Cancer Services Across South East Coast

1. Cancer Services Across South East Coast Steven Duckworth- SCN Manager Senate Presentation- 2nd July 2014

2. Challenges for Cancer • By 2020, 1 in 2 of us will get cancer in our lifetime and by 2030, four million people will be living with a cancer diagnosis (Macmillan Report, 2014) • 25% of all cancer patients diagnosed by emergency route at a late stage and therefore survival poor (NCIN) • 1 in 3 people with cancer die within a year of diagnosis. (ONS Report 2012)

3. Challenges for Cancer (cont) • More than a quarter of people diagnosed with cancer see their GP three times or more before being referred to a specialist. (NCPES). This is compounded by the infrequency with which GPs are presented with genuine cases of cancer – on average less than 9 per year. • These challenges are reflected in our work programme areas the 2 biggest of which are: • Awareness & Earlier Diagnosis • Enhanced Survival

4. Cancer in SEC • Generally, areas within the South East Coast SCN have low income deprivation scores and mainly higher percentages of residents aged 75 and older • There are 5,645 people aged 75 and over, living 15-20 years after diagnosis • Cancer incidence and mortality trends follow very closely the national trend although slightly lower

5. Cancer in SEC (cont) • Lung, Male genital, Upper GI, Breast invasive and Lower GI have the highest mortality rates amongst cancer groups • The 1 year index of survival for all cancers by CCG is highest for NHS Surrey Health CCG (71%) (England (68%) • 11 Trusts achieved the national target of the 62 days waiting time (referral to treatment) for every quarter of 2013

6. Configuration of Cancer Services • 3 Cancer Centres • The Sussex Cancer Centre, Brighton • Kent Oncology Centre, Maidstone and Canterbury • St Luke’s Cancer Centre, Guildford • There are also cancer services delivered at a number of cancer units across the SEC region

8. Regulation around cancer services • Improving outcomes guidance - issued by NICE advising on every tumour type and cross cutting themes such as radiotherapy, and acute oncology • Each service has to comply to the cancer measures for that particular service • These are measured by cancer peer review

9. Cancer Targets • 2 week wait - 2 weeks from referral by GP to see a cancer specialist • 31 day - time from decision to treat to first definitive treatment • 62 day - time from referral by GP to first definitive treatment • Further 31 day target from first definitive treatment to subsequent treatment

10. Cancer Commissioning • Common cancer commissioned by CCGs breast, colorectal and lung • Rare cancers commissioned by Specialised commissioning informed by clinical reference groups Upper GI, Urology, Head & Neck, Thyroid, Gynae • Specific services commissioned by specialised commissioning radiotherapy, specialised tertiary services and chemotheapy

11. Specific areas in SEC • Urology services in Sussex • Upper GI cancer in Kent & Medway • Specialised dermatology across the whole region • Radiotherapy in Sussex and Kent

12. Variation in Cancer Outcomes • Variation across SEC with emergency admission rates for cancer, difference with uptake of direct access diagnostics, stage of disease at presentation, 1 year survival rates – work underway to triangulate these data metrics for CCGs to identify specific areas • CCG profiles have been circulated to all 20 highlighting specific areas for them to address