Cancer strategy: consultation analysis

Question 5

It is important to agree Principles that will underpin a future cancer strategy and guide our planning for and conducting future cancer services. These should reflect the values that we think are important in ensuring the best outcomes.

Our proposed principles are:

• putting patients at the centre of our approach
• actively involve communities and users of services
• be inclusive
• provide high quality, compassionate care
• ensure services are sustainable
• collaborate across all sectors
• use an evidence-based approach and make the best use of emerging data /research/technology
• strive for consistency through a 'Once for Scotland' approach

Do you agree with these principles?

There was a high level of support for the proposed principles among respondents: 94% of respondents agreed with the principles, while 6% 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 175 responses to the open-format question (97 were from individuals and 78 from organisations).

Inclusivity and collaboration

The most common theme was about inclusivity and collaboration. This was a broad category, with the sub-theme of inclusivity encompassing community involvement and the sub-theme of collaboration mainly referring to the provision of services.

Regarding inclusivity, respondents suggested that the principles promoted equitable care that can be accessed by all people regardless of their socio-economic background, thus eliminating inequalities. They also supported the active involvement of communities and the inclusion of deprived areas.

"Again high level but action plan should provide detail and be meaningful. "be inclusive" is too vague - suggest "ensure equity of access and provision of service"." (Organisation response)

A significant number of responses featured collaboration and service provision. Individuals supported that the government should engage with service users, stakeholders, charities and third sector organisations.

"[...] More collaboration across all four nations would benefit everyone but mostly patients." (Organisation response)

Other responses under this theme referred to the distinction between regional and local care, regional disparities and the accessibility of services.

"Collaboration is important but equal access to diagnostic centres for patients living in more rural areas is equally important. These patients frequently will not travel a long distance even if transport is provided. Mini centres have to be created for helping diagnosis patients living in more rural areas." (Individual response)

Patient-centred approach and high-quality, compassionate care

The second most common theme featured the principles of a patient-centred approach and the delivery of compassionate and high-quality care. Some key points of a patient-centred approach raised by respondents included communication with patients, particular attention to students, increased awareness, human rights and patients' empowerment.

"A suggestion would be to put the people of Scotland at the centre, as a member of the public only becomes a cancer patient once they have the diagnosis. Therefore, you can only put them at the centre, if you screen and diagnose the general population early enough." (Individual response)

Regarding compassionate and high-quality care, many respondents were happy to address this principle and encouraged more investment in this area. However, some respondents expressed their concerns about how quality can be measured.

General planning and consistency

Another prominent theme was focused more broadly on planning for the principles set by the strategy, with responses stressing the importance of having a consistent approach. Respondents discussing planning, though being in agreement with the principles outlined, commented that these seemed to be unclear or unrealistic. A number of respondents also mentioned that the 'Once for Scotland' approach was not clear enough. Responses also raised issues around the accountability and delivery of principles, promotion of healthy behaviours, as well as different challenges on the implementation of the plan.

"Again, such a list of principles is also a no brainer but we are a million miles away from them today, and so a more pragmatic achievable set of principles needs also to be honest and take into consideration the lack of capacity to deliver this for many years. No point setting yourself up to fail – we need honesty in politics and healthcare." (Organisation response)

Some respondents addressed the intention of the Scottish Government to strive for consistency, with most of these responses mentioning the 'Once for Scotland' approach. Some mentioned that consistency was not enough, and the strategy principles needed to guarantee efficiency as well.

"All of these points should be standard. Consistency is important. Let's lose the postcode lottery." (Individual response)

Research and sustainability

The next most common theme incorporated ideas around research and sustainability. Responses focused on research included suggestions such as making use of evidence-based approaches, incorporating improved technologies (e.g. artificial intelligence) and conducting data collection. Respondents also acknowledged the importance of educating patients and the workforce as well as offering training opportunities to the latter and ensuring that patients contribute to clinical trials.

"Ensure all patients have equitable access to all evidence-based treatment options for their cancers and opportunity to contribute to that evidence base by participation in clinical trials wherever appropriate." (Individual response)

Responses on sustainability mainly concerned funding, workforce supply and support, and service infrastructure.

"I feel we are already meeting theses needs for the majority of patients, as I said previously, having appropriate staffing can help streamline a patient's journey through the cancer journey" (Individual response)

No further suggestions

Several responses simply noted agreement or disagreement without making further recommendations.

"I would have thought that these strategies are being used already." (Individual response)