NHS Long Term Plan – what next?

Becky Rice, Health Information Officer at Pancreatic Cancer Action feeds back on a follow up meeting for the NHS’s recent Long Term Plan (18/03/2019). She outlines the positives of the plan but also, drawing from personal experience as a NHS nurse, concerns and frustrations.

Pancreatic Cancer Action joined a number of charities, NHS cancer programme representatives, Cally Palmer (National cancer director) and Steve Brine (MP for Cancer) to discuss the recently released NHS long term plan.

This is an ambitious ten-year plan, backed by five-year funding, with a big focus on cancer. Everyone in the room acknowledged that the space and funding given to cancer in the plan is good news for patients and medical professionals alike. Discussion centred on meeting the new NHS cancer targets announced by the government last Autumn with a focus on 75% of all cancers being diagnosed at an early stage (stage 1 and 2). There were two main areas where cancer charities were invited to take part;

Rapid diagnosis centres

Rapid diagnostic centres are considered a potential way of moving towards this target. The idea being that patients with vague but non-specific symptoms (such as back pain, tummy pain, fatigue and other pancreatic cancer symptoms) will be tested and diagnosed faster and for any condition including cancer. This would stop patients bouncing around the system being tested for multiple conditions and experiencing delay. These centres are designed to be integrated in the current health care system, meaning they will involve the use of existing services and we cannot expect new centres for diagnosis to be built up and down the country.

Personalised care

Personalised care was also discussed in relation to cancer. Developments in technology mean that patients will be able to be screened for cancer or made aware of their risk based on their family history and genes. Patients will also be encouraged to self-manage more of their care using technology such as apps. This will need to be managed carefully to make sure access to services is equal for all.

Cancer targets

Separately, cancer targets were discussed, including the introduction of the “faster diagnosis standard” to diagnose cancer and communicate it to patients within 28 days of being referred by their GP. This would replace the two weeks wait target currently in place and aims to increase early diagnosis. The new target will be introduced next year in time for a funding boost for more diagnostics such as scanning equipment. This alongside the changes above, could help to change the way the NHS looks at cancer diagnosis and help move towards early diagnosis for more patients with a greater variety of cancers.

What do we think?

Pancreatic Cancer Action supports charities working together to help create cancer policy. We believe this is a good way of making sure that patients concerns and pancreatic cancer in general, is included in decision making.

We welcome the ambitious challenges set out in the Long-Term Plan for cancer and health in general, including greater disease prevention and so this reduces inequalities in health that lead to variations in cancer deaths across the UK. However, there are issues in delivering the Long-Term Plan, most obviously, staffing issues and diagnostic capacity (number of scanners etc).

Key issues surrounding the plan

A plan for how to recruit NHS staff and retain for them known as the “workforce implementation plan” is yet to be published but will need to include strategies to deal with Brexit, cuts to the nursing bursary and current issues within the NHS. Staff can only come from new graduates, professionals returning to practise or recruitment from other countries, all of which are currently threatened. There are nearly 42,000 nurse vacancies across England alone and there are further shortages in radiologists, specialist cancer nurses and oncologists (cancer doctors).

Increasingly high numbers of medical professionals are leaving or considering leaving the NHS and reported levels of work-related stress rising. This was confirmed in the most recent 2018 NHS staff survey and my own experience of NHS nursing. A theme of having unrealistic time pressures, stress and ever-increasing demand is something that I am familiar with from my own practise. Under these circumstances staff turnover is high, and retention becomes ever more challenging.

For me personally, the NHS represented some of the greatest highs and lows of my life. It was a privilege to work face to face with patients every day. But no one wants to work to feel as though they are failing, and for me that was the dominant feeling too often. Change is never easy in an organisation such as the NHS but it is necessary to ensure that the long term plan can be met and so that the health service as a whole can survive.