Evaluation of the National Cancer Plan
Remobilisation and Recovery of Cancer Services
The National Cancer Plan was written after the first phase of the pandemic with the intention to help services recover. Services had been affected by the direct impact of COVID-19 on hospital beds and staff, and the indirect impact of infection prevention and control measures including social distancing and staffing isolation pressures.
A full evaluation has not been completed given the lack of baseline data and limited resource during the pandemic to agree, collect and analyse data specifically for the Plan. However, a large amount of work has been undertaken to monitor QPIs and strengthen cancer data through work on the Scottish Cancer Registry and Intelligence Service (SCRIS) and Cancer Intelligence Platform. Public Health Scotland collects and analyses a range of relevant data such as incidence, waiting times, screening and mortality as well as specific data requests. Additionally, performance has been monitored through the use of a Tracker of Progress Against Actions. This Tracker has been updated on a quarterly basis and provided to the National Cancer Recovery Group as the oversight body of the National Cancer Plan.
The data reflect a reduction in patients with earlier stage disease being diagnosed. The progressive nature of cancer means that it is likely that outcomes for these patients will be poorer if they are diagnosed at a later stage. Continued monitoring and analysis of trends will be important to understand the longer-term effects of the pandemic on cancer in Scotland.
The impact of deprivation continues to persist in relation to screening uptake, diagnosis and mortality, reflecting the ongoing need to tackle health inequalities.
For treatment, there is some evidence of a recovery in services. For instance, after a marked fall in appointments for Systemic Anti-Cancer Treatment early in the pandemic, patient numbers are now higher than pre-pandemic levels.
While services have remobilised, further waves of the virus have slowed the recovery of services due to the need to again pause or reduce services due to increased staff absence and the need to divert resources because of an increase in unscheduled hospitalisations, as highlighted in Public Health Scotland’s analysis of NHS Waiting Times. This has meant that a number of actions, particularly those involving frontline staff, were paused, re-phased, or re-scoped as reported in the previous sections that have described progress in relation to the individual actions.
Data and Evidence for a New Cancer Strategy
A new cancer strategy is being developed, which will take lessons from this report’s update on progress against actions in the National Cancer Plan. This new strategy will build on successful initiatives such as the flagship actions.
For the new strategy, a monitoring and evaluation framework will be designed to measure data on the wider cancer context in Scotland, and to provide evidence on progress against specific actions associated with the new strategy. Findings from this report will be used as a baseline to support evaluation activities.
This report has collated data that was available up to August 2022. Forthcoming evidence linked to actions in the National Cancer Plan will contribute to baseline data for the new strategy. Table 2 below summarises further planned data, evaluation and research that will report in the next year that will be relevant to the new strategy.
|Action||Commitment Area||Type of Evidence|
|1&2||Transforming Cancer Care||Service activity, Patient outcomes|
|3||A Single Point of Contact Pilots||Evaluation data|
|4||Scottish Cancer Patient Experience Survey||Survey data|
|10||Vaginal Self-Sampling Pilot||Evaluation data|
|12||Rapid Cancer Diagnostic Services||Evaluation data|
|15||Cytosponge™ & Colon Capsule Endoscopy||Service activity, Patient outcomes|
|18&19||National Cancer Diagnosis Audit||Audit data|
|19||Urgent suspicion of cancer referrals||Service activity|
|20||Framework for Effective Cancer Management||Quality Performance Indicators|
|22||Redesign of Liver and Pancreatic Pathways||Audit of patient experience|
|24||Prehabilitation||Evaluation data, Survey data|
|25||A Focus on Lung Cancer||Detect Cancer Early data|
|30||Feasibility of Lung Health Checks||Research data|
|59||National NHS Near Me Data||Patient Outcomes|
|62||Radiotherapy Data||Bespoke analysis|
|66||Cancer Waiting Time Data||Audit data|
* Some data will contain management information and so not all data will be publicly available.
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