NHS England launched a new long term plan this week, which it claims will save up to 500,000 lives through a range of actions on areas including cancer, stroke, respiratory illnesses and cardiac conditions, neonatal care and mental health.

As a medical oncologist, I am particularly interested in the announcement of funding for genomic tests for every child with cancer and for adults with rare conditions. NHS England has stated that this policy will improve early detection for three out of every four cancers by 2028, up from the current rate of one in two. I work closely with cancer patients, discussing with them their treatment options and supporting them throughout their care – so I of course welcome a policy which aims to reduce the number of patients going through this often daunting process.

Prevention, here, is the key – something that Health Secretary Matt Hancock has recognised. He describes prevention as “…not just about keeping well physically and mentally, or preventing ill health in the future – it’s about the environment around us, the lifestyle choices we make and how we manage existing health conditions…”.

But what do we mean by “prevention” in clinical terms? Medical knowledge has advanced rapidly over the past decade, with the prevalence of ‘Big Data’ and advances in basic science. The medical community has made significant progress in understanding the factors that contribute to debilitating and devastating diseases, and such progress is changing the way we diagnose disease, allowing us to offer treatment that is tailored to the individual which can help prevent disease. It’s encouraging that the UK Government wants to harness these medical advances, and develop a balanced approach between prevention and cure.

Yet amongst the conversations about prevention, we mustn’t forget the patients who have cancer, or those who may require treatments in future. Although we can control aspects of our diet and lifestyle which may contribute to cancer, sometimes seemingly healthy people can fall ill. We must ensure that cancer patients continue to receive the advice, support and treatment they require to get better. This includes supporting and overseeing patients post-surgery and throughout their long term care and survivorship.

In order for that support to be maintained, workforce issues will play a part. I share the concerns of some in the medical community about the impact of funding and staffing on the long term plan. The Academy of Medical Royal Colleges welcomed the clear statement about the need for additional staff and a more supportive environment, and insisted that the commitment to improve the working lives of staff must become reality – aspirations I agree with wholeheartedly. However, until progress is made on improving workforce supply, retention, and valuation of staff, the plan’s ambitions may not be realised.

We must also see appropriate service redesign - new ways of working, better configuration and integration of services and removing waste and unnecessary procedures can improve the quality and efficiency of services. Regarding cancer specifically, earlier diagnosis can be made via rapid diagnostic centres where patients can get a range of different tests and consultations with cancer specialists done on the same day. These centres are being trialled in 10 places in England.

The long term funding plan is undoubtedly ambitious on cancer prevention, and indeed on the prevention of many different illnesses. I am encouraged by the willingness of the UK Government to embrace advances in medical research and technology which, if done well, can result in the prevention of many cancers. But government can only achieve this ambition by investing in the workforce through education and training, and by retaining our bright and brilliant clinicians by making them feel valued and by recognising their contributions.

Notes: 

1.Information about the long term plan can be read here: https://www.england.nhs.uk/long-term-plan/about/

Paul Gillen

Contact: Paul Gillen p.gillen@rcpe.ac.uk 0131 247 3658