Challenges and ambitions
We want to ensure Londoners are more aware of signs and symptoms of cancer. We strive for early diagnosis, subsequent care and treatment, delivered promptly and locally where clinically appropriate and consolidated into centres of excellence where this will improve outcomes. Experience will be positive throughout a patient’s journey including optimal support to live well following active treatment, and for patients diagnosed with a terminal cancer we want them to receive support in line with their choices at the end of life.
Key challenges in London
- You can fill Wembley stadium twice with the number of Londoners living with cancer.
- Cancer patients in England have rated eight out of the 10 London trusts as being the worst.
- There is significant variance in one-year cancer survival rates across London.
- Londoners don’t know how to spot signs and symptoms of cancer and screening uptake is low.
- 70% of people with cancer have at least one other long term condition.
The report ‘Achieving World Class Cancer Outcomes: A Strategy for England 2015 – 2020’ was published in July 2015 and has set new ambitions for cancer outcomes to ensure England can match those seen elsewhere in the world:
- 75% one-year survival for all cancers combined (one year survival in London currently ranges from 63.0% to 73.5% with a London average of 69.7%)
- 95% with a definitive cancer diagnosis within four weeks or cancer excluded, 50% within two weeks
- 62% of cancers diagnosed at stage 1 and 2 (% of patients diagnosed ‘early’ in London currently ranges from 47.4% – 59.4% with % of London patients staged ‘early’ at 53.8%)
- 75% bowel screening uptake for FIT (uptake of bowel screening in London currently ranges from 37.3% – 57.3% with London uptake at 48.4%)
- 95% of patients have a patient agreed written after treatment plan (% of patients with a treatment summary within six weeks of end of treatment during 2014/15 ranged from 0% – 12.5% for London Cancer Alliance and 0% – 9.2% for London Cancer)
Why this is important
Cancer remains the leading cause of premature death across the capital. As many as a thousand lives could be saved every year if London’s cancer survival rates matched the best in Europe.
Earlier diagnosis is key to improving survival rates but there is also variation in access to, and outcomes from, the capital’s cancer services. Cancer patients in England have said eight of the 10 worst performing trusts are in London and they also reported poor experiences of support available to them from their GP practice and community services.
To address these issues, a model of care for cancer services was published in 2010 to ensure Londoners receive a world class experience from prevention, from early detection to high quality treatment in centres of excellence, subsequent support and for end of life care.
The Five Year Cancer Commissioning Strategy for London, published in April 2014, reiterated the case for change and acknowledged that there was a need to accelerate the pace of transforming cancer services to ensure early diagnosis and to go further on service consolidation and reducing variation in treatment and experience in London.
The London Health Commission’s Better Health for London set the ambition for London to have the lowest death rates in the world for cancer; and the ambition of the NHS Five Year Forward View to improve survival rates at one year after diagnosis through addressing late diagnosis and the subsequent variation in access to some treatments.