Cancer Workforce and Early Diagnosis — [Mr George Howarth in the Chair]

Part of the debate – in Westminster Hall at 10:08 am on 8 January 2019.

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Photo of Nicholas Dakin Nicholas Dakin Opposition Whip (Commons) 10:08, 8 January 2019

I congratulate my hon. Friend Jim Fitzpatrick on securing this important and timely debate.

We very much welcome the NHS long-term plan. It is a once-in-a-generation opportunity to improve cancer care significantly in this country. The plan rightly recognises that one of the biggest actions the NHS can take to improve cancer survival is to diagnose cancers earlier, and sets out welcome commitments to radically improve early diagnosis. I hope that as the plan develops there will be more specific plans for the less survivable cancers—pancreatic, brain, lung, stomach, liver and oesophagus—that account for more than 50% of all cancers.

As chair of the all-party group on cancer I was pleased to chair the Britain Against Cancer conference last month, which focused on future priorities for cancer care. There were many reasons to be cheerful, but one big concern was whether the workforce will be sufficient to deliver the care that will be needed in the future. There is still a lack of clarity about that, despite efforts in the long-term plan, so it is useful to have this opportunity to focus on that.

We know that the number of people diagnosed with cancer in the UK is increasing and that the changing needs of cancer patients present a challenge for professionals working in cancer care, who are dealing with rising case loads, and increasingly complex needs. The plan’s ambition to diagnose three in four cancer cases at an early stage by 2028 is welcome, but unless we have a plan to deal with staffing shortages, backed up by significant investment, the NHS will struggle to maintain today’s standards.

In NHS North Lincolnshire clinical commissioning group, only 71.9% of cancer patients receive their first treatment within 62 days of an urgent GP referral. That is well below the England average and below the national target of 85%. Delays to cancer waiting times are often caused by a diagnostic bottleneck, where there is not enough capacity to carry out the tests needed to confirm a cancer diagnosis so that the patient can begin treatment. I therefore welcome the announcement made just before Christmas of capital investment for Northern Lincolnshire and Goole NHS Foundation Trust, and of diagnostic equipment for Diana, Princess of Wales Hospital in Grimsby and Scunthorpe General Hospital. I hope that will make a significant difference.

To improve early diagnosis and match the best cancer outcomes in Europe, it is crucial to have the workforce in place to support growing patient need. Although the NHS long-term plan sets out ambitions for the future workforce, funding available for additional investment in that workforce in the form of training, education and continuing professional development through the Health Education England budget, has yet to be set out by the Government. Will the Minister—he is an excellent Minister—set out when that budget will be confirmed and say whether the Government intend to set out further funding arrangements as part of the comprehensive spending review?

NHS staff shortages in primary and acute settings have been consistently highlighted by organisations in the sector in recent years, and there is an urgent need to grow the cancer workforce. Cancer Research UK estimates that the cancer workforce needs to double by 2027. Similarly, Macmillan Cancer Support has estimated that the supply of adult cancer nurses must increase by 45% in the next 10 years. Those are big numbers.

Macmillan’s workforce census last year highlighted considerable variation in vacancy rates for cancer nurse specialists across the country. That is also true for specialist chemotherapy nurses, with vacancy rates as high as 15% in some areas. A recent survey of healthcare professionals working in breast care in hospitals by the charity Breast Cancer Care painted a worrying picture, with 87% of respondents stating that job shortages in their hospital could affect breast cancer patients. A freedom of information request from that charity found that two-thirds of hospital trusts in England do not provide a dedicated nurse for people living with incurable breast cancer. It is therefore crucial that a fully costed plan is produced to demonstrate how the health and care workforce will be sustained and grown. The long-term plan states that there will be a separate workforce implementation plan in 2019, but more detail is needed about the timeframes. Will the Minister say when the plan will be published? “Soon” is not quite good enough. We would like a date, please.

The 2015 cancer strategy recommended the publication of a cancer workforce plan, yet the sector is still waiting for the publication of phase 2 of that plan by Health Education England. Will the Minister outline how the implementation plan relates to the long-promised phase 2 HEE plan on the cancer workforce? If the ambitions of the long-term plan and the 2015 cancer strategy are to be realised, a comprehensive and fully funded workforce plan must set out how the cancer workforce can be upskilled and developed to meet the needs of the growing number of people living with cancer.