Six ways to ensure cancer is not ‘lost’ in the Major Conditions Strategy

As the government pushes ahead with one combined strategy for six major health conditions, Yorkshire Cancer Research is concerned that the absence of a dedicated plan for cancer patients will mean a missed opportunity to receive the treatment and care they deserve.

The Government’s Major Conditions Strategy will see six major health conditions, including cancers, cardiovascular disease including stroke and diabetes, musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia, dealt with under one combined approach.

However, cancer is a complicated and varied disease. In comparison to other similar developed countries, the UK and in particular England, are often among the worst performing countries when it comes to cancer survival, and Yorkshire often fares even worse. This is simply not good enough.

We believe that only a unique and dedicated plan will save cancer from becoming lost among so many other complex and challenging conditions, and so for this reason, we’re calling on the following measures to be included in the Major Conditions Strategy.

Smoking causes 3 in every 20 cancers, and Yorkshire has one of the highest smoking rates in England. There is currently no tobacco control plan and while we welcome some of the government’s proposals, such as vaping starter kits, they do not go far enough to reach a smoking rate of 5% or less by 2030.

Local services need more funding to provide behavioural support, and the government needs to take bold action to halt a new generation of smokers, such as raising the minimum age of sale by one year every year until no one is able to buy cigarettes.

The charity is also calling for stop smoking support to be fully integrated across the healthcare system for people undergoing diagnostic tests and treatment for cancer. Evidence shows that stopping smoking after a cancer diagnosis can not only improve cancer surgery outcomes but also the effectiveness of other treatments like radiotherapy and chemotherapy.

Little to no progress has been made against the government’s current target for 75% of cancers to be diagnosed at an early stage by 2028 – in 2020, only 51% of cancers in Yorkshire were diagnosed at an early stage. Due to the limited NHS workforce and diagnostic backlogs, it is unrealistic to expect the 75% target to be met by 2028. In Yorkshire, the 75% target would lead to an additional 7,000 early-stage cancers each year. However, the region is currently not set to meet this until 2044. This means drastic improvements and recommendations to tackle this are needed.

These could include:

• Speeding up the roll out of Community Diagnostic Centre in areas that need them most.
• A clear strategy for tackling barriers to early diagnosis in the worst performing areas.
• A detailed plan for the roll out of the national lung screening programme.
• Measures to address inequity when it comes to accessing an early diagnosis, such as putting more resource and equipment in areas that need it most.

Exercise has wide-ranging benefits for people with cancer, from helping prepare for surgery, relieving side effects from treatment and speeding up recovery, to improving the likelihood of survival and reducing the risk of cancer coming back. Despite this, only 5% of people with cancer in Yorkshire have been offered the chance to take part in a specialised exercise programme.

We want to see a firm commitment to rolling out tailored programmes for both the prehabilitation and rehabilitation of cancer patients, so they have the best possible treatment and care. This should include a commitment to produce guidelines that outline recommendations for exercise after a diagnosis of cancer and indicate how exercise could be integrated into NHS treatment.

People with cancer do better when they are treated at research-active hospitals. It’s essential that we continue to make time and resource available for innovation within the NHS, so that we can build on the progress made so far in providing better diagnostic tools and treatments for those with cancer.

We want the government to make a commitment to increase the number of people taking part in clinical trials within UK hospitals. Currently 44% of people with cancer in Yorkshire have taking part in research discussed with them, and this ranges from 24% to 51% between different hospital trusts across the region.

Inequalities across the healthcare system are widespread and are linked to many factors including deprivation, ethnicity and knowledge. In Bradford, women from the least deprived areas can expect to live 22 years longer than women from the most deprived areas. For men the difference is 19 years. Unfortunately, this situation is not unique to Bradford and is seen across towns and cities in Yorkshire and beyond.

We want to see greater resource put into diagnosing cancer early and treating cancer in those areas that need it most. This could include:

• Actively working to engage more people with screening programmes.
• Taking action to reduce the number of people being diagnosed with cancer via an emergency route. This could include sharing information so people can spot potential signs and symptoms of cancer and know when to contact their GP.
• Helping people engage with the health system, whether by having information available in different languages, or having patient navigators on hand to support people’s journey from diagnosis to treatment.

The Major Conditions Strategy should integrate with the Levelling Up agenda to ensure that the two are complementary and tackle similar areas of high priority.

We want to see ambitious targets for cancer care that will make a real difference and save lives if successfully achieved. However, it will be essential to review these targets at regular intervals and provide transparent reporting on performance, with clear actions put in place to tackle targets that are not on track.

The Major Conditions Strategy signals a substantial shift in our national health policy, from a focus upon single conditions in isolation to an attempt to emphasise holistic, whole person care that considers multiple conditions in tandem with each other.

We are supportive of encouraging cross-team collaboration in theory, but without a unique strategy for cancer we are at risk of losing an opportunity to save lives.

As the government moves forward with its approach, we will continue to ensure that Yorkshire’s voice is heard at a national level.