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Delivering healthcare is complicated and one of the barriers to improving it has always been the very wide range of different organisations who have a role but don’t always work together smoothly. The pandemic has concentrated minds and forced organisations to sink differences across the public/private divide. This is being demonstrated in a number of ways. The truly global cross-sectoral pursuit of a covid-19 vaccine is just one.

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In the perceived conflict between public and private, there is a third sector that has become a casualty of covid-19; and whose erosion is a key vulnerability in how well we recover from the crisis.

The pandemic has really exposed how vital to the whole system the charity sector is for delivery of healthcare and the support of patients. It is the glue that has kept private and public sector players to task and filled vital gaps in services. Covid-19 has shown how the whole show is kept on the road by charities.

While the health service itself was able to draw upon the resources and funding of central government, the charity partners who we all work with and who are so vital to cancer care were not in that position. Getting these organisation back on their feet must now be priority number one; and, for our part, at MSD we have rolled out a number of grant programmes, as have many other companies. But much damage has been done and it will take a long time to rebuild.

The problem is not simply one of supporting existing patients. It is also about finding the patients to support in the first place, as they’re not necessarily coming into hospital. As we know, non-covid hospital admissions are down, but non-covid excess deaths at home are up. Cancer hasn’t stopped for covid-19, its victims just aren’t seeking the help they need and deserve.

At the outbreak, closing down/restricting access to the health system was designed to protect it in the short-term. The messaging to the public was clear: stay at home - and stay away they did.

The statistics are stark. Some 2.5 million screenings having been estimated to have not taken place during the pandemic peak; Cancer Research UK estimate the opportunity to catch more than 24,000 cases of cancer early have passed as a result of the suspension of normal services, with 14,000 fewer test just for lung cancer; total cancer admissions dropped by 80 per cent in the early weeks of lockdown.

Restarting the system and managing that backlog of patients is going to take us all working together – public, voluntary and industry too.

Moves to telemedicine, treatment via centralised cancer hubs, wider use of so-called “covid-friendly” cancer medicines, and changes that allow for more out of hospital care will all contain some innovations that people will want to keep when the initial crisis period subsides.5 They will also contain innovations that the NHS cannot deliver alone.

We have seen the barriers to collaboration come down in recent months, both in terms of system integration as well as in charity/public/private sector partnering. We are going to need to keep those barriers down if patients are to have the best possible experience and outcome during what will be a challenging autumn.

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