It is an astonishing fact, but every two minutes someone else in the UK is diagnosed with cancer. This is a disease most of us will be affected by in some way, either personally, or as a result of a loved one being diagnosed.
There are more than 200 types of cancer but lung, bowel and prostrate cancers are three of the four most common. It probably comes as no surprise that the most common is breast cancer.
In 2005 more than 45,500 women were diagnosed with breast cancer, that’s around 125 women a day! In addition around 300 men are diagnosed with the disease each year. These are frightening statistics, so is it any wonder that cancer is the number one fear for the British public, beating Alzheimer's, heart attacks and terrorism.
The outgoing Labour Government demonstrated its commitment to the delivery of cancer services with the launch of the Cancer Reform Strategy in 2007. This Strategy is being developed by the National Cancer Director, Professor Mike Richards. The intention is that by 2012 it will be possible to ensure that “every person has access to world class NHS services at every point of the cancer pathway”.
Regrettably, despite the improvements in cancer diagnosis and care, Professor Richards warned that patients are having to undergo more aggressive treatment and even dying unnecessarily due to GPs failures to identify symptoms of cancer and delays in referring them for specialist investigations.
The Government’s Cancer Reform Strategy identified late diagnosis as a major reason why the UK cancer survival rates are so much worse than other countries in Europe. Whilst a joint report by the Department of Health and the National Patient Safety Agency found between January 2004 and November 2006 more than 1,900 patients suffered missed or late diagnosis, the problem is thought to be much greater. Breast, bowel and lung cancer were the likeliest to involve such errors.
In April 2010 Dr Charles West Liberal Democrat Parliamentary Candidate for Shrewsbury and Atcham issued a warning that The Royal Shrewsbury Hospital was expected to lose more services as part of a review of cancer surgery in the area. He identified a trend for the concentration of services in major cities and the ensuing risk to the future of hospitals in the more rural parts of the country such as Shropshire.
It appears he was right to be concerned. The National Cancer Plan published in 2000 designated certain hospitals as cancer centres, and smaller units as cancer units approved for the treatment of particular types of cancer. So for example a hospital might be a designated cancer centre for breast cancer and bladder cancer, but not for stomach cancer.
In 2005 NICE (The National Institute of Clinical Excellence) published “Improving Outcomes Guidance.” It recommended that in some types of cancer too few were being treated in Shrewsbury and that some departments did not fit with their standard model service. They suggested that cancer surgery in certain areas should cease at Shrewsbury.
In 2006 the Greater Midlands Cancer Network was set up. It included The Hospitals at Wolverhampton, Dudley, North Staffs, Shrewsbury and Telford. A review of cancer services was commissioned by the group chaired by Professor M J Lind which reported in November 2009. That report has looked at the numbers of patients undergoing surgery for gynaecological cancers, urological cancers and cancers of the head and neck.
Proposals have now been formally made for the referral of certain cancer patients from Shrewsbury to what are now termed “more specialist services” available at the University Hospital of North Staffordshire, with its new £30 million cancer centre. Interestingly, as an aside, we are now told of a severe shortage of cancer nurse specialists in North Staffordshire who are already said to be unable to cope with high work loads placed upon them.
We still do not know however what if any decisions have been made regarding the provisions of cancer services here in Shrewsbury and the threatened closures.
Cancer remains a disease which demands early diagnosis and prompt specialist treatment. If the future of cancer services in Shropshire is under threat and more and more patients are to be referred, just how will this impact on Patient care? Can we really expect these patients and their families, often coping with the distress of a cancer diagnosis and a life threatening illness, to travel across to Staffordshire for treatment? Will it really improve patient care? Brian Castling a Head and Neck Surgeon at Shrewsbury and Telford NHS Trust has been quoted as saying that patients will only lose out if such services are transferred to fit in with a national plan, and that these decisions are not being made for any proven patient benefit.
Paula Nash is a clinical negligence specialist with Shropshire law firm Lanyon Bowdler, she says “I see all too frequently the impact of a missed or delayed diagnosis on patients and their families. In the aftermath of a cancer diagnosis families rely heavily on local care and support. It is my view that there needs to be a public debate before these decisions are taken.”