Independent Cancer Task force Independent taskforce charged with developing a five-year action plan for cancer services that will improve survival rates and save thousands of lives. . The taskforce has been asked to deliver the vision set out in the NHS Five Year Forward view which call for action on three fronts: Better prevention; swifter diagnosis and better treatment, care and aftercare.

Membership Harpal Kumar – Chair Shafi Ahmed – Royal College of Surgeons Jane Allberry – Department of Health Maureen Baker – Royal College of GPs Juliet Bouverie – Macmillan Cancer Support Adrian Crellin – Radiotherapy Clinical Reference Group Sean Duffy – NHS England Kevin Hardy – St Helens and Knowsley Teaching Hospitals NHS Trust Anne-Marie Houlder - NHS Stafford and Surrounds CCG Liz Hughes – Health Education England John Newton – Public Health England Clara Mackay – Cancer 52 Cally Palmer – Royal Marsden Martin Reeves – Coventry City Council Mike Richards – Care Quality Commission Richard Stephens – NIHR CRN for Cancer Consumer Liaison Group Sarah Woolnough – Cancer Research UK To note: addition of Martin Reeves as local government representative Mike, Liz and Cally were not present for first meeting. Apologies received from Martin Reeves Sean Duffy and Anne-Marie Houlder have asked to dial in.

Approach Evidence call Workshops Stakeholder group meetings (charities, health care professionals) Themes (ie end of life, patient experience)

Statement of Intent: Signposting initiatives Big shifts over the next five years: Up-weighting of prevention efforts, including secondary prevention A multi-faceted approach to detecting many more cancers earlier Reductions in variability of access to optimal diagnosis and treatment Better planning and care of patients beyond initial treatment A holistic model of care that addresses all aspects of patients care, particularly at key transition points in the system Patients feeling better informed, and more involved and empowered in decisions around their care Commissioning models based around health and wellbeing outcomes, with a population focus Clearer leadership and accountability for driving improvements, across the health system

Cancer 52 – evidence (workshop and NCPES analysis) Early diagnosis Low levels of symptom awareness (professional and public) Lack of adequate referral pathways Delayed investigations Access to treatment Access to specialists/specialist centres Variation in practice Access ‘processes’ (CDF/NICE) – fit for purpose ? Patient Experience CNSs Information about disease/support groups Communication

Statement of Intent That there is unacceptable variation in access to and experience of care across geographies, segments of the population and in cancer types That research efforts must be maintained, both in the UK and internationally’, for cancers, like ‘lung, pancreas, oesophageal cancer and most brain tumours [where] survival remains stubbornly low.’ ‘That some CCG populations have outcomes for some cancers close to some of the best performing countries, but nowhere does this include all of the types of cancers studied.’ In most cases, patients presenting with symptoms to a GP are referred after the 1st or 2nd visit. But in around of one-fifth of cases - particularly with less common cancers or where symptoms are less specific, patients visit their GP 3 or more times before referral for a diagnostic test. There are variations in levels of satisfaction and amongst different group of patients. For example, patients with rare and less common cancers have lower levels of satisfaction than patients with common cancers . That many patients do not have a satisfactory end of life experience. For example, only one in 5 of those cancer patients who die at home have complete pain relief all the time in the last 3 months of their life. The new strategy will ‘seek to address variability in access to optimal diagnosis and treatment in access.

Statement of Intent At the heart of the new strategy will be proposals designed to streamline the diagnostic pathway for patients and reduce the burden of diagnosis relayed visits to GPs. One example is the multi-disciplinary diagnostic centres model… and consider whether a broader range of triage tests should be provided in the primary care setting. System changes for earlier diagnosis also need to reduce, where possible, the number of repeat visits required. Single tier system for referral of patients with suspicious symptom…the Strategy will consider whether all referrals for testing for suspected cancer should be regarded as urgent. We will consider whether CCGs should be required to…undertake an audit of diagnosis by emergency admission. More holistic care, including patients’ mental care, social care, and greater emotional and practical support, for example dealing ‘with the financial consequences of a cancer diagnosis.

Next steps… Apr-May – final TF meetings and workshops Strategy – in time for Comprehensive Spending Review ….