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Workforce challenges threaten success of Cancer Strategy

Health Education England reveals plans to ‘transform future cancer workforce’

Louise Prime

Tuesday, 05 December 2017

Some progress has been made in getting investment in cancer services to the frontline – but challenges facing the cancer workforce are seriously threatening the Cancer Strategy for England, Macmillan Cancer Support warned this morning. In response to the All Party Parliamentary Group on Cancer’s latest report on the strategy’s implementation, the charity said that funding is being held back in many areas, and it urged the health secretary to act urgently. Macmillan also said it was disappointed that Health Education England’s (HEE) plan to “transform the future cancer workforce”, unveiled this morning, was “not accompanied by the investment which is needed to ensure the NHS workforce is fit to meet the future challenges cancer poses”.

The APPG on cancer found that some progress has been made in the past year: 16 Cancer Alliances and three vanguards have been established, there has been a commitment of an additional £200 million in transformation funding for early diagnosis and support for life after treatment, five Cancer Alliances have started to pilot a new quality of life metric to measure longer term outcomes for cancer patients, and 23 NHS trusts have now received new and upgraded radiotherapy machines.

But, it said, the challenges facing the cancer workforce were “a significant threat to the success of the Cancer Strategy”. The implementation of many recommendations rely on having enough staff, with the right skills, to deliver cancer services – yet a strategic review of the cancer workforce has been significantly delayed; and there were recurrent concerns about the transparency and communication relating to the bidding process for transformation funding.

Dr Fran Woodard, executive director of policy and impact at Macmillan Cancer Support said: “Doctors and nurses working in cancer care have told us that they are currently seriously overstretched, and this is beginning to affect patient care. … The health secretary and NHS England must urgently address the concerns raised in the report if we are to see the change that is needed in the promised timeframe.”     

HEE said its “comprehensive cancer workforce plan”, developed with NHS England, “will make sure the NHS has enough staff with the right skills to deliver improvements for people affected by cancer over the next three years”. It outlines plans for a skills expansion over the next three years to support growth and transformation, and includes:

  • investment in 200 additional clinical endoscopists to support increased diagnostic capacity and free up consultants’ time to spend on complex cases;
  • investment in 300 reporting radiographers by 2021 to support increased capacity for earlier diagnosis;
  • retention initiatives to produce an additional 746 consultants working in cancer by 2021, (an estimated 21% increase on 2016);
  • expansion of cancer nurse specialists to develop consistent competencies and a clear route into training;
  • continued development of cancer staff skills through a national dedicated Skills Fund;
  • work with partners to identify and tackle the root problems behind workforce gaps in a national Cancer Staff Forum to make working and remaining in the NHS more attractive.

Macmillan welcomed the plan as a “first step” in tackling the increasingly difficult climate in which healthcare professionals are working. But Dr Woodard warned: “Pressures on those working in cancer care have mounted to an extraordinary degree over the past couple of years. Against that backdrop, it has been immensely frustrating to see such slow progress in tackling the workforce challenges facing the people working in cancer care. 

“Recent Macmillan research suggests that pressures facing the workforce have begun to impact on the quality of care cancer patients are receiving. … As well as immediate action now, further work next year on nursing and a longer-term plan will be critical to really drive the improvements required.

“It is disappointing to see these commitments are not accompanied by the investment which is needed to ensure the NHS workforce is fit to meet the future challenges cancer poses.”

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