New cancer strategy: consultation

Section F: Consultation Questions - Scope and Framing

54. We want to hear your views on how broad the strategy and actions plans should be, in addition to what the main areas of focus should be. We are proposing that themes are used consistently in the overarching strategy and 3 year action plans, these currently include:

• Person-centred care
• Prevention
• Timely access to care
• High quality care
• Safe, effective treatments
• Improving quality of life and wellbeing
• Data, technology and measurement
• Outcomes

Question 6a
Do you agree with these themes?

Description
Do you agree with the proposed themes (54.), please respond yes or no.

Answer

Question 6b
Please explain your answer and provide any additional suggestions.

Description
Please explain your answer for Question 6a.

Answer

49. Person-centred care means 'mutually beneficial partnerships between people diagnosed with cancer, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making'^[23]. Care focuses on the individual and their particular health and care needs, ensuring people's preferences and values are taken into account.

50. Under Person-centred care we are considering:

• Individual experience (by responding to Scotland Cancer Patient Experience Survey 2022 (SCPES^[24]); and by working with Third Sector and key partners on projects such as Care Opinion^[25])
• Co-production of some actions with people affected by cancer
• Wider support for people living with and beyond cancer and their supporters (for example Single Point of Contact, Transforming Cancer Care, Prehabilitation)

Question 7a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for person-centred care, please respond yes or no.

Answer

Question 7b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on the person-centred care.

Answer

Question 7c
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 7a and 7b.

Answer

51. We propose to look at Prevention in relation to risk factors for cancer that can be modified at the population level and at the individual level. We are considering, for example:

• alcohol minimum unit pricing,
• smoke-free zones,
• restricting promotion and advertising of foods high in fats, sugar and salt,
• mandatory calorie labelling,
• raising awareness of weight management services,
• healthy eating advice,
• smoke cessation services.

Question 8a
In your experience, what actions do you think would be most effective for helping to stop people getting cancer and reducing inequalities in cancer incidence?

Description
Please focus your response on the prevention of cancer and inequalities in cancer incidence.

Answer

Question 8b
Please explain your answer and provide any additional suggestions.

Description
Please explain your answer for Question 8a.

Answer

52. Timely access to care means trying to identify cancer as early as possible. Actions include, for example, education for the public and health professionals, screening programmes (general and targeted), getting the right tests quickly, and being referred and seen at the right time by the right people.

53. 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)

Question 9a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for timely access to care, please respond yes or no.

Answer

Question 9b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on timely access to care.

Answer

Question 9c
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 9a and 9b.

Answer

54. Under High quality care, we want to think about actions outside of direct treatment that affect the care given to those affected by cancer. We are considering:

• Workforce (thinking, for example, about requirements and modelling for oncology and other workforce, including specialist nurses; leadership)
• Service delivery (thinking about national, regional and local services; flexible use of workforce; role of cancer network; strategic alliances and working across health boards, for example)
• Inequalities (thinking about how to make sure everyone is included, and targeting those who may be at a disadvantage)
• Accessibility (breaking down barriers such as geographical, cultural or language)
• Integrated support services between NHS and Third Sector

Question 10a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for high quality care, please respond yes or no.

Answer

Question 10b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on quality of care.

Answer

Question 10c
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 10a and 10b.

Answer

55. Safe, effective treatments are the cornerstone of managing cancer. The majority of cancer treatments have continued throughout the pandemic but there are noted variations around the country. Treatment may come with side effects – or even a negative outcome: realistic medicine means encouraging people using healthcare services and their families to discuss their treatment fully with healthcare professionals, understanding the potential benefits and risks.

56. Under Safe, effective treatments, we are considering:

• Surgery
• Radiotherapy
• Systemic anti-cancer treatment
• Acute oncology
• Realistic medicine
• Consent

Question 11a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for safe and effective treatments, please respond yes or no.

Answer

Question 11b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on treatment.

Answer

Question 11c
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 11a and 11b.

Answer

57. Treatment may not be the solution and, alone, is not sufficient. We also need to consider the overall Quality of life and wellbeing of people living with and affected by cancer. This can be influenced by where a person lives and other social factors. Wellbeing and quality of life can be improved by strategies such as prehabilitation (helping people prepare for cancer treatment), psychological support and support for families and carers. Patients' experience of cancer is affected by how quickly and smoothly they move through the 'patient pathway' from symptoms to diagnosis to treatment and care. And care beyond surgery, radiotherapy and chemotherapy is important too, including palliative and end-of-life care.

58. Under Improving quality of life and wellbeing, we are considering:

• Prehabilitation and rehabilitation
• Psychological support
• Patient pathways (including quality of care, waiting times, less survivable cancers)
• Palliative medicine, Best Supportive Care and End of Life care
• Support to family/carers

Question 12a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for quality of life and wellbeing, please respond yes or no.

Answer

Question 12b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on quality of life and wellbeing.

Answer

Question 12c
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 12a and 12b.

Answer

59. Data (knowledge, information and statistics) are important to help manage cancer care as well as for measuring how well we are doing. There continue to be new innovations and technology that can help with diagnosis and more precise treatment. And research is important to stay up-to-date and know what works best. We want to make the best use of Data, technology and measurement, and are considering:

• Data, for example
  • Outcomes e.g. recurrence, benchmarking
  • Scottish Cancer Registry and Intelligence Service (SCRIS)
  • Quality Performance Indicators (QPIs)
  • Cancer Waiting Times (CWTs)
  • Cancer Medicines Outcome Programme (CMOP)
  • Patient Reported Outcome Measures (PROM)
  • Multi-disciplinary teams (MDTs)
• Research, technology and innovation (including regulation/quality/safety)
  • clinical trials
  • precision medicine
  • genetics/genomics/molecular pathology (screening, diagnostics, treatment)
  • robotics
  • e-health, for example, Near Me and Connect Me

Question 13a
Do you agree with these areas of focus?

Description
Do you agree with the proposed areas of focus for data, technology and measurement, please respond yes or no.

Answer

Question 13b
In your experience, what aims or actions would you like to see under any of these areas?

Description
Please focus your response on data, technology and measurement.

Answer

Question 13c
Is there any technology that you would like to see introduced to improve access to cancer care?

Description
Please consider access to screening, diagnostics, results, tracking of your pathway.

Answer

Question 13d
Please explain your answer and provide any additional suggestions.

Description
Please explain your answers for Question 13a, 13b and 13c.

Answer

60. The final proposed section is Outcomes, where we will describe how we will monitor and evaluate the strategy and plan.

Question 14
What suggestions do you have for what we should measure to make sure we are achieving what we want to in improving cancer care and outcomes?

Description
Please focus your response on cancer care and outcomes.

Answer