Digital must be at heart of a new National Cancer Control Plan
Almost every country in the world has a National Cancer Control Plan – an initiative backed by the World Health Organisation – to improve patient outcomes and standards of cancer care, as well as equity of access. However, much to the frustration of many within our healthcare system, there is no dedicated strategy or proposal for England’s cancer care outside of the NHS’ wider long-term plan.
Right now, the type of treatment someone with cancer receives often depends on the resources of the Trust they are seen in, meaning there is a huge disparity even between neighbouring healthcare providers in the ways cancer is treated. When we consider that the UK has a higher rate of cancer cases than Europe on average, but proportionally fewer cancer workers and less treatment equipment, the need for a national cancer plan to address these issues – as well as growing waiting lists and clinical staff burnout – is unavoidable.
But there are other challenges to be addressed too. Although there is huge impetus behind rolling out time and cost-saving technology, often the digital infrastructure in Trusts differs dramatically. At the most fundamental level, there are also usually limited resources to focus on deploying innovative technology and demonstrate the impacts that it can deliver.
What this means is that innovation happens in pockets across the NHS and is rarely joined up so, as a result, adoption of technology is sporadic. The need for a ‘gold standard’ of digital tools and a pathway for rolling them out across the NHS is paramount, and requires long-term strategic thinking to be successful.
A cancer care plan for the digital generation
Over the coming months and years, there are two key areas of oncology that a National Cancer Control Plan could help to improve by implementing the right technology. The first is that, with a growing list of increasingly complex cancer diagnoses, blended with a stretched workforce, much of our nursing resources are suffering from burnout.
Natalie Bingham, Head of Specialty Services at Lloyd’s Pharmacy Clinical Homecare and former chair of the UK Oncology Nursing Society’s Lead Nurse Forum, explains: ‘The amount of unhappy clinical staff in the NHS is actually quite frightening. People are put under a huge amount of pressure and even though burnout was there 13 or more years ago, it is massively exacerbated now. The same issues of capacity and cost were being discussed then but it has been systematically left for so long that it has become systemic itself.’
Rethinking traditional models of treatment and prioritising those who need face-to-face care while reducing unnecessary appointments for patients who are doing well could have a significant impact on capacity. However, this would mean having some level of oversight of patients to monitor them when they are at home and not in a hospital setting. The most effective and efficient way to do this is through technology, which can connect patients with their clinical teams remotely and help to triage patients who need urgent medical attention.
A second systemic problem which has only been getting worse across the UK is the SACT (systemic anti-cancer therapy) crisis and the resulting disparity in the way cancer is treated. There is critically low capacity to deliver SACT treatment to patients across the board, often resulting in delays and declining patient outcomes. For many Trusts, the way they treat their patients comes down to what resources are available to them.
Often, these resources are scarce. A Radiotherapy UK report found that only around 24-27 per cent of patients are treated with radiotherapy, which is much lower than the internationally recommended standard of approximately 52 per cent. There is also no national infrastructure to audit all the data accumulated about treatment journeys from the hundreds of thousands of people treated for cancer every year. This means that reams of data around testing and implementing innovation nationwide for the benefit of patients is overlooked.
Sarah Quinlan MBE, Director of Radiotherapy UK, outlines the problem: ‘In the UK, we have less than half of the internationally recommended rate of access to radiotherapy which we know is the most cost-efficient cancer treatment and the second most effective cancer cure after surgery. On top of this, around 20 per cent of the radiotherapy machines that are in operation in England are outside of their lifespan. The entire healthcare system – and especially those in decision-making positions – must focus on technology and treatments that are helping patients, as well as enabling innovation and unlocking data.’
However, none of these issues can be addressed at scale right now without a National Cancer Control Plan which means there is no standardisation of technology in sight, next to no adoption, and very little scope for profound change.
Moving beyond the early technology adopters
Change is exactly what is needed. What we have seen in the digital cancer care space is that early adopters – both in the NHS and private sectors – understand the benefits technology can provide to patients and clinicians. However, the NHS procurement process especially is cumbersome and very often pilots which have already demonstrated impact elsewhere are repeated unnecessarily.
It’s true that there is no one-size-fits-all digital solution, proposition or provider that can address every problem that the NHS faces, however each Trust has its challenges – such as improving patient experience, tackling capacity issues or rising costs of treatment – for which great UK-grown technology is already available.
Encouragingly, Wes Streeting and the new Government are already taking steps to address this and unravel some of the bureaucratic red tape. A new consultation will review the tech procurement process including evaluating evidence and a framework for bringing in digital solutions. A key thing to consider will be that every clinical team undergoing digital transformation or the adoption of tech tools to support them in delivering care needs a leader who is brought in and ready to manage the transition.
Across the cancer care space, there is hope that this restructuring and willingness to make meaningful change will lay the foundation for a forward-thinking National Cancer Control Plan backed by robust digital solutions and a clear pathway for innovation to turn the tide for a sector currently straining under pressure.
Paul Landau is CEO of Careology, the digital cancer care platform trusted by the NHS and private oncology sectors.