A letter to Health Secretary Steve Barclay

Dear Steve Barclay,

Re. Major Conditions Strategy & The War on Cancer

Yorkshire Cancer Research is Yorkshire’s independent cancer charity. For over 95 years, the charity has been dedicated to funding pioneering research that has led to improvements in the prevention, diagnosis, and treatment of cancer, and we are committed to saving lives in Yorkshire.

We read with interest your recent written statement announcing a new “Major Conditions Strategy” to be developed and published by your Department.

The principle aim to improve the lives of millions of people in England is, of course, laudable. We support, in particular, the intention to narrow the gap in healthy life expectancy by 2030: in Yorkshire, the disparity gap in Bradford, for example, is at 19 years for men and 22 years for women when considering the difference between the most and least deprived.

Tackling clusters of significant disadvantage and deprivation within our region is a priority for Yorkshire Cancer Research and we would actively support any well-structured and well-funded measures aimed at achieving this goal.

We have reservations, however, about including cancers in this wider strategy, alongside chronic long-term conditions such as cardiovascular disease, dementia and mental ill health.

We are very disappointed that the “war on cancer” and 10-year cancer plan announced last year has been abandoned and the significant number of evidence-based submissions which could have informed this ground-breaking policy have been waylaid. In the same way that each of the 30,000 new cases of cancer diagnosed in Yorkshire each year are unique and require a personalised treatment pathway, tackling cancer as a whole is unique and requires a personalised long-term strategy.

Whilst we agree that those living with cancer must receive integrated, whole-person care across the health system, evidence demonstrates that despite improving survival rates, more than 13,300 families still lose a loved one to cancer each year in Yorkshire alone. Cancer is the largest cause of death in those under the age of 75, with the rate of death 1.5 times higher than for cardiovascular disease and nearly 3.5 times higher than for respiratory disease. These figures demonstrate it is not sufficient to group cancer together with these other conditions and that a clear and specific long-term strategy is essential to improve the diagnosis and treatment of people with cancer and their families.

Additionally, Yorkshire has higher rates of cancer incidence and mortality than most other areas in England which highlight the need for any strategy to consider equity, not just equality, as some regions will need a greater level of investment due to poorer health outcomes.

We support your stated intention to shift towards a model of preserving good health and early detection and treatment. Evidence demonstrates quite clearly that when cancer is diagnosed early, survival outcomes are much improved: screening, symptom awareness and effective referral pathways are essential to achieving the current goal of 75% of cancers being diagnosed at stage 1 or 2 by 2028.

In Yorkshire, this would lead to 7,000 additional early‑stage cancers each year, but the region is currently not set to meet the target until 2044, indicating the need for drastic improvements and recommendations to tackle this within any new strategy.

Yorkshire Cancer Research is working towards improving early diagnosis by actively funding programmes such as the multimillion-pound Leeds Lung Health Check which delivers lung screening in mobile units at convenient community locations and from which the clinical trial data has been instrumental in the recent UK National Screening Committee lung screening recommendation.

We are also funding a new clinical trial offering tests to women to identify if they have inherited the genetic faults that cause one in every 20 breast cancers as well as multiple other research studies aimed at improving rates of early diagnosis.

Furthermore, there is a continual requirement to evaluate current methods of treatment and invest in scientific research to investigate new life-saving treatment possibilities that may make a huge difference to people with cancer.

Yorkshire Cancer Research funds a large portfolio of clinical trials aiming to improve and enhance treatments available for patients with many different cancer types including prostate, lung and bowel cancer. We are also investing considerably in a pioneering programme called Active Together which provides people with cancer with physical activity, nutritional and psychological support before, during and after treatment. More broadly, the Government has committed to investing in research and development and we hope that this will be evident in the provision of ringfenced funding available for cancer treatment research within this new strategy.

In terms of prevention, we would urge you to include robust measures to prevent cancer in this strategy, such as embedding smoking cessation services across the NHS and adopting Dr Javed Khan’s recommendations towards achieving a smokefree society by 2030. Two in three lifelong smokers will die of smoking-related deaths if they do not quit.

Prevention measures aimed at promoting regular exercise, a healthy diet and reducing alcohol consumption must also be considered essential in achieving the Government’s manifesto commitment of gaining five extra years of healthy life expectancy by 2035, as well as alleviating both short, medium and long-term pressures on the health system. The impact of such measures would undoubtedly have a significant effect upon your stated aim of reducing ill health-related labour market activity: in Yorkshire alone, smoking costs £1.6 billion, including lost productivity costs of £1.2 billion.

England has an incredible opportunity to transform its approach towards cancer and offer a world-class service but it requires strong political leadership to devise a well-funded, clear and dedicated strategy. We urge you to ensure that the Major Conditions Strategy contains a strong, evidence-based and fully-funded plan to tackle cancer.

However, we also ask that you commit to a personalised, unique, long-term strategy for cancer where outcomes are monitored and tailored over time, and the strategy is underpinned by good investment and funding. Measures aimed at tackling the disparity gap, improving preventative measures, increasing rates of early diagnosis and investing in research to develop treatments are all key components if we are to truly make a difference for generations to come.

We have a strong library of evidence-based research, data and expertise at Yorkshire Cancer Research and would be pleased to assist your team as they gather information ahead of devising and publishing the plan for cancer.

Yours sincerely,

Dr Kathryn Scott
Chief Executive
Yorkshire Cancer Research