The seminar focused specifically on issues related to clinical and policy priorities for cancer care in Wales.
The agenda was set against the backdrop of the Quality Statement for Cancer, which sets out quality attributes and the vision for good quality cancer services in Wales, and marks a new approach to cancer care, and a departure from the format of the previous Cancer Delivery Plan.
Stakeholders and policymakers discussed progress, key challenges and the way forward for providing effective, timely and person-centred care, including:
- Impact of the pandemic – tackling waiting lists and missed diagnoses – service recovery and future residence – funding priorities
- Patients – improving experiences and outcomes – and meeting challenges posed by an ageing population
- Service delivery – plans to reconfigure the patient pathway – achieving a more holistic and person-centred approach to care
- Workforce – preparing to meet forecast demand – talent pipeline in specialist areas – recruitment, retention and professional development – supporting staff morale and wellbeing
- Quality – ensuring consistency and high standards of access and care across Wales
- Research & Innovation – support for innovation – assessing the future for digital care – priorities for utilising research and innovation to improve patient experience
- Policy – assessing the key priorities and next steps following the publication of the Quality Statement for Cancer, and outlining what this means for practitioners and patients moving forward
So what is happening in Wales ?
There is a healthcare backlog, as seen elsewhere within UK and beyond, due to the COVID pandemic – with cases of COVID still being reported and admitted to hospital. But new measures have been brought in to help tackle this, whilst addressing the needs of those new to care.
Screening programmes have resumed – please do not miss out on your screening if invited.
Meeting your needs – do discuss with your specialist team about how and when you are being seen, they are there to work with you to ensure your best care.
New referrals and ongoing care – Wales (Govt & NHS) has taken time to develop improved ways of working and starting your care pathway more effectively and efficiently. But there are still challenges due to staffing / workforce availability, resources and in promoting, maintaining and sustaining research and innovation.
Changes in pathway (your route from symptoms to diagnosis and care)
Previous / current pathway started either as:
- an Urgent Suspected Cancer (USC) referral by your GP – where symptoms/ clinical assessment fulfilled specific criteria (usually NICE guidance) and referral is accepted as suspected cancer by secondary care
- a Not Urgent Suspected Cancer (nUSC) referral – for all patients diagnosed with cancer by other referral routes e.g. via A+E, or a surprise finding on an investigation for something else.
The majority of patients in Wales diagnosed with cancer do not come through the USC pathway (~55-65%). Over recent years, a number of audits have been undertaken demonstrating that patients are waiting a long time from the point of suspicion (PoS) of cancer until they start treatment, especially when on the nUSC pathway.
The Wales Cancer Network (WCN), in partnership with the Cancer Site Groups (CSGs) and Multi-disciplinary teams (MDTs) across Wales, are establishing consistent generic and site specific pathways that describe all routes of entry onto the pathways from point of suspicion (PoS). They describe good practice diagnostic and treatment pathways (and opportunities for improvement) and where patients should receive consistent information and support.
The Suspected Cancer Pathway (SCP) is a Welsh Government target for diagnosing cancer and starting treatment more quickly. It also indicates where information and support should be provided across the pathway.
The Single (Suspected) Cancer Pathway (SCP) programme is to improve access to timely and effective diagnostic tests and treatments, ensure patients are supported through the pathway and allow improvement of upstream factors that will improve earlier detection of cancer. The SCP is a Welsh Government target for diagnosing cancer and starting treatment more quickly.
The performance target for the SCP is that at least 75% of patients start their first definitive treatment (FDT) within 62 days of the point of suspicion (POS).
National Optimal Pathways
The NHS Wales National Optimal Pathways (NOPs) have been developed to support the SCP programme of work. The Wales Cancer Network (WCN) has worked with health professionals, third sector organisations, and the Welsh Government to develop these cancer specific NOPs. The pathways are owned and reviewed by the relevant Cancer Site Group (CSG). They describe good practice diagnostic and treatment pathways for site specific cancers to support a shortened time to accurate diagnosis.
The Neuroendocrine cancer NOP development was led by Dr Mohid Khan (Consultant Gastroenterologist, Cardiff and Vale UHB / NET Clinical Lead for Wales) alongside Catherine Powell and Kathryn Cook (Neuroendocrine Tumour CNS’s, Cardiff and Vale UHB) – and is available to read here
This article forms part of series of articles providing updates on cancer care across all 4 UK Nations – with particular reference to how it relates to Neuroendocrine Cancer.