Limiting the impact of Covid-19 on cancer patients has been a top priority, with the majority of vital cancer treatments continuing throughout the pandemic.The NHS has consistently either met, or been very close to meeting, the 31 day cancer standard (95% of those diagnosed with cancer will receive their first treatment within 31 days of urgent suspicion of cancer referral) – currently 97.7%. The 62 day standard (95% of those referred with an urgent suspicion of cancer will receive their first treatment within 62 days) remains more challenged - this reflects diagnostic pressures that have been exacerbated by the impact of the pandemic.
The Scottish Government Framework for Effective Cancer Management, introduced in February 2018, required all NHS Boards to improve overall cancer waiting times performance.To incorporate the new ways of managing cancer pathways and services across NHS Scotland that have emerged as a result of Covid-19, a refresh of the Framework is underway and will be published September 2021.
Over this term of Parliament, we will also invest an additional £40 million in targeted improvements designed to maintain the 31 day standard and achieve the 62 day standard on a sustainable basis by:
- Provision of additional clinics for the most challenged pathways including urological, colorectal and breast cancers
- Provision of additional follow up clinics for breast cancer patients
- Introduction of new surgical techniques for urological cancer
- Increasing nurse workforce, and upskilling clinical nurse specialists
- Provision of additional surgical theatre sessions
- Investing in chemotherapy delivery, including staffing and equipment
- Continued investment in diagnostics including endoscopy services
This is in addition to the overall investment of £114.5 million to support the delivery of the National Cancer Plan.
This overall investment will support the transformation of Cancer Care Partnerships, including the continued roll out of the pioneering partnership with MacMillan, support the national population screening programmes to reduce inequalities in screening and address the impact of the pandemic, provide all cancer centres in Scotland with the most up-to-date radiotherapy equipment and, through our national cancer network, improve access to the best treatments and care for rarer cancers.
Delivering rapid and high quality cancer treatment after diagnosis is essential, but so too is diagnosing cancer earlier. All of the national screening programmes have now restarted and two additional strands of work are also vital in this regard.
We will have invested £20 million in, and continue to support the Detect Cancer Early (DCE) Programme. This will provide greater public awareness of signs and symptoms of cancer through campaigns and support the development of optimal pathways to improve earlier diagnosis rates. We will also develop additional DCE public awareness campaigns to reach those in areas of deprivation to reduce the health inequality gap.
We have also established a network of Early Cancer Diagnosis Centres (ECDCs). These will provide a fast-track diagnostic pathway through a new referral route for primary care for patients with non-specific symptoms suspicious of cancer, but who do not currently meet existing tumour specific referral pathways. Around 60% of cancers are diagnosed through the urgent suspicion of cancer (USC) pathway in Scotland, leaving around 40% which are detected through alternative routes (for example, routine or urgent referrals from primary care). The ECDCs are intended to speed up this diagnosis of those not covered by the USC pathway.
Three ECDCs have already been established in NHS Ayrshire and Arran, NHS Dumfries and Galloway and NHS Fife. These will be evaluated on an ongoing basis and the findings will inform the delivery of the roll out of further Centres.
We are also supporting a 'prehabilitation' programme for cancer patients, to ensure the best possible preparation for treatment and improve both the experience of treatment and the clinical outcomes from it. Key to this is clear communications, and to that end, we are developing, and already piloting a "single point of contact" for cancer patients to support them throughout their treatment.