"The Department of Health's strong direction and high
profile leadership has resulted in improved cancer services in key
areas. Further improvement depends, to a significant degree, on
raising standards of practice around the country up to the best. A
key factor in driving this is a much improved approach to
information on cancer services."
Amyas Morse, head of the National Audit Office, 18
November 2010
Improvements and efficiencies have been made in key areas of
cancer care since the Cancer Reform Strategy was published in 2007,
according to an NAO report today. However, a lack of high quality
information on costs of cancer services and their outcomes inhibits
substantial further improvements. The performances of Primary Care
Trusts (PCTs) still vary significantly and there is scope for
greater efficiencies, worth hundreds of millions of pounds each
year, in the delivery of care.
There have been high levels of achievement against cancer
waiting times standards and significant reductions have been made
in the number of days cancer patients spend in hospital - largely
as a result of increasingly treating patients as day cases.
However, whilst the Strategy aimed to minimise emergency admissions
for cancer patients, these are still increasing, with wide
variations between PCTs and poor understanding of the reasons for
those variations.
The NAO estimates that cancer cost the NHS approximately £6.3
billion in 2008-09, but the Department of Health has limited
assurance as to whether the implementation of the Strategy is
achieving value for money. Reported spending on cancer care varies
between PCTs - in 2008-09 varying from £55 to £154 per head - and
there is unexplained variation from year to year.
There are opportunities to achieve better outcomes and free up
resources to meet the increasing demand for cancer services. For
example, by reducing the average length of stay in hospital to the
level of the best performing PCTs, efficiencies worth some £113
million a year could be achieved. And if the number of inpatient
admissions per new cancer diagnosis was reduced to the level of the
best performing PCT, bed days equivalent to around £106 million
each year could be saved. In addition, radiotherapy machines could
be used more productively to help the NHS meet increasing
demand.
High quality information is essential to be able to commission
services successfully and to monitor performance. Some information
on cancer has improved, but significant gaps still remain. For
example, data on chemotherapy activity and outcomes are poor and
the introduction of a national chemotherapy dataset is almost two
and a half years behind the original commitment made by the
Department.
Publication details:
HC: 568, 2010-2011
ISBN: 9780102965551