Cancer survival rates in England are higher than they have ever been and earlier diagnosis is a key part of improving survival rates further.
The NHS Long Term Plan continues to expand upon work to transform cancer care so that from 2028, an extra 55,000 people each year will survive for five years or more following their cancer diagnosis, plus three in four cancers (75%) will be diagnosed at an early stage.
Earlier diagnosis is critical to meeting this ambition, as it means patients can receive treatment when there is a better chance of achieving a complete cure.
By providing dedicated focus and capacity, the Alliance is working to drive forward change in order to deliver improvements in cancer outcomes locally. Humber, Coast and Vale Cancer Alliance is working with partners to develop and deliver strategic plans for radiology, pathology, and endoscopy services across the area. These plans include:
Rapid Diagnostic Centres
The rollout of Rapid Diagnostic Centres (RDCs) across England is an ambitious five-year programme that is designed to speed up diagnosis of cancer and other serious conditions. The programme, which started in 2019, supports innovation across cancer pathways and aims to ensure everyone with suspected cancer gets the right test at the right time, in as few visits as possible.
By bringing together existing diagnostic capabilities and clinical expertise to provide a coordinated access to diagnostic pathways, RDCs offer a more personalised, accurate and rapid diagnosis for patients with symptoms that could indicate cancer.
RDCs also introduce a non-specific symptom pathway for patients who display symptoms that could indicate cancer but don’t align to specific cancers, such as unexplained weight loss, fatigue or vague abdominal pain.
The core principles of RDCs are to provide; a coordinated access to a diagnostic pathway, accurate, personalised and rapid diagnosis through networked provision, and one urgent cancer referral in order to be diagnosed with cancer. The RDC approach contains seven key components:
The Alliance is now working with stakeholders to embed RDC principles and pathways across our region. There are currently three live RDC pathways across Humber, Coast and Vale which have already supported a faster diagnosis for approximately 550 patients. By 2024, the Alliance aims to accomplish the national ambition of achieving full population coverage across England by applying RDC principles to every non site-specific and site-specific symptom pathway.
Community Diagnostic Hubs
An independent report published by Professor Sir Mike Richards in October 2020, recommended the need for a new diagnostics model, where more facilities are created in free standing locations away from main hospital sites.
The Alliance is currently working with stakeholders across Humber, Coast and Vale to develop ambitions and plans for Community Diagnostic Hubs (CDHs) across our region, which will contribute to the following aims:
- To improve population health outcomes by reaching earlier, faster and more accurate diagnoses of health conditions.
- To increase diagnostic capacity by investing in new facilities, equipment and training new and existing staff, contributing to recovery from COVID-19 and reducing pressure on acute sites.
- To improve productivity and efficiency of diagnostic activity by streaming provision of acute and elective diagnostic services where it makes sense to do so; redesigning clinical pathways to reduce unnecessary steps, tests or duplication.
- To contribute to reducing health inequalities driven by unwarranted variation in referral, access, uptake, experience and outcomes of diagnostic provision.
- To deliver a better and more personalised diagnostic experience for patients by providing a single point of access to a range of safe, quality diagnostic services in the community.
- To support integration of care across primary, community and secondary care and the wider diagnostics transformation programme.
Imaging and Endoscopy Networks
Networks and alliances bring together teams working in particular areas of healthcare, especially where some services cannot be delivered in all NHS trusts or where efficiencies can be achieved from cross-trust working.
A national strategy published by NHS England in 2019, set out a proposal for implementing collaborative imaging networks on a national basis across England. The use of imaging networks will help to deliver better quality care and better value services for patients by enabling shared viewing and reporting of images across the network footprint, reducing duplication and sharing use of valuable clinical resources. Imagining networks also provide NHS staff opportunities to develop their career and increase their productivity.
For endoscopy, a network is being established in order to work together to assess capacity and demand; reduce the proportion of patients not attending or cancelling late; improve procurement; develop joint training; introduce centralised scheduling; offer patients choice of location for endoscopy; and centralise highly complex cases.
Digitisation and IT connectivity will be vital for networks to work efficiently. IT linkage between hospitals, all diagnostic hubs, and GP practices is vital for effective pathology and genomic services. Image sharing across networks will facilitate the efficient use of radiology staff for reporting. This should include linkage to allow home reporting of images. Digitisation is a necessary precursor to large-scale future use of artificial intelligence in the diagnostics field.
Our plans for diagnostic services are also shaped by and in line with national guidance, including:
Innovative and collaborative use of workforce
To ensure we have the right number of skilled staff in order to provide high quality care and services, the Alliance is supporting the NHS Cancer Workforce Plan, which focuses on three key themes:
1. Development of new roles, including educators, clinical leadership roles, advanced care practitioners, and radiographers.
2. Improving access to training; working with Health Education England (HEE) to develop online training and review the types of degree courses that can be accessed.
3. Improving ways of working, including developing networks of practitioners, improving remote working, and utilisation of new technology to improve efficiency.