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Written Statement - Improving Cancer Services in Wales

Mark Drakeford, Minister for Health and Social Services

Assembly Members, I am really pleased to share with you real evidence of the improvements in cancer care that are being made here in Wales. I would like to take this opportunity to share this good news with you, as well as how I intend to build upon this in the coming months to ensure that cancer care offered in Wales continues to make sustained improvements.

Cancer is about more than “waiting times”. It is about people and their care.  In our recent Cancer Patient Experience Survey, I was pleased to see that so many people rate their care highly.

The results of the Cancer Patient Experience Survey, run in partnership with Macmillan Cancer Support, and published on the 27 January asked people diagnosed with cancer to provide feedback on the care and treatment they received. Overall, the care received by cancer patients in Wales was either ‘excellent’ or ‘very good’ according to 89 per cent of patients who responded. That figure rose to 97 per cent of patients who thought their care was ‘good’. It is encouraging to see that so many patients had a positive experience of their cancer care and the evidence of effective systems being in place alongside support to individuals is very clear

The survey reported the views of 7,352 cancer patients. With a 69% response rate the results provide a robust and comprehensive analysis of people’s experiences of cancer. The clear message of this survey is the majority of people receive excellent care and support in a wide range of areas.  

The survey did not just concentrate on medication and surgical procedures. It considered the whole journey faced by a person, starting when they are first given a diagnosis of cancer. I am pleased to report that 85% of people said they were always treated with respect and dignity by staff; 87% had confidence and trust in the doctors and nurses caring for them and 94% said they had enough privacy when being treated.

Importantly, the survey has also highlighted areas of care which need improvement. Variation does exist between hospital sites and some cancer types and effort is needed to drive down this variation. For example those with breast cancer were more positive in their responses than those with sarcoma, lung or urological cancers. While two thirds of patients were given the name of a key worker, and report the benefit of having key workers and cancer nurse specialists, it is clear that more work is needed to improve consistency of access. There is ongoing work with the cancer networks in Wales about what duties clinical nurse specialists should provide.  Whilst 68% of patients said they had discussed or been given information about the impact of cancer on work or education, only 51% said they had been given information about how to get financial help or benefits by hospital staff. More action will be taken to meet the holistic needs of the patient.

This is the first year this survey has taken place in Wales and the NHS as a whole will need to listen to and act upon the voices of patients. This survey helps us in gathering the right kind of evidence so we can better understand the different needs of people who use our services. It provides us with an important picture of what matters to individuals, not simply the currency of time. With the evidence they have given to us, we can continue to improve our services and ensure the experiences of patients, both present and future.

On the 31 January, we published our second Cancer Annual Report. I was very pleased to learn that Wales has the biggest increase in cancer survival rates in the UK. The report demonstrates real improvements in cancer care in Wales over the past year and this is a tribute to all those involved in the planning and delivery of care.

Another area of success highlighted by the report is in the increase in the uptake of the HPV vaccine, from 85.5% in 2011/12 to 86.6% in 2012/13. This vaccine prevents cervical cancer, which is the second most common cancer in women under the age of 35.

The report also highlights a number of areas where we need to focus efforts in the coming year.  This includes reversing the decline in the numbers of people taking up bowel cancer screening. And while the report tells us we have consistently achieved the 31 day target since July 2013 on a monthly basis, we aim to build on recent improvements against the 62-day target for those newly diagnosed with cancer.

While our cancer survival improvement has been the best in the UK, we are still to reach the levels achieved in a number of other European countries. We need to continue to make progress here.

It is important we don’t judge services on access times alone. In the survey in response to the question about waits for hospital 78% said they felt that they were seen as soon as they thought was necessary. The Cancer Delivery Plan allows us to look at a variety of measures which impact on overall outcome survival rates.

I continue to be advised by the most senior oncologists in Wales that the distinction between 31 and 62 day cases is not one which reflects today’s highest standards of patient care.

I have recently received advice from senior clinicians concerning targets for access to cancer services. They recommended the development of a single patient pathway with waiting times reported from GP referral or from diagnosis depending on the route to diagnosis. This would result in a move away from using individual breech reports as a primary descriptor of the quality of care received by the majority of cancer patients towards s system that is  more representative of the whole population and  the increasing complexity of cancer care. I have asked that we pilot this system relatively quickly. I will evaluate the results of the pilot and if there are immediate changes recommended, I will action them rapidly. Wider work will proceed through clinical engagement on the development of the pilots between now and April 2014.

Every patient deserves the best care. Whilst the results of both the Annual Report and the patient survey report indicate we are taking steps in the right direction, we will continue to work to make improvements in all aspects of cancer care and treatment.

I am clear, that the policies and process we and the health boards have worked hard to develop in support of cancer care is now having a real impact upon cancer care.  I am determined to ensure that these improvements continue.