What the new NHS England Long Term Plan means for bowel cancer patients

On Monday (7 Jan 2019), Prime Minister Theresa May and Chief Executive of NHS England, Simon Stevens, published the new NHS Long Term Plan. This sets out ambitious improvements to the NHS over a ten year period and is paired with a £20.5 billion spending boost over the next five years. A cancer section features in the plan, and includes bold ambitions across diagnosis, treatment and care.

In October 2018, we submitted our response to the NHS Long Term Plan consultation setting out our priorities for bowel cancer to be addressed. These included:

1. An optimal Bowel Cancer Screening Programme
2. Expanding workforce capacity
3. Personalised medicine and access to innovative treatments

You can see more on these priorities in our blog from October.

So what was promised for bowel cancer?

The NHS Long Term Plan includes commitments across diagnosis, treatment and care.

• The Long Term Plan reaffirms commitments made to improving the Bowel Cancer Screening Programme to detect cancers earlier, with the introduction of the faecal immunochemical test (FIT), and lowering the screening age from 60 to 50;
• From 2019, NHS England will start the roll-out of new Rapid Diagnostic Centres (RDCs) across the country;
• The use of personalised, risk stratified screening and beginning to test the family members of cancer patients where they are at increased risk of cancer;
• The introduction of a new, faster diagnosis standard from 2020 to ensure most patients receive a definitive diagnosis or ruling out of cancer within 28 days of referral from GP or from screening;
• Safer and more precise treatments including advanced radiotherapy techniques and immunotherapies. As part of this, there will be a £130 million upgrade of radiotherapy machines across England;
• By 2020, all bowel cancer patients will receive a stratified follow-up approach for people who are worried their cancer may have recurred;
• From 2020/21 the NHS will begin to offer genomic testing to patients who are newly diagnosed with cancers so that by 2023 over 100,000 people a year can access these tests;
• By 2021, offering patients diagnosed with cancer access to personalised care, including a needs assessment, care plan and health and wellbeing support and information;
• By 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients.

A missed opportunity to address workforce challenges

Disappointingly, workforce challenges highlighted in our Capacity Crisis campaign are not addressed by the plan, which outlines a number of reforms for the NHS workforce without the required funding guaranteed to deliver them. This is particularly worrying as a number of initiatives proposed rely on increased staff capacity and budget.

Instead, the Long Term Plan points to a separate workforce implementation plan due to be published later in 2019. This again is a missed opportunity, as budget decisions around workforce will be made this spring by Government.

This capacity crisis has been considered one of the main barriers to improving cancer care for a number of years. The 2015 cancer strategy recognised this issue, and recommended a long term workforce plan. This was never completed, and again with the new NHS Long Term Plan, we are still waiting for this crisis to be addressed.

As part of our recent Capacity Crisis campaign, we had over 500 NHS staff sign our open letter to the Secretary of State for Health and the Chancellor. Of these 500, a number completed a follow-up survey on the impact of insufficient staff capacity. Increasing patient demand, staff retention, vacancy rates and a lack of continued professional development (CPD) were the top four challenges identified by staff.

The impact of these workforce shortages resulted in a reduction in staff morale, delays to patient’s treatment, extending working hours, breaching national cancer waiting time targets, and affected the quality of patient care.

“The Government has quite rightly prioritised early cancer diagnosis but it needs to invest in the workforce involved in delivering this. At the moment we are overstretched and under-appreciated.” – NHS Histopathologist.

We need to receive a firm date as soon as possible for the publication of this workforce strategy to prevent any further delays to improving cancer outcomes for patients.

What's next?

Local NHS organisations known as Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) have now been tasked with developing their own local strategies for taking forward the NHS Long Term Plan. These local plans for 2019/2020 are expected in April 2019, and their five-year plans by autumn this year. There is not yet a publication date given for plans after the five year point.

Bowel Cancer UK will be working closely with these organisations over the coming months to ensure issues affecting bowel cancer remain a top priority for local implementation.

• Find out more about the NHS Long Term Plan and read it in full.
• Read our blog on our top priorities for bowel cancer over the next ten years.
• Find out more about our Capacity Crisis campaign.
• To keep up to date with our campaigns, sign up to become a campaign supporter today.