Site last updated:
July 2010
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Articles
The Editorial Advisory Board invites the submission of articles and opinion pieces on any topic regarding the commissioning and provision of cancer services in the UK.
Recent articles include
The New NICE Guidelines for Management of Breast Cancer—A Personal Commentary
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Earlier this month, the nation was shocked to hear that the NHS was set to go bust in 2011 unless it prepared to make some serious cuts in spending.
In this edition of Cancer Services Forum, Professor Chris Poole’s personal commentary on the new NICE guidelines for breast cancer provides a colourful account of what he describes as NICE rationing. He discusses some controversial issues around continuing inequalities, a perceived non-transparency of data analysis and the problems with clinical trial crossover when looking for meaningful endpoints on which to base funding decisions.
Chemotherapy: Putting Patient Safety First
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In the past 2 months we have seen the publication of three major reports that will have an impact on the way chemotherapy is delivered in future years.
The report on chemotherapy from NCEPOD (National Confidential Enquiry into Patient Outcome and Death), For better, for worse?, makes disturbing reading. Although we are using increasing amounts of cancer chemotherapy, there are many aspects of governance and collaborative working across organisational boundaries that need to be improved to make sure patients have access to safe services. Please read on for analysis of these reports and a comment from Alison Jones, Chair of the Association of Cancer Physicians.
Chemotherapy delivery: challenges for the future
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As a result of the rising incidence of cancer and the expanding range of treatments available, UK cancer services are working under growing pressure.
In this article Gill Donovan discusses national and local strategies for coping with the demand for cancer care, looking specifically at the issues of patient capacity and the drive to deliver cancer treatments nearer to patients’ homes.
Time To Stop Hiding Behind The Skirts of NICE—The UK Renal Cell Carcinoma Expert
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The recently produced Cancer Commissioning Toolkit will aid commissioners in making informed decisions about the services that they commission. Darzi points us to ensuring that services are high quality and as local as possible, whilst World Class Commissioning ensures that this approach is safe and leads to a reduction in health inequalities.
The UK Renal Cell Carcinoma Expert Group highlights a key issue that commissioning will have to tackle—the availability of drugs. The group looks at the example of the renal cell carcinoma drugs, sunitinib and sorafenib and equality of care within the constraints of available funding.
Commissioning Cancer Drugs and Services: Shared Strategies For A Common Goal
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The commissioning of cancer drugs remains a challenge despite the fact that the spend on them has doubled since 2000, up to an estimated expenditure of nearly £700 million last year. We continue to hear examples of inequalities with postcode prescribing and the new drug pipeline continues to produce exciting but expensive new agents that we struggle to place.
The London Cancer New Drugs Group (LCNDG) has worked consistently to inform the managed entry of new drugs for cancer treatment and to promote the cost effective and equitable provision of these.
The National Tariff: How Chemotherapy May Be Funded
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NHS reform is proceeding at an increasingly rapid pace. An understanding of the impact of patient choice, competition and stronger commissioning is required by clinical leads and managers of all services.
The arrival of the Cancer Reform Strategy in late Autumn 2007 will fuel the redesign of cancer services, moving care, where safe to do so, closer to home. There may be new providers of cancer services in the community, and a shift in services from cancer ‘centres’ to ‘units’.
Clinicians who will lead service delivery, as well as the managers and commissioners they work with, will find ‘The National Tariff—how chemotherapy may be funded’, a welcome introduction to what can be a complex topic. Anne Hines, Lead Pharmacist at the Merseyside and Cheshire Cancer Network provides a clear yet comprehensive account of the concept and its possible impact on chemotherapy services. The long, sometimes complicated documents issued by the Department of Health are referenced for further reading if necessary. Clinical teams by 2009 will have to demonstrate their clinical outcomes and would be well advised to also be ready to demonstrate their financial viability.
