistency are important. But put more simply we want to provide high quality patient-centred care and services available at the right time, in the right place all of the time. Given the aims set out below, we are presuming that preventative services are within the general definition of "cancer services" noted in this vision and that reducing the incidence of cancer through such services a desirable outcome." (Organisation response)

Respondents also highlighted the necessity for strengthening the workforce and suggested that further training should be offered, including in how staff approach and support patients. For example, respondents suggested that staff need to work closely with patients and inform them appropriately.

"This is what people want and expect but the NHS will need to invest heavily in staffing to improve morale, we cannot continue a service on good will." (Individual response)

Finally, respondents believed that the vision should be directed towards improving cancer survival rates.

"Cancer survival rates is the highest it's ever been. Despite this progress NHS Scotland can improve access to curative treatment and support long-term survival of cancer patients in Scotland." (Organisation response)

Planning and methods

The second most popular theme concerned general planning and methods. It consisted of two sub-themes that were both mentioned quite extensively. The first sub-theme was about planning and suggestions on the overall strategy of the Vision, as well as concerns about its delivery. Respondents mentioned that the strategy should be more detailed. This sub-theme also included considerations on the treatment of specific cancer types.

"Vision is one thing, but the practical aspects will need discussion and attention. There is no point of having a vision if the bottle necks are not sufficiently identified and solutions are not created." (Individual response)

The second sub-theme was about the necessity to do further innovative research and improve existing methods. Some responses provided statistical evidence relevant to cancer, while some respondents also suggested that a comparison with international relevant evidence would be beneficial. Another point raised was that the vision should find effective ways to measure its expected outcomes.

"We agree with the vision but this needs all boards to be on a level playing field in terms of access to services, research and innovation" (Organisation response)

Equality, equity and fairness

The next most common theme within the responses combined the themes of equality, equity and fairness. Respondents suggested that the Vision should ensure that services can be delivered to all patients and diminish inequalities.

"The vision encapsulates and sets out well the aim of having a forward looking compassionate caring cancer service focused on outcomes and survival. We wonder whether it might be helpful to include the attribute equitable, in addition to compassionate and consistent - as equity features strongly in the aims and is important element." (Organisation response)

The geographic distribution of services was repeatedly linked to equality. Some common views were that the postcode lottery approach should be abolished, and policies should be applied equally across all regions. Other people highlighted the importance of more local treatments and health boards.

"Consistency across the country is key, at the moment it varies so much from one health board to another." (Individual response)

Prevention and aftercare

Another common theme was about prevention and aftercare. A significant number of respondents suggested that the Vision should incorporate prevention and timely diagnosis, as well as other aspects related to time, such as the reduction of waiting times.

"Focus needs to be on early diagnosis to save more lives." (Individual response)

Some respondents held the view that the vision should consider the impact being diagnosed with cancer has on patients' lives during and after treatment. Furthermore, respondents were interested in different ways that incurable patients could potentially be treated.

"[...]The other point that needs to be taken in to account is living after being treated, once all the chemo, surgery and radiotherapy is complete, the support seems to decrease and this probably due to how busy all the cancer clinics are." (Individual responses)

General comments

Some respondents simply agreed with the proposed vision without making further suggestions, while a small number of responses disagreed without providing alternative ideas for improvement.

"Currently being treated and well, not impressed!" (Individual responses)