Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent discussions she has had with NHS England on ensuring that cancer is (a) diagnosed and (b) treated as quickly as possible.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department engages in ongoing discussions with NHS England, and is taking steps to reduce cancer diagnosis and treatment waiting times across England. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.

Recently, following ministerial approval, NHS England consolidated the cancer waiting times standards on 1 October 2023. This followed the clinically led review of standards across the National Health Service, which recommended consolidating cancer waiting times from 10 standards into three. The three standards are: the Faster Diagnosis Standard (FDS), ensuing a maximum 28-day wait for communication of a definitive cancer or non-cancer diagnosis for patients referred urgently, or those identified by NHS cancer screening; a maximum 62-day wait to first treatment from urgent general practitioner referral, NHS cancer screening, or consultant upgrade; and a maximum 31-day wait from the decision to treat to any cancer treatment starting, for all cancer patients.

To achieve the FDS target and early diagnosis, NHS England has implemented a non-symptom specific pathway for patients who present with non-specific symptoms, or combinations of non-specific symptoms, that can indicate several different cancers, and a Best Timed Practice Pathway to ensure patients are diagnosed or told that cancer is ruled out within 28 days of an urgent referral.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what discussions she has had with NHS England on the impact of staffing on the (a) National Cancer Patient Experience Survey programme and (b) collection of data on people with pancreatic cancer.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

We are not aware of an impact of staffing on the National Cancer Patient Experience Survey programme, or on the collection of data on people with pancreatic cancer.

The Department is working closely with NHS England to make sure we have the right workforce with the right skills, across the country. In 2023, the National Health Service published the first ever Long Term Workforce Plan, backed by over £2.4 billion of Government funding, to deliver the biggest training expansion in NHS history. Regarding cancer specifically, the number of staff in the cancer workforce has increased by 50% since 2010.

The 2022 National Cancer Patient Experience survey showed respondents’ average rating of care was 8.8 out of 10, with zero being very poor and 10 very good. 75.5% of respondents said they definitely received the right amount of support for their overall health and wellbeing from hospital staff.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what estimate they have made of the average monthly proportion of lower gastrointestinal cancer patients started treatment within 62 days of referral for each year figures are available.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The following table shows the average monthly proportion of lower gastrointestinal cancer patient starting treatment within 62 days of referral:

Source: NHS England Cancer Waiting Times data

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what progress has been made on the Government's major conditions strategy with specific reference to breast cancer; and if she will make a statement.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

In the development of the Major Conditions Strategy, we are considering how we improve outcomes for people in this country living with multiple conditions. Aligning work across several groups of conditions including cancer for this strategy, will allow us to focus on where there are similarities in approach and ensure care is better centred around the patient, maximising existing resources both within patient pathways and in integrating between pathways.

Improving early diagnosis of cancer, including breast cancer, is a priority for the Government. The National Health Service has an ambition to diagnose 75% of cancers at stage 1 or 2 by 2028, which will help tens of thousands of people live for longer. We know that breast cancer remains the most common cancer in England, with over 49,000 people being diagnosed each year. Thanks to advances in screening, treatment, and care, alongside NHS awareness campaigns, more women are surviving the disease than ever before.

The NHS Cancer Programme has also commissioned five new cancer clinical audits, including primary and metastatic breast cancers. These will provide timely evidence for cancer service providers of where patterns of care in England may vary, will increase the consistency of access to treatments, and help stimulate improvements in cancer treatment and outcomes for patients.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she has held discussions with NHS England on the need for a dedicated and specific cancer plan.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department works closely with NHS England on a wide range of issues relating to cancer, and to deliver the key priorities on cancer as set out in the NHS Long Term Plan. Current priorities include work on improving cancer survival rates through earlier diagnosis, and reducing cancer treatment waiting times across England, including the time between an urgent general practice referral and the commencement of treatment. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment activity.

On 14 August 2023, the Government published a strategic framework for the Major Conditions Strategy to consider the six conditions, including cancer, that contribute most to morbidity and mortality across the population in England. This is because we recognise that most cancer patients will have at least one other condition, so we are developing a Major Conditions Strategy that will include cancer. The Major Conditions Strategy will apply a geographical lens to each condition, to address regional disparities in health outcomes, supporting the levelling up mission to narrow the gap in healthy life expectancy by 2030.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps her Department is taking to increase the number of patients with lower gastrointestinal cancers who receive their first treatment within 62 days of being urgently referred by their GP.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The Department is taking steps to reduce cancer treatment waiting times across England, including the time between an urgent general practice referral and the commencement of treatment for cancer for patients. The Government is working jointly with NHS England on implementing the delivery plan for tackling the COVID-19 related backlogs in elective care, and plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment.  Interventions include a pathway re-design to maximise capacity, including comprehensive faecal immunochemical test implementation to detect lower gastrointestinal cancers faster.

In the 2023/24 Operational Planning Guidance, NHS England announced that it is providing over £390 million in cancer service development funding to Cancer Alliances in each of the next two years, to support delivery of the strategy and the operational priorities for cancer, which includes increasing and prioritising diagnostic and treatment capacity.

Additionally, the Government published the Major Conditions Strategy Case for Change and Our Strategic Framework on 14 August 2023, which sets out our approach to making the choices over the next five years that will deliver the most value in facing the health challenges of today, and of the decades ahead, including for cancer.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what criteria were used to determine the cancer types selected for the evaluation of treatment and services by the Royal College of Surgeons and NHS England; and whether an assessment was made of the potential merits of including liver cancer in that study.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The cancer clinical audit review undertaken in 2021 was based on the level of variation apparent, based on proxy indicators and the difference in outcomes we might expect that variation to result in. This led to five new cancer clinical audits being commissioned in 2022, with liver cancer being taken into consideration during the selection process, but not proposed for an audit at that time.

As part of NHS England’s commitment to implementing wider NHS Long Term Plan actions relating to both cancer and liver disease detection and management, there have been discussions as to whether a review of adult liver services should be undertaken in the future. Should such a review take place, the Specialised Commissioning Hepatobiliary Clinical Reference Group will be a key contributor, working in collaboration with colleagues responsible for non-specialised aspects of the liver pathway, including the Hepatitis C and early diagnosis programmes, as well as integrated care boards. The case for a review of liver services will be considered in the context of available resources, taking into account the other priorities to be delivered by the NHS England specialised commissioning team, other related national programmes, and local commissioning teams.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what recent assessment she has made of the effectiveness of (a) community liver health checks, (b) primary care pilots and (c) surveillance for hepatocellular carcinoma as part of NHS England's early detection of liver cancer programme.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

The care of and treatment for patients with cancers, including liver cancer, is a priority for the Government. National Health Service cancer standards have been reformed with the support of clinicians to speed up diagnosis for patients, which means people will receive a diagnosis or have cancer ruled out within 28 days from urgent cancer referral from their general practice. NHS England’s Early diagnosis of Liver Cancer Programme is contributing to deliver the NHS Long Term Plan’s commitment to diagnose 75% of all cancers at stage one or two by 2028.  Identifying those at risk and ensuring patients are tested and referred to a surveillance programme, where necessary, will lead to improved patient outcomes.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure equitable access to cancer treatment and care across different regions of the UK; and what steps they are taking to improve cancer survival rates.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Reducing inequalities and variation in cancer treatment is a priority for this Government as is increasing early cancer diagnosis, as this is a key contributor to reducing cancer health inequalities. People in deprived areas are at greater risk of contracting cancer, more likely to have a cancer diagnosed at a later stage and suffer from higher cancer death rates and poorer survival. Survival rates have been improving for almost all cancers and across all demographics, with 74.6% people surviving a year after diagnosis, up from 65.6% in 2005, and 55.7% surviving five years, up from 47.9% in 2005.

The National Health Service has rolled out Targeted Lung Health Checks, prioritising more deprived areas, so that people in the most deprived quintile are now more likely to be diagnosed with lung cancer at an early stage, namely stage one or two, than those in the least deprived quintile, giving them a much greater chance of survival.

On 14 August 2023, the Government published a strategic framework for the Major Conditions Strategy to consider the six conditions, including cancer, that contribute most to morbidity and mortality across the population in England, including cancer. The Major Conditions Strategy will apply a geographical lens to each condition to address regional disparities in health outcomes, supporting the levelling up mission to narrow the gap in healthy life expectancy by 2030.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the potential merits of publishing a dedicated cancer strategy.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

On 24 January 2023, the Government announced plans to publish the Major Conditions Strategy, which will focus on tackling the six major conditions groups: cancers, mental ill-health, cardiovascular disease including stroke and diabetes, dementia, chronic respiratory diseases, and musculoskeletal disorders, that account for around 60% of ill-health and early death in England. Addressing cancer together with other major conditions will allow the Department and NHS England to focus on similarities in approach, ensuring care is better centred around the patient.

Following the call for evidence for a 10-year cancer plan in 2022, the Department received over 5,000 submissions. These findings are being fed into the development of the Major Conditions Strategy.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she plans to take to tackle less survivable cancers in the Major Conditions Strategy.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

Cancer is being diagnosed at earlier stages, more often, with survival rates improving across almost all types of cancer with the National Health Service seeing and treating record numbers of cancer patients over the last two years.

The planned Major Conditions Strategy will look at the early diagnosis and treatment of cancer. The strategy will look at a wide range of interventions and enablers to improve outcomes and experience for a range of cancer patients, including those less survivable cancers. We have already acted upon some of the areas that the 2020 Less Survivable Cancer Taskforce report requested, for example the introduction of targeted lung health checks, trials for cytosponge, and the roll out of non-specific symptom pathways. The report is available at the following link:

https://lesssurvivablecancers.org.uk/our-asks/

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of implementing a dedicated cancer strategy to work in conjunction with the Major Conditions Strategy.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

On 24 January 2023, the Government announced plans to publish the Major Conditions Strategy, which will focus on tackling the six major conditions groups: cancers, mental ill-health, cardiovascular disease including stroke and diabetes, dementia, chronic respiratory diseases, and musculoskeletal disorders, which together account for approximately 60% of ill-health and early death in England. Addressing cancer together with other major conditions will allow the Department and NHS England to focus on similarities in approach, ensuring care is better centred around the patient.

Following the call for evidence for a 10-year cancer plan in 2022, the Department received over 5,000 submissions. These findings will be fed into the development of the Major Conditions Strategy.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the Royal College of Radiologists’ 2022 Workforce Census, what assessment he has of the adequacy of the size of the NHS clinical oncology workforce.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

In June 2023, NHS England published the NHS Long Term Workforce Plan, which sets out the steps the National Health Service and its partners need to take to deliver a workforce that meets the changing needs of the population over the next 15 years.

The Government is backing the plan with over £2.4 billion funding over the next five years to ensure additional education and training places. This is on top of increases to education and training investment, reaching a record £6.1 billion over the next two years.

We are taking steps to build our cancer workforce. As of August 2023, there are currently over 1,600 full time equivalent (FTE) doctors working in the speciality of clinical oncology in NHS trusts and other core organisations in England. This is over 70 or 4.9% more than last year, almost 300 or 22.1% more than 2019, and almost 630 or 61.9% more than in 2010.

This includes 880 FTE consultants. This is 34 or 4.0% more than last year, almost 130 or 17.1% more than in 2019, and over 390 or 80.6% more than in 2010.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to reduce waiting times for cancer treatment.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

• Improving cancer treatment waiting times is a top priority for the government and is a key focus of our elective recovery plan, backed by an additional £8bn in revenue funding across the Spending Review Period.

• In the 2023/24 Operational Planning Guidance, NHS England announced it is providing over £390m to Cancer Alliances. This will support delivery of operational priorities for cancer which includes increasing and prioritising cancer treatment capacity.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether she plans to publish a long-term cancer strategy for England.

Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)

On 24 January 2023, the Government announced that it will publish a Major Conditions Strategy, spanning six major conditions including cancer. This will focus on delivering better, joined-up and holistic care to address the needs of patients, rather than focusing on one illness at a time.