Agenda item - Cancer Services (Diagnosis and Treatment)

Report of the Executive Lead, Strategy, Governance and Law (copy attached)

15.1    This item was presented by Ben Stevens, University Hospitals Sussex (UHSxE) Chief Operating Officer; Lola Banjoko, Executive Managing Director, Brighton & Hove CCG; Becky Woodiwiss, Public Health Principal, BHCC; and by Dr Sarah Richards, Brighton & Hove CCG Medical Director.

15.2    Mr Stevens told the committee that the pandemic has impacted cancer services, with a significant reduction of referrals as fewer people have been accessing healthcare. This is reflected in performance against the national cancer targets:

·         62 day referral to treatment target: the national target is for 85% of people to begin receiving treatment within 62 days of referral. UHSxE is currently performing at 65-75%. This is a national problem, and many systems are struggling with this target.

·         28 Day referral to diagnosis target: the national target is for 75% of people to receive a diagnosis within 28 days of referral. [BL(NC1] 

15.3    Services are planning to increase treatment and diagnostic capacity to meet these challenges. This includes the deployment of a new community diagnostics hub at the Amex in addition to diagnostic services at the Royal Sussex County Hospital. Services are also looking at re-designing treatment pathways: e.g. by enhanced use of virtual appointments and by using new diagnostic techniques. There is a major focus on NHS restoration & recovery around cancer, particularly targeting long waits.

15.4    Ms Woodiwiss told members that there are three main national cancer screening programmes:

·         Breast screening – the national target is to screen 70% of those eligible. Current local performance is 66%.

·         Cervical screening – the national target is 80%. Current local performance is 68%.

·         Bowel screening – the national target is 60%. This is currently being met locally.

15.5    The pandemic has had a major impact on screening, but rates are beginning to pick up locally. Services strive to communicate about screening, working closely with Albion in the Community.

15.6    Lola Banjoko told members that services are very conscious of the importance of inequalities in screening rates, with some geographical communities and some groups of people having much lower rates of screening uptake.

15.7    Dr Richards told the committee that there is an enhanced early diagnosis service now in primary care. Primary care is also starting to follow-up on patients who do not attend screening appointments. Brighton & Hove is also a pilot area for targeted lung health checks: e.g. offering x rays/CT scans for any smokers. Ms Banjoko added that there is additional annual funding from NHS England for the community diagnostic hub.

15.8    Cllr Grimshaw noted that current difficulties in getting non-urgent GP appointments may discourage people from seeking advice on possible cancer symptoms. Ms Banjoko acknowledged the problem, and that some communities are much more reluctant to come forward than others impacting on the screening uptake as opposed to access. Dr Richards agreed that current access to primary care may be a challenge, particularly for the most deprived communities. There is investment in digital and in longer opening hours to improve access. However, GPs are exceptionally busy, and there is no easy fix to this.

15.9    Cllr Deane noted that historically breast screening rates were lowest in areas of the city with no easy access to the Preston Park screening centre. Ms Woodiwiss responded that access is a recognised problem. However, schemes such as travel vouchers have not proved successful. There is more to unpick here in terms of what the real access barriers are.

15.10  Cllr Brennan noted that the Princess Royal Hospital has arrangements in place that allow people to travel free on buses as long as they show proof of an appointment. Ms Banjoko responded that this such a scheme would be the responsibility of the council.

15.11  Cllr Brennan also noted that the diagnostics centre at the Amex is poorly signed from bus stops. Ms Banjoko agreed to feedback to the service on its signage.

15.12  The Chair noted that Brighton & Hove had challenged  performance against cancer screening and treatment targets long before the pandemic, and that this was an issue that the HOSC should maintain an overview of. Members agreed to receive an update report in 18 months’ time.

15.13  RESOLVED – that the report be noted.