Comprehensive Spending Review 2021: what does it mean for bowel cancer?

Yesterday, the Government set out its spending plans for the next three years. This was a chance for them to lay out how they were going to 'build back better' and make their manifesto commitments a reality especially since this is likely to be the last spending review before the next General Election.

It was a critical opportunity to set a new course for bowel cancer survival in this country by building back cancer services better by growing the cancer workforce and investing in diagnostic equipment.

One of the most significant barriers to improving bowel cancer survival, is the lack of capacity in endoscopy and pathology services due to workforce shortages and a lack of key diagnostic equipment and facilities. So in the lead up to yesterday, we've been working collaboratively with the whole cancer community through One Cancer Voice and All-Party Parliamentary Group to call for urgent investment.

So did the Government deliver?

More diagnostic equipment to transform services

To ensure the NHS has the ability to diagnosis bowel cancer safely and efficiently now, and in the future, the 2020 review of diagnostic services led by Professor Sir Mike Richards called for a substantial and urgent expansion of diagnostic capacity. The report estimated that around 20 NHS trusts will require a complete rebuild of their endoscopy facilities and others need improvements and that 200 new endoscopy rooms are required to meet patient need.

Earlier this week, the Chancellor announced an additional £5.9 billion to cut waiting times and tackle the backlog built up as a result of the COVID-19 pandemic. From that money, £2.3 billion will be used across the next three years to transform diagnostic services with at least 100 community diagnostic centres across England. These diagnostic centres have the potential to expand capacity with new endoscopy suites and blood testing labs while helping millions of patient's access key cancer tests closer to home.

In a bid to improve efficiency within the NHS, £2.1 billion will be invested in technology and data. It is hoped the new and improved IT will help NHS staff have access to digital patient records which will ensure patients get the best care wherever they are.

A bigger, better trained NHS workforce

Before COVID-19, staff shortages affected every part of the cancer pathway and Health Education England – a body which provides education and training for NHS staff – previously estimated the NHS will require a growth of 45% in its cancer workforce to deliver world-class cancer services by 2029. Staff shortages are already limiting the ability to implement initiatives in the NHS Long Term Plan, for example, lowering the bowel screening age from 60 to 50 which has begun but it will take until at least 2025 to be fully rolled out.

Yesterday, the Government announced there will be 'hundreds of millions of pounds of additional funding' to build a bigger, better trained NHS workforce. This is a step in the right direction but it's currently unclear how much money will be given, or how this will be allocated so we don't yet know whether this increased funding will grow the numbers of staff in the cancer workforce.

We will be pushing the Government to urgently clarify that yesterday's announcement will deliver the much need investment to grow the cancer workforce especially in endoscopy and pathology services which are needed to improve bowel cancer outcomes and meet the demand of a growing, ageing population.

What next?

While there are still many unanswered questions following yesterday's Spending Review, overall the Government made some positive commitments to cancer services. However, the proof really will be in the detail to see if this investment truly makes a difference to improving the lives of bowel cancer patients. It is unclear whether these commitments will be enough to meet their manifesto commitment to improve cancer survival or meet the Government ambition to diagnose 75% of cancers early by 2028. Now, we'll be working to fully understand what the commitments made yesterday will mean for bowel cancer patients now and in the future.

The announcements today are also specifically for England. While any increase in spending means that devolved administrations will be given additional money, there's more work for us to ensure that the vital investment by the UK Government to grow the cancer workforce and expand diagnostic equipment is replicated in Scotland, Wales and Northern Ireland.

Our response

Genevieve Edwards, Chief Executive of Bowel Cancer UK, comments: "We welcome the increase in funding for the NHS, especially given the huge impact of COVID-19 on cancer services, and the Government's commitment to build a bigger, better trained NHS workforce. However it is unclear exactly how much additional money will be given to support this and how the money will be allocated.

"The Government has committed to diagnosing 75% of all cancers early by 2028, and the evidence for years has pointed to the fact that staff shortages is a major barrier to making this commitment a reality.

"Bowel cancer is the UK's second biggest cancer killer, but it's treatable and curable, especially if diagnosed early. Early diagnosis is key to saving lives but we need the workforce in order to be able to do this.

"The proof really will be in the detail, which has not yet been provided, to see if this investment truly makes a difference to the more than 16,000 people who die from bowel cancer every year."

• Support the cancer workforce petition calling on the Government to invest in training more cancer staff

• Find out more about our End the Capacity Crisis campaign

• Become a campaigner. Join #teambowelcancer and help save lives