A ‘radical re-think’ about cancer care services is needed to improve survival rates in the UK, the Health Foundation has said.
The charity’s report, Unfinished businesss, looked at the progress that has been made in cancer care in the NHS over the last two decades but said there remains a ‘gap’ in survival rates in England compared to other countries.
It said the proportion of people being diagnosed with cancer at an early stage in the UK remained almost static between 2015 and 2017.
Despite recent investment in diagnostics equipment, the UK ranks ‘right at the bottom’ of the Organisation for Economic Co-operation and Development for absolute numbers of CT and MRI scanners – ranking 35th out of 37 countries for CT scanners and 31st out of 36 for MRI equipment.
There is also a shortage of staff to operate machinery and report scan results, the Health Foundation warned.
It has called for more investment in the diagnostic workforce and diagnostics equipment to meet the demand for patients needing investigation – including more CT, MRI and endoscopy facilities.
According to the report, the skills mix in diagnostics needs to be addressed, as well as the ‘complicating factor’ of private practice which it said could lead to ‘perverse incentives’ in the workforce.
The exact causes of late diagnosis are not fully understood but GP ‘gatekeeping’ is often cited as a contributing factor, the charity said.
It said GPs in the UK are less likely to refer a patient to hospital or diagnostic services than doctors in comparable countries due to the health service struggling with referral demand – and that patients are ‘uniquely worried about bothering doctors’.
Extra funding as well as changes to the NHS’ gate-keeping model will be required to give the public faster access to primary care and diagnostics services, the report said, and GPs also need to be encouraged to lower their thresholds for referring patients.
Professor Karol Sikora, chief medical director at independent cancer care provider Proton Partners International, said: ‘The current system of incorporating diagnostic services within hospitals is simply not working.’
He said patients with cancer symptoms should be treated in non-hospital based facilities to speed up diagnosis and then refer a patient on to a specialist if needed.
‘That would be a real game changer in cancer diagnostics in the UK and more lives will be saved,’ he added.
Steve Powell, chief diagnostic officer at Rutherford Diagnostics, a subsidiary of Proton Partners International, added: ‘GPs need to be empowered to use CT, MRI and endoscopy services without having to make endless referrals.
‘This will not only lead to quicker diagnoses but will prove hugely cost-efficient too,’ he said.