The Future of Cancer Care in England

Part 1 of our three part “Right Patient, Right Drug, Wrong Place” series

Favourable lung cancer outcomes in England really are all about Location, Location, Location

It might seem obvious, but a patient with lung cancer in England residing within a ‘culture of care’ (that is a local NHS that emphasises active treatment for the disease) is likely to survive longer than a patient elsewhere in the country where such a culture is lacking.

Not the most ground breaking of statements, I know.

But what if I was to provide some additional numbers behind these:


  • Over 800 patients a year could benefit from meaningfully prolonged survival, if treatment rates everywhere could be increased towards the currently highest levels


(which, in any event, are ‘…still below the levels required for optimal survival outcomes’).


And this statement is pretty damning:


“Lung cancer outcomes in England are inferior to comparable countries”.



Sparked your interest now?

These statements and figures were obtained from a study article published last month (Møller et al. March 2018; details and link below) that concluded that regional variations in lung cancer treatment in England are directly associated with patient survival.

In the case of systemic anti-cancer therapy, the survival gradient between the lowest and highest rates of treatment was largely due to the survival of patients with metastatic disease. Among this group, more active treatment had the potential to reduce the number people dying within 6 months of diagnosis by 318, compared with less active treatment.


“Extending a clinical culture that is active in its use of available therapies will mean more patients will receive the right treatment”.


Again, it’s obvious, but having developed the agents used to provide treatment, pharma has an opportunity to support the clinical community in ensuring this happens.


Pharma just needs to think about how.


The need to raise standards

A second publication, from the National Lung Cancer Audit Annual Report 2017, underlines the issue of variation and the need to raise standards. David Baldwin (chair of the Clinical expert group for lung cancer and mesothelioma, NHS England) sums the situation up well:


“…Although there will always be some variation, which is inevitable as progress is made, I believe that committed, enthusiastic clinicians working in a supportive environment can make a huge difference. The commissioning guidance recommends that all MDTs (Multi-Disciplinary Teams) have committed experts in the same numbers as in the better resourced trusts, and if this cannot be provided within your trust, it is sourced elsewhere and still provided in the local area…”.


End of Part 1.


Join us on Thursday 26th April for the second part of the series, entitled “Achieving world-class cancer outcomes by 2020 — how realistic is this?”, where we look at the present day issues facing cancer patients in England.

Møller H, Coupland VH, Tataru D, et al. Geographical variations in the use of cancertreatments are associated with survival of lung cancer patients.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license

National Lung Cancer Audit Annual report 2017 (for the audit period 2016), January 2018) from the Royal College of Physicians, Care Quality Improvement Department.

Photo credits

  1. photo by nikko macaspac on Unsplash
  2. Photo by Felipe P. Lima Rizo on Unsplash