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December 2011
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Cancer Commissioning—at a global and a local level: London Cancer New Drugs Group Annual Meeting
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Funding UK cancer services—are there realistic alternatives?
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Nick Bosanquet (Professor of Health Policy, Imperial College, London) cited enormous challenges for cancer service commissioners in getting value for money for patients. Getting more value for the cancer service pound at a local level is a worthy ideal, as is more power for local clinicians and multidisciplinary teams (MDTs). However, central planning has left the NHS with a legacy of soaring costs, while patients have ever-increasing expectations.
Professor Bosanquet reported that although in the next 5 years there will be a 5% rise, at best, in real funding for the NHS, there will be a 20% increase in demand for its services—and a 30% reduction in acute beds in London.
The pressure on resources has never been greater, he said. For example, there are now more than 80,000 people in the UK living with end-stage renal failure, each costing the NHS about £25,000 a year.
“We must move away from current top-down process in terms of health technology assessment,” he commented. “This has developed for negative reasons—mainly to control costs rather than to secure value for money. There is a danger that central planning of medical services will leave very little discretion for local clinicians. Instead, we must encourage greater local planning and delivery of cancer services.”
The Cancer Reform Strategy has already set an agenda for funding an increase in access to local services via a 100,000 reduction in hospital inpatient admissions, although this is clearly not yet happening.
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Discussion.