Greg Manuel on what Incisive Health’s new report The state of cancer: An analysis of public attitudes towards NHS cancer services in England means for the NHS
Cancer affects everyone in some way. Half of us will be diagnosed with cancer during our lifetime and the number of new diagnoses is projected to rise. We should all be confident that the NHS will be able to offer the best possible cancer care to us and our loved ones. But is this how the public feel?
To answer this question, we partnered with Populus to carry out in-depth polling on the public’s perception of cancer care. We explored attitudes to the quality of cancer services, how the public would improve cancer services, workforce, access to treatments and the prioritisation of cancer in comparison to other diseases, amongst other topics.
A divided public
Three years on from the publication of the Independent Cancer Taskforce’s Cancer Strategy we found that public opinion is deeply divided about NHS cancer services in England. Although one in four (27%) respondents agreed that the NHS offers the best cancer care in the world, slightly more (29%) disagreed with the statement. Nor is there any consensus about how cancer services have fared since 2015; one fifth of the public (19%) agree that cancer services have worsened and the same proportion disagree with this assessment.
Looking to the future
Nevertheless, the public are optimistic about cancer services, with just over a third (36%) believing that cancer services will improve over the next three years. This optimism reflects a clear wish from the public for cancer services to be prioritised for investment over the coming years.
Cancer is the public’s top priority for NHS investment ahead of Alzheimer’s disease and dementia, heart disease and depression. Three in five (60%) respondents selected cancer as one of their top two priorities for more funding.
The public’s willingness to prioritise extra investment in cancer appears partly to be explained by their perception of the current funding settlement. Only 18% agree with the statement “I am confident that NHS cancer services have the money they need to offer the best cancer care in the world” while half (50%) disagree.
No time for complacency
The public have two clear priorities for improving cancer services. 66% want to prioritise earlier diagnosis, selecting “increasing the number of tests for suspected cancer so as to diagnose more people with cancer before it has spread” as a priority. While 65% identified “making available the latest cancer treatments to help either cure or enable people to live longer with cancer” as one of their top three priorities.
Delivering on the public’s optimism means there is no time for complacency. Our finding that cancer is the public’s top priority for extra investment is timely given the Prime Minister’s announcement in June that the NHS will receive more funding over the next five years. But more money is unlikely to be enough to change public attitudes alone.
If we want more people to be confident in NHS cancer services then funding needs to translate into better care and outcomes. Focusing on the public’s priorities of early diagnosis and better access to treatment would be a good place to start.
Saving lives, averting costs
As our work with Cancer Research UK has shown, diagnosing cancer early can save lives, reduce the impact of treatment on people’s health and avert costs for the NHS. The Cancer Strategy has already made important progress on early diagnosis. From investment in the Be Clear on Cancer public awareness programme, changes to NICE referral guidelines and investment in the Accelerate, Coordinate, Evaluate (ACE) programme, the Cancer Strategy’s emphasis on early diagnosis is clearly translating into policy change.
We’re starting to see this making a difference to people with cancer, with the latest data showing the number of people diagnosed with cancer who first present as an emergency falling over the past five years.
As coverage of our findings in The Observer highlighted, a reluctance on the part of the public to come forward with a potential symptom of cancer, shows that more needs to be done to encourage the public to seek medical help. The reasons for these issues are complex, with respondents highlighting a concern about wasting the doctors’ time and fear of what they might find as reasons to delay seeking help for a potential symptom of cancer.
Confidence in primary care professionals spotting the signs and symptoms of cancer will also play an important role in when people are diagnosed. Yet, while the majority of respondents (53%) agree that GPs will identify signs of cancer, one in five (20%) disagree that they are confident that their GP would identify the signs and symptoms of cancer.
Getting the best treatment for people with cancer
Ensuring that NHS patients access the latest innovations in cancer care – whether surgery, radiotherapy or medicine – is potentially an even bigger challenge. Our findings reveal that the public remain to be convinced that access to cancer treatments has improved in the last three years, with 29% agreeing that the NHS is too slow with 10% disagreeing and 60% saying they neither agree nor disagree, or that they don’t know.
There is also manifest concern about the pace at which new cancer tests and treatments are made available, with 45% agreeing that the NHS is too slow and only 9% disagreeing (46% say they either don’t know or neither agree nor disagree).
Even with new funding to kickstart the upgrade of radiotherapy equipment,reforms to the Cancer Drugs Fund and the introduction of the Early Access to Medicines Scheme, our polling makes clear that NICE, NHS England and the newly launched Accelerated Access Collaborative have their work cut out to deliver on the public’s priority of making the latest cancer treatments available on the NHS.
Making it a reality
As more and more of us are diagnosed and live longer with cancer we should all be confident that the NHS delivers care that matches the best in world. Our findings show that the public believe we’re not there yet and that getting there will require bold action on the part of the health system and politicians. The Cancer Strategy set a bold, ambitious and optimistic vision for cancer services in England, our study makes clear that there’s still more to do to make this a reality.