1. BETTER CANCER CARE A Discussion Elizabeth Porterfield Head, NHS National Planning Team SGHD

2. BETTER CANCER CARE  Update 2001 strategy in light of Better Health Better Care  Preparatory work with clinical communities  12 weeks discussion launched February 2008  Updated strategy published Summer 2008  Prioritisation within existing financial envelope - but significant contributions across a variety of areas from agreed Scottish budget and general NHS allocations

3. THE CHALLENGE FOR SCOTLAND  Current incidence c.27,000 new cases per year  Projected incidence c.36,000 new cases per year by 2020 (Updated Cancer Scenarios, 2008 (to be published in final plan)  Significant improvements in survival over 25 years to 2004 What are the prospects for continuing decreases in mortality rate?

4. PREVENTION  The “preventable fraction”  Smoking cessation/tobacco control, diet, exercise and alcohol management – all contribute to preventing cancer How many cancers could be avoided if health improvement strategy fully implemented and effective?

5. “PREVENTABLE FRACTION” Average annual preventable colorectal, breast and lung cancer diagnoses by life style factor – draft – not for publication – work in progress for final plan

6. INEQUALITIES  Inequalities in terms of prevalence and survival rates (deprivation, geography, gender, etc)  Access and availability of services  Ministerial Taskforce provides focus What more can we do to address inequalities in access and outcomes?

7. SCREENING  Breast – implementing 2 views – estimated additional 275 early cancers each year  Cervical - 400k smears in 2006-07 of which 3.5% showed pre-cancerous change  Bowel – to be implemented by end 2010 – estimated saving of up to160 additional lives per year What more can we do to increase participation, reduce inequalities in uptake and extend screening approaches?

8. DIAGNOSIS AND TREATMENT  Surgery  Chemotherapy  Radiotherapy  Genetic services What more can we do to shift the balance of care?

9. ASSURING QUALITY OF CARE  NHS QIS core and tumour specific standards – due to be published by summer 2008  Integrate research into routine care  Options for new waiting times targets being assessed – to be more meaningful for patients and more inclusive What more can we do to drive all aspects of quality improvement and further eliminate variations in practice?

10. PUTTING PATIENTS AT THE CENTRE  Supported self management – within context of broader work on long term conditions  Better Together – early focus on cancer What more can we do to improve the experience of care throughout the patient’s journey?

11. PALLIATIVE CARE  Integral to cancer care  Feedback from Better Cancer Care will be passed on  A plan to be published in due course

12. DELIVERY  New cancer drugs – SMC/NHS Board exceptional case processes  Service planning – regional cancer networks/operational interface with NHS Boards  E-health – GCS, CEPAS(?) and C-PORT  Clinical leadership How can we best support the implementation of the new plan?

13. ACTION FOR NHS BOARDS Make connections – planning, CHPs, operational management and networks Preventative care – how does Keep Well impact on cancer risk? “Levelling” standards, reporting and confidence

15. THANK YOU. NOW OVER TO YOU…