Cancer strategy: consultation analysis

Question 4

The Aims of the strategy set out more-specific goals that we will prioritise and that we can measure. Our proposed aims are:

• Slowing down the increasing incidence of cancer
• Earlier stage at diagnosis
• Shorter time to treatment
• Lower recurrent rates
• Higher survival rates
• High quality, consistent experience of the health service for people affected by cancer
• An enabling environment for research and innovation in diagnosis and treatment
• Reduced inequalities in all these areas

Do you agree with these goals?

There was a high level of support for the proposed aims among respondents: 91% of respondents agreed with the aims, while 9% 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 (105 were from individuals and 81 from organisations).

Planning, service provision and innovation

The majority of respondents provided answers related to planning, service provision and innovation. Regarding planning, respondents provided suggestions for the implementation of the strategy. Among others, they underlined that the strategy should clarify the targets, introduce new policies or improve the current policy context, encourage leadership and accountability, increase workforce supply and raise awareness among the public (for example regarding cancer symptoms). However, some respondents highlighted the limitations of the strategy, such as it does not include incurable cancers, or they expressed doubts regarding the extent to which the set aims are achievable.

"Whilst we agree we acknowledge they are high level and are curious how they can be prioritised over each other. Action plans should facilitate." (Organisation response)

Respondents discussing service provision emphasised issues such as the necessity for efficient coordination among service providers, provision of care for incurable cancers, the accessibility of services, the need for high-quality treatment and the role of informal care.

"Every instance of terminal cancer causes a legacy within the family which can further impact the health service through the support of mental health etc" (Individual response)

Respondents were also concerned with research and innovation. Suggestions were made that the strategy should focus on measuring its intended goals, improving treatment methods and data collection, supporting research and innovation, and developing expertise and new models.

"We also feel it would be important to prioritise funding for research and innovation; and bringing greater awareness to the signs and symptoms of individual cancers, such as bladder cancer." (Organisation response)

Efficiency, impact and inequalities

The second most common theme focused on efficiency, impact and inequalities. Regarding efficiency, respondents felt that the new cancer strategy needs to aim at achieving higher survival rates, less deaths, a better quality of life and wellbeing, reduced risks related to cancer, and lower recurrence rates. Furthermore, they suggested that the strategy considers the long-term impacts and side effects of cancer diagnosis and treatment.

"But there also needs to be dealing with the long term physical and mental impacts of a cancer diagnosis" (Individual response)

It was stated that inequalities were largely associated with the variance of access to care depending on patients' region of residence. Therefore, respondents suggested that the strategy prioritised tackling regional inequalities, such as by ensuring equitable access to patients in both urban and rural/island areas. Furthermore, people mentioned that they would like to see improvements in health inequalities across socio-economic groups. Finally, some suggested that national and local treatments be considered separately.

"The inequalities that rural patients face must be a priority" (Individual response)

Time considerations

The next most common theme was focused on time. Most responses reflected on the first three aims listed, namely (i) slowing down the increasing incidence of cancer, (ii) earlier stage at diagnosis, and (iii) shorter time to treatment. Respondents were happy with the aim of shortening the time to treatment and they supported the view that early diagnosis should be a priority. They also underlined that waiting lists should decrease, as they can cause stress to patients.

"A specific aim is needed around monitoring and early detection of incurable secondary cancers" (Individual response)

"We agree with this prioritised list. We would recommend Goal C) is changed to read "shorter time to the correct treatment" given the importance of patients receiving the most appropriate treatment for their unique cancer diagnosis." (Organisation response)

Engagement and support

The next most commonly discussed theme was about engagement and support. Under this theme, several sub-themes were covered. Specifically, respondents suggested that the strategy should encourage communication between patients and experts, collaboration between key bodies (e.g. NHS, stakeholders, academia, industry, or patient representative bodies), and incorporation of a more active role for cancer patients in determining and managing their care.

"Again, we believe that in order to provide more consistent care to all cancer patients, more needs to be done to create better communication and joint working between specialist services and board level cancer care." (Organisation response)

Respondents also discussed the need for greater support to patients, their families and the health system more broadly, ranging from mental health to financial support. Among others, they suggested that the strategy should include funding priorities, post-treatment support, and funding for research and innovation.

"These are the right aims but will need to be qualified/tempered by the challenges which stand in the way of making these improvements. There will be a requirement for investment and for workforce recruitment & retention." (Organisation response)

A smaller number of respondents mentioned how the time of a diagnosis can be defined by one's age and raised concerns over the higher rates of cancer diagnosis as well as disease across different age cohorts.

"I believe more people would be diagnosed at earlier stages if mammograms were available for younger patients" (Individual response)

No further suggestions

Few respondents simply agreed with the aims without suggesting significant changes.

"Agree with all aims" (Individual response)