NHS England has announced a new national system for the Cancer Drugs Fund designed to end regional variation in ‘fast-track’ access to cancer drugs.

However, according to the charity Macmillan Cancer Support, the new system has halved the number of indications for which drugs are covered by the fund.

The single national list of drugs approved for ‘fast-track’ funding contains 28 drugs to treat 64 cancer indications, compared to the 129 previously covered by the ten SHAs through the Fund.

The Cancer Drugs Fund, which was established in 2010 and will end in March 2014, provides £200m per year for access to drugs not approved as cost-effective by NICE but requested by doctors for individual patients.

NHS England (formerly the NHS Commissioning Board) took over responsibility for management of the Cancer Drugs Fund from 1 April, ending the regional administration that had seen variations in access to cancer drugs.

Sean Duffy, NHS England’s National Clinical Director for Cancer, said: “Having one consistent method for consideration of overall clinical benefit and funding means that all applications will be assessed by the same criteria. Regional variation of the past is clearly not acceptable for patients.”

Any patient who is already receiving funding for a cancer drug, or has been told they will receive funding as part of an agreed treatment plan, will continue to receive that treatment where clinically appropriate.

The single drugs fund list was developed by the National Cancer Action Team together with the regional clinical leads for the ten former SHAs. A national Clinical Reference Group for Chemotherapy, appointed by NHS England, has approved the proposed list.

However, Mike Hobday, Head of Policy and Research at Macmillan Cancer Support, commented: “It is worrying that the reduced list of cancer drugs that can be funded will restrict access to drugs which were previously routinely available. For rarer cancers, this will be particularly acute.”

Cancer patients in the north of England believe they receive a better experience of care than individuals with the disease in London, a new survey has revealed.

A survey by MacMillan Cancer Support found that nine out of the bottom ten trusts for patient experience were based in the capital; whereas eight out of the top ten performing trusts were located in the north of England.

Harrogate and District NHS Foundation Trust was voted the best performing trust for the second year running with Imperial College Healthcare NHS Trust in London again performing the poorest.

Ciarán Devane (pictured), Chief Executive of Macmillan Cancer Support, said that although hospitals had raised standards “far too many cancer patients are being let down by hospitals failing to provide an adequate level of care.”

The Chief Executive has now called for struggling trusts to “take heed” of the findings and work with the charity to improve the standards of care they offer to patients. “Imperial, while still at the bottom of the table, is committed to addressing the problem and working well with Macmillan and cancer patients,” he said. “But these things take time, and won’t happen if they do not have sustained, top-level commitment.”

In the survey Imperial was criticised on the amount of time outpatients waited to be seen and on the access patients had to a clinical nurse specialist. However, respondents did state that their first appointment with a hospital doctor was sooner than expected.

A spokesperson for the Trust acknowledged that the “experience of some of our cancer patients was below the standard we strive to deliver”.

“We are fully committed to working with Macmillan Cancer Support, as well as other cancer charities and patient groups, and are doing our very best to improve the experience of our cancer patients. We are also continuing to strengthen our relationships with GPs and community services.

“We have listened to patient feedback and have implemented a number of improvement programmes.”

Meanwhile, Harrogate was praised for giving patients easy to understand written information about test results and how ward nurses answered nearly all the questions patients asked.

Research also found that patients with breast cancer felt they were given the best experience of care with those with sarcoma believing they had the poorest experience.

Top 10 performing trusts

*ranked on the number of times they appear in the top 20% of Trusts, further ranked by the number of times they appear in the bottom 20% of Trusts.

Bottom 10 performing trusts

**ranked on the number of times they appear in the bottom 20% of Trusts, further ranked by the number of times they appear in the top 20% of Trusts.

The number of people in the UK who have been diagnosed with cancer will increase by a million each decade, according to researchers.

The study by Kings College London predicted that the steepest rise in cancer incidence would be among those aged over 65.

The authors concluded that NHS and community care resources would be challenged by the increased prevalence of cancer, but more effective screening and treatment would improve survival rates.

The number of elderly people in the UK who had been diagnosed with cancer in 2010 was 1.3m. According to the study, by 2040 it could have reached 4.1m.

Research team member Professor Henrik Møller said: “The research shows that large increases can be expected in the oldest age groups in the coming decades, and with this an increased demand upon health services.”

“These stark predictions should act as a warning to the NHS and social care providers of the problems ahead if older cancer patients are not offered the best treatment and support,” observed Ciarán Devane, Chief Executive of Macmillan Cancer Support.

“For cancer survival to improve, older people must be given the right treatment at the correct level of intensity, together with the practical support to enable them to take it up.”

A DH spokesperson said the increasing number of cancer survivors was partly due to more successful treatment – and noted that from 1 October 2012, discrimination against the elderly in health and social care would be illegal.

The last year has seen patient experience of cancer treatment improve, according to a national survey.

Overall 88% of patients rated their care as excellent or very good, and 98 trusts have improved on their scores from last year.

Approval of the speed, choice and privacy of treatment all showed slight improvement relative to the first survey in 2011.

Reports have been sent to individual trusts on feedback from patients in their care, enabling them to focus on weaknesses.

The survey, carried out by Quality Health, also found that 95% of cancer patients were keen to participate in cancer research.

Over 70,000 patients were surveyed. Relative to 2010, approval increased for speed of treatment (83% from 81%), choice of treatment (84% from 83%) and privacy of treatment (94% from 93%).

The 10 most improved foundation trusts in the survey were: Portsmouth Hospitals, Guy’s & St Thomas’, Tameside Hospital, The Royal Marsden, Western Sussex Hospitals, East Kent University Hospitals, University Hospital Bristol, South Tyneside, Norfolk & Norwich University Hospitals and Medway.

“The information from this survey is vital to driving improvements on the ground for patients,” said National Cancer Director Professor Sir Mike Richards (pictured). “By seeing what areas they can improve upon, the local NHS can focus on the areas that matter most to patients.”

Macmillan Cancer Support and the Royal College of Nursing (RCN) welcomed these findings, but emphasised the need for rarer cancers to be treated as effectively as more common types.

Dr Peter Carter, RCN Chief Executive, noted that the survey “recognises the important contribution that specialist nurses make to patients with cancer”

Macmillan Cancer Support has attacked NICE for not including key cancer survival indicators in the first ‘menu’ of the NHS Commissioning Outcomes Framework (COF).

NICE published 44 indicators including ones for stroke patients, COPD, maternal care and access to mental health services.

However, Ciarán Devane, Chief Executive at the charity, said Macmillan is “shocked” at the omission of key cancer indicators.

He added that the absence of these indicators would result in commissioners lacking “strong incentives to improve cancer survival rates” and that NICE must include a revised list of indicators if the NHS is to hit survival targets.

From April next year, the COF will be used to hold CCGs to account for improvement in quality of local healthcare and patient outcomes through the services they commission.

The indicators have been developed using the Outcomes Framework, NICE Quality Standards and existing indicator collections, such as national audits.

A further menu of indicators will now be developed using NICE’s quality standards to ensure that all topics are covered.

NICE has defended its first ‘menu’ of indicators insisting the Framework will allow the NHS Commissioning Board to “identify the contribution” of CCGs in achieving national priorities.

The Department of Health has agreed to fund a host of charities to develop their skills as commissioning support organisations.

Macmillan Cancer Support, Arthritis Care and Epilepsy Action are amongst the organisations awarded a grant of £56,500 from the DH’s Innovation, Excellence and Service Development Fund.

Ciarán Devane (pictured), Chief Executive of Macmillan, said the grant will help the charity move one step closer to achieving “the best clinical outcomes and patient experience for all cancer patients”.

The charities will work alongside the Neurological Commissioning Support (NCS) as part of its programme to support health and social care commissioners.

NCS was established by the MS Society, Parkinson’s UK and the Motor Neurone Disease Association to provide advice and expertise to public sector commissioners.

The body worked with the DH to highlight how patient services and value for money could be improved further if charities were involved to develop their skills to advise commissioners.

Since then, it has been awarded funding as part of a development programme for the new two years.

“The voluntary sector hasn’t been seen as a credible partner for health and social care commissioning in the past, but the shift towards local commissioning provides a real opportunity to change that,” said Sue Thomas, Chief Executive of NCS. “Charities can reach out and engage people living with particular conditions, unlocking this previously untapped source of expertise.”

The £3.3m Innovation, Excellence and Service Development Fund currently supports 57 projects around the country.

Elderly cancer patients are being denied standard treatment options because of their age, a new report has found.

Macmillan Cancer Support’s The Age Old Excuse: the under treatment of older cancer patients exposed levels of discrimination within elderly patients due to ‘ill-founded assumptions’.

Ciarán Devane, Chief Executive of Macmillan Cancer Support, says the practice of recommending treatment based on age instead of a patient’s health is “an unacceptable act of discrimination”.

Currently, there are approximately 310,000 people diagnosed with cancer and around 156,000 deaths in Britain each year. It is the biggest killer of people aged 75 and over.

The amount of people dying from cancer is reducing in most age groups. However, the report found the number of deaths is reducing at a slower rate in those aged 74 to 84, and death rates in those aged 85 and over are increasing.

Research published in Cancer Epidemiology says there could be 14,000 fewer deaths from cancer in those aged 75 and over if mortality rates from cancer matched those in the US.

Macmillan is now calling for a more effective way of assessing older people for treatment and suggests short-term practical support to enable an uptake in recommended treatments. The charity also says training is needed for healthcare professionals working with elderly patients within the NHS to end the discrimination they currently face.

“We have a moral duty to treat people as individuals and give them the best chance of beating cancer, regardless of their age,” commented Ciarán Devane.

“As our population ages, and the number of people diagnosed with cancer grows, it is vital that steps are taken to ensure that the right people get the right treatment at the correct level of intensity, together with the practical support to enable them to take up and complete the treatment.

“Efforts are being made to increase early diagnosis and promote healthier lifestyles, but much more needs to be done to tackle under treatment.

“The NHS and social care providers must wake up to the specific issues older people face and ensure treatment decisions are based on their overall health not just their date of birth. Writing people off as too old for treatment is utterly shameful.”

Paul Burstow, Care Services Minister, says that cancer patients of all ages should “expect the best care”, but insisted the NHS already provides this.

“We are under no illusions that there are unjustifiable variation in standards, which is why we have funded five pilots jointly with Macmillan to help us understand how older people with cancer are cared for,” he said.

“The learning from the pilots will help the NHS to ensure that all older patients with cancer have their needs properly met.

“Not only is the NHS under a moral obligation not to discriminate, but we sent a clear message that any age discrimination in the NHS is unacceptable when we did not ask for any exemptions on age in the Equality Act.”

The Chief Executive of Macmillan Cancer Support, Ciarán Devane, will join the NHS Commissioning Board Authority as a Non-Executive Director from 1^st January 2012.

Mr Devane will work with the Commissioning Board’s Chair Professor Malcolm Grant in developing the Authority and a new clinical commissioning system.

Mr Grant said the appointment was “great news” and that the new director will be a “strong source of knowledge and advice”.

The NHS Commissioning Board – which will be an independent, statutory body – will officially become operational subject to the Health and Social Care Bill becoming law.

Health Secretary Andrew Lansley – who will remain responsible for promoting a comprehensive health service, and retain ultimate accountability for securing the provision of services under the reforms – backed the appointment. “Ciarán Devane has a strong track record of success and a passionate commitment to improving care for patients. I am delighted that he is bringing his unrivalled expertise to this important role. I am confident that he is the right person for the job.”

Mr Devane joined Macmillan as Chief Executive in May 2007. He currently serves as a member of the Cancer Outcomes Strategy Implementation Advisory Group and is a member of the health and work network of the Responsibility Deal. He also co-chairs the National Cancer Survivorship Initiative and sits on the board of the National Cancer Intelligence Network.

NICE has recommended two new treatment options for patients with multiple myeloma.

Celgene’s Thalidomide has been recommended as a first-line treatment in people where high-dose chemotherapy with stem cell transplantation is considered inappropriate. If the patient is intolerable to Thalidomide, Janssen’s Velcade (Bortezomib) is then recommended.

Dr Carole Longson, Health Technology Evaluation Centre Director at NICE, claimed that the new regimens have been shown to be “more effective at delaying disease progression and improving patients’ life expectancy.”

Multiple myeloma is a rare type of cancer that develops from cells in the bone marrow. Almost 4,000 cases are diagnosed every year in the UK.

Mike Hobday, Head of Policy at Macmillan Cancer Support, stated: “It is great news that NICE has recommended these drugs for cancer patients with multiple myeloma and that their needs have been listened to.

“For too long patients with less common cancers, such as multiple myeloma have lost out on receiving the vital medicines they need on the NHS.

“This decision recognises the need to fund drugs that improve the quality and length of life for cancer patients with rarer cancers, which is a key step to improving better access to treatments for all.”