Everything you need to know about the new government healthcare strategy
The Government recently published the National Genomic Healthcare Strategy setting out the future of healthcare for people in the UK. We’ve delved into the detail to find out what this means for people affected by bowel cancer.
What is the National Genomic Healthcare Strategy?
The National Genomic Healthcare Strategy is the latest plan by the Government to improve the mental and physical wellbeing of everyone in the UK over the next 10 years. It aims to do this by harnessing the power of the latest scientific advances in genomic medicine.
Genomic medicine involves using genetic information from your DNA to understand the disease, predict how it may develop, and to help find the most effective treatment for you.
This strategy is a welcome step towards a more personalised approach to healthcare for everyone affected by bowel cancer.
What does it say?
The strategy is structured around three key areas:
Diagnosis and personalised medicine – incorporating the latest genomics advances into routine healthcare to improve the diagnosis and treatment of illness.
Prevention – enabling predictive and preventative care to improve public health and wellness.
Research – supporting fundamental and translational research and ensuring a seamless interface between research and healthcare delivery.
Alongside these areas there are five cross-cutting themes:
A. Engagement and dialogue with the public, patients and our healthcare workforce, placing the patient and the diverse UK population at the heart of this journey.
B. Workforce development and engagement with genomics through training, education and new standards of care.
C. Supporting industrial growth in the UK, facilitating entrepreneurship and innovation for projects and companies of all sizes, through common standards, funding, procurement, and R&D structures.
D. Maintaining trust through strong ethical frameworks, data security, robust technical infrastructure and appropriate regulation.
E. Delivering nationally coordinated approaches to data and analytics. This will enable healthcare professionals and approved researchers to easily access and interpret our world-leading genomic datasets.
What does this mean for bowel cancer patients?
Early diagnosis and reduced treatment delays
Nine out of 10 people will survive bowel cancer if diagnosed early. When diagnosed at the latest stage, only one in 10 people will survive.
The Government aims to prevent and identify cancer earlier by using emerging genomics technologies, imaging from scans and health data from research studies. Health officials aim to routinely offer genomic testing to people with cancer if it would be of clinical benefit. They also anticipate that new tests will be able to detect if the cancer is coming back earlier. This would mean that patients will get the treatment and care they need sooner.
For example, in Wales and Scotland, tests for tumour DNA in the blood of advanced bowel cancer patients has helped categorise the patients to ensure they get the treatment that works best for them quicker.
Some patients have a rare, but serious reaction to the chemotherapy drugs capecitabine or fluorouracil (also known as 5FU). In some cases this can be life threatening and even fatal. This is because some people have low or no levels of a protein called DPD in their body. This is called DPD deficiency.
Patients in Wales will be the first in the UK to receive routine testing for DPD deficiency. By testing patients before they receive chemotherapy, the new test will reduce the number of people with bowel cancer in intensive care and can save lives. The Government has also committed to introducing routine testing in Scotland, England and Northern Ireland at a later stage. We want to see it made available in all four nations as soon as possible.
The faecal immunochemical test (FIT) is vital for improving the chances of an early diagnosis as it has the potential to detect more early stage cancers. FIT has been rolled out in England, Scotland and Wales and is due to be introduced in Northern Ireland in a few months. In October 2019, Professor Sir Mike Richards’ Independent Review of Adult Screening Programmes in England highlighted key opportunities to improve the Bowel Cancer Screening Programme. These included lowering the starting age for bowel screening to 50, increasing the sensitivity of the test and to expand the workforce and resources for endoscopies.
The new strategy acknowledges this review and the Government has committed to continue to develop a public health and screening system that uses genomics to intensify screening and interventions in those at high risk. This includes personalising screening and testing family members of people affected by cancer to identify if they have a higher risk.
What are we doing?
The value of genomic medicine cannot be underestimated. Therefore, access to genetic testing for bowel cancer patients to improve their diagnosis, treatment and care has been a priority for us for a number of years. This work has included campaigning for universal Lynch syndrome testing and a national screening and surveillance programme, as well as work to build the evidence base to support DPD testing across the UK. As such, we were invited to sit on the National Genomics Board, which was responsible for shaping this report, and were able to call attention to the genomic healthcare needs of bowel cancer patients – much of this has been reflected in the final strategy.
We welcome the strategy and are pleased to see the Government’s commitments to using genomic medicine to advance healthcare for bowel cancer patients. We will continue to highlight the genetic needs of people affected by the disease, through our public campaigning and acting as a voice for patients at meetings with the NHS and other relevant bodies, to ensure that commitments made in this strategy are implemented across the UK.