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This article was organised and fully funded by Bristol Myers Squibb, and developed in collaboration by BMS and HSJ. This article has no promotional intent. Bristol-Myers Squibb does not intend to encourage the use of, or advocate the promotion of, its products through the objectives of this article.
The NHS has pioneered the introduction of many world firsts including cutting edge therapies, new workforce roles and patient centred service delivery. The UK is also home to a thriving life sciences sector which, in partnership with the NHS, continues to innovate the treatment landscape.
However, the emergence of COVID-19 has had a profound impact on this landscape. It has also exposed pre-pandemic fault lines which may further risk the system’s ability to balance its business-as-usual priorities with the capacity required to stay ahead and prepare itself for the future wave of treatment innovations appearing on the horizon.
Jagtar Dhanda, Policy, Advocacy and Government Affairs Manager at Bristol Myers Squibb, explores this challenge from a cancer treatment perspective and makes the case for clinically-led peer-to-peer service development as an empowering and effective tool in supporting the NHS to better prepare itself for innovative cancer therapies.
Cancer patient survival rates have doubled in the last 40 years,[i] thanks to a range of factors, such as more screening to achieve earlier diagnoses, but also partly due to major innovations in cancer treatment. Yet, despite this progress, there is an ambition to improve these patient outcomes further and ensure that survival rates keep pace with those seen in other European and developed countries. [ii]
Across all cancers, the five-year survival rates in England are 47% and 53% for men and women respectively, both of which are lower than the European averages of 50% and 58%.[iii] This has been exacerbated by the pandemic, with urgent primary care referrals down by 60% in April 2020 when compared with the same month in the previous year.[iv]
There is also a continuing problem with the uptake of new treatments in the UK. The UK’s adoption of NICE-approved medicines in the first year after launch is only 21% of the median uptake of comparator countries such as Belgium, France, and Germany.[v] The UK can be particularly slow at adopting innovation due to barriers, such as poor access to evidence, data and metrics, and also lack of effective innovation architecture.[vi]
Against the backdrop of these uptake challenges, the NHS must also deal with cyclical pressures such as, but not limited to, the winter flu season and more long-term entrenched challenges associated with workforce attrition. [vii]
However, by virtue of experiencing these problems first-hand and in learning how best to navigate the complexities of the health system, NHS staff are often best placed to support NHS leadership in introducing, spreading, and sustaining innovation.
In collaboration with the NHS, industry could greatly benefit from harnessing the expertise of those healthcare professionals who have early exposure and experience of innovative cancer therapies. These individuals will have continuously stress-tested and adapted, improved, or redesigned the end-to-end processes of a cancer treatment pathway and the learnings taken from these experiences should be shared. Such an approach is critical to making sure innovative cancer therapies are eased in effectively. Without this, the implementation of these innovative therapies could otherwise exacerbate patient safety and workforce capacity concerns and add to existing service to service handover bottlenecks. [viii]
The reality, however, is that often this expertise may be under-utilised. This view is certainly shared by a growing number of healthcare professionals that engage with BMS. BMS is therefore keen to work in partnership with the NHS to identify and champion best practice exemplars of clinically led peer to peer service development and explore the possibility of a more standardised and widely used approach. One where those with early exposure and first-hand experience of innovative cancer therapies are empowered to share best practice and learning and are actively supported to share this knowledge beyond their organisational boundaries.
The net result will be an empowered workforce working together with the unifying aim of facilitating staff led service development that maps out the most efficient and least disruptive process for introducing innovative cancer therapies to the NHS. Importantly, this would also reduce geographical variation in standards of care and improve access to innovative treatments across the UK.
As the system re-calibrates to support the evolution of integrated care systems, there is an opportunity to be seized by those working with patients to develop and share best practice from both a bottom up and top-down perspective, to deliver a truly co-ordinated approach to peer led service development. The passage of the Health and Care Bill, and its subsequent implementation, mean that now is the time to do just this.
This is why Bristol Myers Squibb is hosting an upcoming HSJ roundtable event onThursday 23 September to provide a forum for health leaders to discuss ways they can work together to make better use of cutting-edge insights and experience to drive improvements in cancer care for patients across the UK.
[i] Cancer Research UK. Cancer survival statistics. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival Last accessed: September 2021
[ii] The Health Foundation. Radical rethink required to close gap on cancer survival between England and comparable countries. Available at: https://www.health.org.uk/news-and-comment/news/radical-rethink-required-to-close-gap-on-cancer-survival Last accessed: September 2021
[iii] Cancer Research UK. Cancer survival statistics for all cancers combined. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/all-cancers-combined Last accessed: September 2021
[iv] BMJ. Covid-19: Urgent cancer referrals fall by 60%, showing “brutal” impact of pandemic. 12 June 2020. Available at:https://www.bmj.com/content/bmj/369/bmj.m2386.full.pdf Last accessed: September 2021
[v] Office for Life Sciences. Life Sciences Competitiveness Indicators. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/811347/life-sciences-competitiveness-data-2019.pdf Last accessed: September 2021
[vi] NHS England. Innovation – Health and Wealth. Available at: https://www.networks.nhs.uk/nhs-networks/joint-working-nhs-pharmaceutical/documents/InnovationHealth-Wealth.pdf Last accessed: September 2021
[vii] GP Online. Pension tax warning as BMA highlights NHS shortfall of 50,000 doctors. Available at: https://www.gponline.com/pension-tax-warning-bma-highlights-nhs-shortfall-50000-doctors/article/1727285 Last accessed: September 2021
[viii] Health Education England. Strategic Framework 2014 – 2029. Available at: https://www.hee.nhs.uk/sites/default/files/documents/HEE%20strategic%20framework%202017_1.pdf Last accessed: September 2021
Job code: ONC-GB-2100374