NHS England recently committed a further £15 million over three years to evaluate and treat patients with a modern, more precise type of radiotherapy, stereotactic ablative radiotherapy (SABR). This evaluation programme will mean a significant increase in the number of cancer patients eligible to access SABR treatment by around 750 a year. The programme will widen the number of cancers being treated by SABR, including cancer that has spread to another part of the body. This new investment is in addition to NHS England’s pledge to fund up to £6 million over the next five years to cover the National Health Service treatment costs of SABR clinical trials, most of which are being led by Cancer Research UK. One of these trials is for pancreatic cancer.
Regarding cancer drugs, the National Institute for Health and Care Excellence (NICE) has recommended gemcitabine as a treatment option for pancreatic cancer in technology appraisal guidance published in May 2001, subject to certain clinical criteria, and has been asked to appraise a number of other pancreatic cancer drugs. Where a pancreatic cancer drug is not routinely available on the NHS, patients may be able to access it through the Cancer Drugs Fund (CDF). There is one anti-cancer therapy available through the CDF that is used in pancreatic cancer, Albumin bound Paclitaxel (Abraxane).
More generally on treatment, NHS England’s pancreatic cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. In addition, a pancreatic cancer clinical guideline and quality standard have been referred to NICE by NHS England.
Other action is also ongoing to improve cancer survival rates, including for pancreatic cancer, which we know can be particularly difficult to detect and diagnose. In January 2015, NHS England launched a major early diagnosis programme, working jointly with Cancer Research UK and Macmillan Cancer Support to test new approaches to identifying cancer more quickly. These include: offering patients the option to self-refer for diagnostic tests; lowering the threshold for general practitioner (GP) referrals; creating a pathway for vague symptoms like tiredness; and setting up multi-disciplinary diagnostic centres so patients can have several tests done at the same place on the same day. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17.
In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support tool, which includes pancreatic cancer, for GPs to use in their routine practice. It is designed to help GPs recognise the symptoms of cancer and identify patients that they might not otherwise refer urgently for suspected cancer. The system is currently installed in over 1,000 GP practices, and Macmillan Cancer Support is working in partnership with companies supplying GP information technology systems to develop versions of this software to make it available to all GPs as part of their standard software offer.
The Department has regular meetings with NHS England on improving cancer survival rates, including for pancreatic cancer.