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News Article
NHS to test using drones to fly chemotherapy drugs to Isle of Wight
Patient Safety Learning posted a news article in News
The NHS plans to use drones to fly chemotherapy drugs to cancer patients in England to avoid the need for long journeys to collect them. The devices will transport doses from Portsmouth to the Isle of Wight in a trial that, if successful, will lead to drones being used for similar drops elsewhere. They will take 30 minutes to travel acrss the Solent, which will save patients on the island a three to four-hour round trip by ferry or hovercraft. On Tuesday, Amanda Pritchard, NHS England’s chief executive, unveiled the move to help mark the 74th anniversary of the health service’s creation by the postwar Labour government. “Delivering chemo by drone is another extraordinary development for cancer patients and shows how the NHS will stop at nothing to ensure people get the treatment they need as promptly as possible, while also cutting costs and carbon emissions,” she said. Read full story Source: The Guardian, 5 July 2022 -
News Article
Three-month ‘urgent’ cancer waits top 10,000 for the first time
Patient Safety Learning posted a news article in News
More than 10,000 people are waiting three months or longer following an urgent referral for suspected cancer, internal NHS data seen by HSJ reveals. Patients with suspected cancer are not supposed to wait more than two months from a referral. However, information shared with HSJ shows that of the 313,000 people on the national cancer waiting list, just over 10,000 had waited 104 days or more. Information about three-month cancer waits is not made public on a regular basis. NHS England publishes data for the total backlog of patients waiting over 62 days, but does not make public the regional or trust-level results, or reveal how many patients are waiting three months or more. One senior figure in cancer policy told HSJ the backlog position was “awful” and “a reflection of a worsening trajectory overwhelming diagnostic capacity in particular”. Breast, skin and lower gastro-intestinal cancers saw the biggest increases in long waiters. Read full story (paywalled) Source: HSJ, 5 July 2022 -
Content ArticleClosed-loop communication—when every test result is sent, received, acknowledged and acted upon without failure—is essential to reduce diagnostic error. This requires multiple parties within the healthcare system working together to refer, carry out tests, interpret the results and communicate them in language the patient can understand. If abnormal test results are not communicated in a timely manner, it can lead to patient harm. This Quick Safety case study looks at the case of a 47-year-old school teacher who had a screening mammogram. The radiologist identified a suspicious area of calcifications, which required follow up. The patient’s GP was not on the same electronic medical record (EMR) as the imaging centre and, because of front office changes, missed the notification to follow up. The patient was told that the radiologist would contact her if the results were abnormal and therefore assumed she was okay. A year later when seeing her GP, the patient was told that she needed follow-up testing and that she had stage 3 cancer. Her lesion had grown significantly, and she now required surgery, chemotherapy and radiation for advanced breast cancer. The case study suggests safety actions that should be considered to prevent this error from happening again.
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News ArticleThe NHS is wasting time and money due to a ‘culture of overtreatment’ in cancer care, a report has revealed. An All-Party Parliamentary Group paper released on Tuesday on minimally invasive cancer treatments (MICTs) found only 10 per cent of cancer patients are offered non-invasive treatments. This is despite many of these treatments being recommended by the National Institute for Health and Care Excellence (NICE). And many doctors and patients remain in the dark about some of the newer treatments due to ‘a severe lack of education’ . The APPG, which is made up of different political parties and peers, was formed to drive awareness of Minimally Invasive Cancer Therapies - proven cancer treatments that provide similar outcomes to cancer surgery but are more targeted and less invasive than traditional surgery. Paul Sayer, founder of charity Prost8, which launched its ‘ONE in EIGHT’ campaign to help men with prostate cancer get better access to minimally invasive treatment, said: “The report has identified a culture of overtreatment even when it’s not the best or safest option. Read full story Source: The Independent, 29 June 2022
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News Article
Are we failing young people with cancer?
Patient Safety Learning posted a news article in News
When you think of cancer, a glamorous mum in her mid-30s is not the first image that springs to mind. But You, Me and the Big C podcaster Dame Deborah James was just 35 when she found out she had bowel cancer. Blood and stool tests had come back normal and her GP had laughed "not once, but three times over the course of six months" at the idea she could possibly have a tumour in her bowels. The diagnosis came only when she paid to have her colon examined privately. Her experience has raised questions about how good we are at spotting and treating cancer in the under-40s. Simply - are we failing young people with cancer? Overall, around 4.3% of cancers diagnosed in the UK are in the under-40s, while those over 75 make up more than a third of all cancer cases, which poses a challenge for us and the doctors who treat us. When we are young, we're less likely to attribute any ill health to cancer. Changes to our bowel movements could just be stress, blood in the toilet after we poo could be inflammatory bowel disease or haemorrhoids. Because, for most people, cancer is something that happens to our parents or grandparents. Your doctor should be alert to major warning signs of cancer, but there is a medical saying: "When you hear hooves, think horses, not zebras". It's a call to look for the most common or likely explanation, and the younger you are, the less likely cancer is to be behind your symptoms. This helps channel the health service's limited resources to those most likely to need them. But that means some younger people aren't being seen quickly enough, although the problem can affect older people too. Bowel Cancer UK's Never Too Young report in 2020 found that four in 10 people surveyed had to visit their GP three or more times before being referred for further tests to see if they had cancer. "I don't think GPs are a problem," says Genevieve Edwards, chief executive of Bowel Cancer UK. "It [bowel cancer] is rare in younger people... It will usually be something else." The question is - what if you are the zebra, that relatively rare case who does have cancer at a young age?" Read full story Source: BBC News, 14 May 2022 -
Content ArticleThis article in The BMJ examines the risks and benefits of current prostate cancer screening methods in the UK. It highlights issues that prevent early diagnosis including great variation in how prostate cancers behave and the poor performance of prostate specific antigen (PSA) testing in identifying disease that requires treatment. As a result of the limited benefits of screening for prostate cancer, routine screening is not recommended by the UK’s National Screening Committee or the US Preventive Service Task Force. The authors highlight that a bid by NHS England to find an estimated 14,000 men who have not yet started treatment for prostate cancer due to the pandemic, seems to contradict this recommendation. The NHS campaign warns that people shouldn’t wait for symptoms and encourages men to use a risk checker which informs patients of risk factors including family history, age and ethnicity. The authors express concern that the campaign implies there is great benefit in detecting asymptomatic disease, which could lead people to believe that the NHS is promoting screening. They argue that the NHS needs to be clearer and more consistent in its messaging, making sure that information aimed at the public emphasises that although PSA testing is available on request for men older than 50, it is not currently recommended, and why.
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Content ArticleThis retrospective cohort study in the British Journal of General Practice aimed to identify opportunities for timely investigations or referrals in patients presenting with potential symptoms of colon and rectal cancer, or abnormal blood tests. The study found evidence that patients with these cancers presented with low haemoglobin, high platelets and high inflammatory markers as early as nine months pre-diagnosis, and the authors suggest that starting cancer-specific investigations or referrals earlier may be beneficial in patients with some of these diagnostic markers.
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News Article
High Street pharmacists to make cancer referrals
Patient Safety Learning posted a news article in News
People with a worrying cough, problems swallowing or blood in their urine will soon be able to be referred for scans and checks by a pharmacist, rather than having to wait to see their GP. The new pilot scheme, in England, aims to diagnose more cancers early, when there is a better chance of a cure. High Street pharmacies will be funded to refer customers for the checks. The NHS will also send out more "roaming trucks" to perform on-the-spot scans in the community. Lung-scanner vans driven to locations, including supermarket car parks and football stadiums, have already resulted in more people having checks. Now, some liver lorries will join them. Health and Social Care Secretary Sajid Javid said: "Ensuring patients can access diagnosis and treatment easily in their communities and on High Streets is a fundamental part of our 10-Year Cancer Plan." Dr Anthony Cunliffe, national clinical adviser for primary care, at Macmillan Cancer Support, said: "Doctors and nurses are working tirelessly to diagnose and treat the tens of thousands of people entering a very busy cancer care system. "This pilot will give people the opportunity to access more trained professionals in their community to get symptoms investigated." Read full story Source: BBC News, 15 June 2022 -
Content ArticleThis ITV documentary tells the story of how surgeon Ian Paterson duped his patients into believing they had cancer and performed unnecessary surgeries on them, before he was caught and jailed for 20 years in 2017. It features personal accounts of patients who were harmed by Paterson while he worked in NHS and private practice. Further reading: Report of the independent Inquiry into the issues raised by Paterson (4 February 2020) Patient Safety Learning’s response to the Paterson Inquiry (11 February 2020) Government response to the independent inquiry report into the issues raised by former surgeon Ian Paterson (16 December 2021)
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Content ArticleFew things are more devastating than a cancer diagnosis, shares Maria Caulfield, minister for women’s health. She should know – she’s worked on a cancer ward for the best part of twenty five years and supported women through diagnosis, treatment, and recovery. Here, she speaks exclusively to Marie Claire UK about her ten year plan and how we can make gynae issues a thing of the past. Not only does she want to prevent the five gynaecological cancers, but she wants to help make sure we diagnose them early, too: we know that the earlier you are diagnosed, the higher your chance of survival.
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News Article
Doctors' concern over reduced mention of women in NHS advice
Patient Safety Learning posted a news article in News
Leading doctors say they have concerns about the NHS reducing mentions of the word "women" in ovarian cancer guidance. They say "it may cause confusion" and create barriers to care. But NHS Digital, which writes the online advice, said they wanted to make it relevant for everyone who needs it. The updated guidance now says that people with ovaries, such as trans men, can also be affected. Until February, the NHS guidance began by explaining ovarian cancer was "one of the most common types of cancer for women". Now, the only specific mention of women comes on the third page with the explanation that ovarian cancer can affect "women, trans men, non-binary people and intersex people with ovaries". NHS Digital said the changes were introduced to make the advice more relevant and inclusive. The Royal College of Obstetricians and Gynaecologists, which represents thousands of women's health specialists and pregnancy doctors, said the language used "does need to be appropriate, inclusive and sensitive to the needs of individuals whose gender identity does not align with the sex they were assigned at birth". But it added: "Limiting the term 'woman' to one mention may cause confusion and create further barriers for some women and people trying to make an informed choice about their care. "We would therefore support the use of the word 'woman' alongside inclusive language." Read full story Source: BBC News, 8 June 2022 -
News ArticleWhen Jenny* had a mastectomy after being diagnosed with breast cancer, she believed the major surgery to remove her breast, although traumatic, had saved her life. She described feeling “rage” when at a follow-up appointment three years later, she said to her surgeon, “I would probably be dead by now” if she had not received the surgery, to which he replied: “Probably not.” It was only then, after she had already undergone invasive and life-changing treatment, that Jenny learned about “overdiagnosis”. While breast cancer screening programs are essential and save lives, sometimes they also detect lumps that may never go on to cause harm in a woman’s lifetime, leading to overtreatment, and psychological and financial suffering. Jenny is 1 of 12 women from the UK, US, Canada and Australia whose stories were published in the medical journal BMJ Open. It is the first study to interview breast cancer patients who believe they may have received unnecessary and harmful treatment, highlighting the effect this has had on their lives. “The usual story of breast cancer screening is ‘screening saves lives’,” an author of the study and a professor of public health at the University of Sydney in Australia, Alexandra Barratt, said. “This study reports the other side of the story – how breast cancer screening can cause harm through overdiagnosis and overtreatment.” Read full story Source: The Guardian, 8 June 2022
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Content ArticleThis study from Pickles et al. explores experiences of women who identified themselves as having a possible breast cancer overdiagnosis.
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News Article
Racial disparity in cancer diagnoses via screening in England
Patient Safety Learning posted a news article in News
Black people are more than a third less likely than white people to be diagnosed with cancer via screening in England, according to the first study of its kind, prompting calls for targeted efforts to improve their levels of uptake. Screening programmes save lives by preventing cancer from occurring or spotting it earlier, when treatment is more likely to be effective. In England, screening for cervical cancer is offered to women aged 25 to 64, breast cancer screening is offered to women aged 50 to 70, and everyone aged 60 to 74 is offered a bowel cancer screening home test kit every two years. The latest research, however, lays bare stark disparities in screening diagnosis rates between different ethnic groups for the first time. The study of more than 240,000 cancer patients over a decade found that 8.61% of patients were diagnosed via screening. Broken down by ethnicity, the figure for white people was 8.27%, almost exactly the same as the national average, but among black people it was 5.11%. The findings suggests that black people are 38% less likely to be diagnosed via screening than white people. Diagnosis via screening in mixed-race patients was much higher at 9.49%, and higher still in Asian patients at 10.09%, almost double the rate for black patients. The results were published in the British Journal of Cancer. Jabeer Butt, the chief executive of the Race Equality Foundation, said the findings should prompt urgent action. “Cancer screening saves lives,” he said. “That’s why it is so important that effective outreach and culturally appropriate interventions are prioritised to reduce health inequalities. “We know that awareness of cancer symptoms is lower among minority ethnic groups, particularly black Africans, with higher reported barriers to seeking help. But we also know from previous research on colorectal cancer interventions that speaking to someone who explains the steps of the screening process ahead of time can lead to improvements in screening uptake in minority patients." Read full story Source: The Guardian, 6 June 2022 -
Content ArticleUK Asian and Black ethnic groups have poorer outcomes for some cancers and are less likely to report a positive care experience than their White counterparts it was found in a study from Martins et al. reported in the British Journal of Cancer. The study investigated ethnic differences in the route to diagnosis (RTD) to identify areas in patients' cancer journeys where inequalities lie and targeted intervention might have optimum impact. Across the 10 cancers studied, most patients were diagnosed via the two-week wait (36.4%), elective GP referral (23.2%), emergency (18.2%), hospital routes (10.3%), and screening (8.61%). Patients of Other ethnic group had the highest proportion of diagnosis via the emergency route, followed by White patients. Asian and Black group were more likely to be GP-referred, with the Black and Mixed groups also more likely to follow the two-week wait route. However, there were notable cancer-specific differences in the RTD by ethnicity. These findings suggest that, where inequalities exist, the adverse cancer outcomes among Asian and Black patients are unlikely to be arising solely from a poorer diagnostic process.
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News Article
Cervical screening every five years ‘prevents as many cancers as every three’
Patient Safety Learning posted a news article in News
Women could be screened for cervical cancer every five years instead of every three and as many cancers could still be prevented, a new study suggests. Researchers at King’s College London said that screening women aged 24 to 49 who test negative for human papillomavirus (HPV) at five-year intervals prevented as many cancers as screening every three years. The study of 1.3 million women in England, published in the BMJ, found that women in this age group were less likely to develop clinically relevant cervical lesions, abnormal changes of the cells that line the cervix known as CIN3+, and cervical cancer three years after a negative HPV screen compared to a negative smear test. Lead author Dr Matejka Rebolj, senior epidemiologist at King’s College London, said the results were “very reassuring”. She added: “They build on previous research that shows that following the introduction of HPV testing for cervical screening, a five-year interval is at least as safe as the previous three-year interval. “Changing to five-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.” Read full story Source: The Independent, 31 May 2022 -
News ArticleCovid-19 vaccination is effective for cancer patients but protection wanes much more rapidly than in the general population, a large study has found. Vaccine effectiveness is much lower in people with leukaemia or lymphoma, those with a recent cancer diagnosis, and those who have had radiotherapy or systemic anti-cancer treatments within the past year, according to the research published in Lancet Oncology. The authors of the world’s largest real world health system evaluation of Covid-19 in cancer patients highlighted the importance of booster programmes, non-pharmacological strategies, and access to antiviral treatment programmes in order to reduce the risk that Covid-19 poses to cancer patients. Peter Johnson, professor of medical oncology at the University of Southampton and joint author of the study, said, “This study shows that for some people with cancer, covid-19 vaccination may give less effective and shorter lasting protection. This highlights the importance of vaccination booster programmes and rapid access to covid-19 treatments for people undergoing cancer treatments.” Study leader, Lennard Lee, department of oncology, University of Oxford, said, “Cancer patients should be aware that at 3-6months they are likely to have less protection from their coronavirus vaccine than people without cancer. It is important that people with a diagnosis of cancer are up to date with their coronavirus vaccination and have had their spring booster if they are eligible.” Read full story Source: BMJ, 24 May 2022
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News Article
Breast cancer screening process in Scotland to change after recent errors
Patient Safety Learning posted a news article in News
NHS Scotland is to change the way women are called to breast cancer detection appointments after major recent errors in the screening programme. Some eligible for screening were not invited because they had moved between GP practices or were aged over 71 by the time their practice was called. Women aged 50 to 70 are invited for appointments once every three years, based on their GP practice. It emerged hundreds of women in NHS Lothian may have missed screenings. The health board said in January that 369 women considered to have a higher risk of developing the disease may not have received appointments at the right time. A major review of the programme in Scotland has made 17 recommendations to strengthen and improve services. They include: A more "person-centred" approach based on calling individual women - rather than the GP practice where they are registered - to set their next test date. Greater flexibility of appointments to provide better access and uptake, with more contact such as texts or phone calls to keep appointments on patients' radar. An online appointment cancellation and rebooking system to provide greater individual convenience. Evening and weekend appointments and more availability in rural and semi-urban locations. Read full story Source: BBC News, 24 May 2022 -
News ArticleObese adults in Britain are on course to outnumber those who are a healthy weight within five years, a stark report has revealed. Experts have warned there will be a “tipping point” in 2027 when one third of adults will be obese if current trends continue. By 2040, they predict there will 21 million people classed as obese in the UK, and 19 million deemed to be overweight. The analysis by Cancer Research UK shows seven in 10 (71%) people will be overweight or obese by 2040. Of this, almost four in 10 (36%) adults will be obese. At present, 64% of adults are overweight or obese, with figures rising every year. Being overweight or obese increases the risk of at least 13 different types of cancer and also causes other conditions such as high blood pressure and Type 2 diabetes. The new data comes after former Conservative leader William Hague attacked the government for postponing a ban on “buy one get one free” deals for foods high in fat, salt and sugar for a year because of the cost-of-living crisis. Read full story Source: The Independent, 19 May 2022
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Content ArticleThe results of an analysis published by Cancer Research UK estimate that more than 21 million UK adults will be obese by 2040, which equates to almost 4 in 10 of the UK adult population (36%). The analysis also suggests that if current overweight and obesity trends continue, the number of UK adults who are overweight or obese may exceed this, reaching around 7 in 10 people, or 42 million people, by 2040, 71% of the population. Worryingly, the report also indicates that the number of people who are obese could overtake the number who are a healthy weight in the UK by 2040. This ‘tipping point’ could happen as early as the late 2020s for the UK as a whole and England, with Northern Ireland following suit in the late 2030s. For Scotland and Wales, the crossover is not expected to happen before 2040. The report also suggests those experiencing higher levels of deprivation could suffer the most. In England in 2019, 35% of people living in the most deprived areas were obese, and this is estimated to increase to almost half (46%) by 2040. In comparison, 22% of people living in the least deprived areas were obese in 2019 and this is estimated to increase to 25%. These projections predict an increase in the relative deprivation gap for obesity prevalence between the least and most deprived quintiles by 13%, from 45% in 2019, to 58% by 2040 in England. Obesity increases the risk of at least 13 different types of cancer. Every year around 22,800 cases of cancer in the UK are due to being overweight or obese. More research is needed to understand the link between obesity and cancer.
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News Article
Cancer recovery target will be missed, says national leader
Patient Safety Learning posted a news article in News
The NHS will miss its target to return cancer treatment waits to pre-covid levels by next March, a national cancer leader has said. When asked at the HSJ Cancer Forum whether the service would be back to “business as usual” performance by next spring, Liz Bishop, who sits on NHS England’s national cancer board, said: “I think it depends on what you mean by ‘business as usual’. “If you mean hitting the 62-day numbers, and the 104-day numbers, by next March, then no. If I am honest, I don’t think we will. “Do I know when that date will be? No, I don’t know. But what I do know is that everyone is working really hard to do it and get there.” NHSE initially said the number of patients waiting longer than 62 days for treatment following an urgent referral would return to pre-pandemic levels by March this year, but has since pushed this back to March 2023. Read full story (paywalled) Source: HSJ, 18 March 2022 -
Content ArticleThis first report in National Voices' ‘Behind the Headlines’ series gathers insight and intelligence from member organisations on what the cost of living crisis means for people living with ill health. It examines the close link between poverty and health, highlighting that people living in poverty are more likely to be living in poor health. Equally, lack of support for people living with ill health and disability can make people poor. The report gathers case studies and data on topics including include cancer, kidney conditions, older people and homelessness. It makes a set of recommendations based on this insight.
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News Article
More than 65,000 people are left waiting to find out if it’s cancer each month
Patient Safety Learning posted a news article in News
New calculations from Cancer Research UK estimate that, on average, over 65,000 people in England are left waiting longer than 28 days to find out whether they have cancer each month. These estimates are based on the latest data from the Faster Diagnosis Standard (FDS). The FDS is a performance standard introduced by Government in 2021. It’s used to better capture how long people on certain cancer-related referrals wait for a diagnosis. This applies to people referred by their GP urgently with suspected cancer, following breast symptoms, or have been picked up through cancer screening. The current FDS target is set at 75%, meaning three quarters of people being urgently referred should be told they have cancer or given the all-clear within that timeframe. However, this target has yet to be met. In addition, the data has revealed major variation across the country – with only 78 of 143 trusts meeting the 75% target. This means that despite the tireless efforts of NHS staff, chronic capacity issues mean that people continue to be failed by the system. Michelle Mitchell, our chief executive, said: “As a country we should not be willing to accept that over 1 in 4 people on an urgent referral are left waiting over a month to find out whether they have cancer. Nor should we stand for the variation that exists across the country.” The charity is calling on Government to include a more ambitious target within its upcoming 10-year cancer plan, to help ensure around 54,300 more people each month receive a diagnosis or have cancer ruled out within a month. With a robust plan and sustained investment to build a cancer workforce fit for the future, patients will be diagnosed quicker and earlier, which will save more lives. Read full story Source: Cancer Research UK, 9 May 2022 -
News Article
Cancer checks: Record number of patients referred in England
Patient Safety Learning posted a news article in News
A record 2.7 million people were referred for cancer checks in the last year, NHS England has said. It comes after figures suggested the Covid pandemic saw numbers dramatically decline in 2020. But at least 30,000 people are still waiting to start treatment. Charities have welcomed the increase in referrals but warned of the "devastating" impact the pandemic has had on cancer care. Referrals for suspected cancer remain at about 16% higher than pre-pandemic levels and rose overall from 2.4 million to 2,65m in the past 12 months. Dame Cally Palmer, national cancer director for NHS England, said there were still 30,000 people who had not started treatment due to the pandemic but that the new figures suggested some progress. She said: "We are going further and faster than ever before in our ambitions to diagnose more cancers at an earlier stage so that we can save more lives." It is "vital that we keep these referral rates high", she added. Read full story Source: BBC News, 2 May 2022 -
Content ArticleThis webpage by the British Association of Dermatologists contains a selection of resources about skin cancer and sun safety for patients. it describes the different types of skin cancer, how to get moles checked and how to stay safe in the sun.
