Is the UK steadily approaching an oncology crisis? What are we really doing about health inequalities?
In this blog, we explore the potential oncology crisis and analyse how a fully integrated health care system could prevent the crisis from occurring.
The NHS was intended to work as a unified health care system that provides fair and equal healthcare in the UK. Rather than being ‘joined-up’ the NHS is becoming increasingly fragmented due to being underfunded, divided into separate autonomous trusts and workforce shortages in all clinical areas.
This fragmentation has resulted in substantial inequalities impacting cancer treatment in the UK.
Many R&D departments are struggling to effectively open clinical trials that would be give patients the best opportunities of access to new treatments. Bureaucratic, political and cultural influences in addition to leadership, education and training issues reduce ability to deliver patient centred services.
Most new treatments are developed by pharmaceutical companies through international trials. Very few hospitals are selected to be research sites. It is often the usual cancer centres with recognised investigators are often chosen with limited look-in for new or smaller sites, as many hospitals are not considered. Management by individuals without appropriate skills and understanding of the demands of cancer medicine and research has caused established centres to decline. As cancer trials become more complex, research teams often lack the knowledge and experience of the cancer, the treatments and/or trial processes. This results in failure to deliver the trials and the commercial clinical leadership model collapses.
Why is the UK close to an oncology crisis?
The 2019 Royal College of Radiologist workforce census revealed that a shortage of oncologists has emerged rapidly in the last three years. The current number of trained oncologists in the UK could only fit half the current vacancies for oncologists as the oncology workforce is understaffed by a staggering 19%. To address the workforce shortages in the oncology healthcare, a new fully-integrated healthcare system is needed.
Variation in access to treatment
Access to potentially curative standard of care chemotherapy in the recent National Bowel Cancer Audit varied substantially between hospital-trusts. The observed variation in chemotherapy administration was between 26% and 86% of patients actually receiving chemotherapy when this was considered appropriate according to the cancer diagnosis.1
How effective are R&D departments?
In 2018, the UK spent £37.1 billion on R&D, the equivalent of 1.7% GDP.
It is impossible to provide an average price for the total cost of R&D support in the UK for a single clinical trial, but the costs that must be considered include regulatory preparation and compliance work, support services, data collection, local study coordination and R&D support for finalising research approval.
Due to current local and national challenges, R&D departments may not be able to open trials at all or within the designated timeframe, resulting in a loss of treatment opportunities for patients, financial earnings and poor patient experiences. Adopting a single, centralised approach will remove unnecessary costs and improve the performance through efficiencies and consistency of trials and patient care within the UK. NHS locations that have been praised historically for their oncology services are falling behind due to their consultants and clinical teams not having the supportive functions, expertise training or experience to host oncology trials.
Outreach Research & Innovation Group
The CEO and Medical Director, in this not for profit organisation is global oncologist and key note speaker Prof Andrew Wardley.
As an aspiring entrepreneur creating his first start-up, Prof Andrew Wardley motivation and determination stems from his passion in providing equitable access to treatments since 2001. Unfortunately, various workforce and cultural challenges did not see the development of his integrated model of care.
In 2020, Prof Andrew Wardley took himself and his team through an intensive 12 week entrepreneurial sprint project where he indirectly led a team of volunteers in acquiring £100k partnership deal with The University of Manchester the Manchester Breast Centre and Action Against Cancer, for a programme exploring research across HER2+ type breast cancer patients whose tumours are not responding to treatment and positioned Outreach Research & Innovation Group in a strategic partnership with the Better Health Programme (BHP), a Foreign & Commonwealth Office (FCO) funded international development programme focused on 8 middle-income countries.
At its core, Outreach Research & Innovation Group provide healthcare business services which complement the growth, sustainability and access to clinical sites increasing research opportunities, enabling economical growth and reducing inequality.
Through by combining a multi-disciplinary approach with deep, practical industry knowledge, Prof Wardley and his team have helped partners meet challenges across the health services by optimising standard of care delivery and systemic anti-cancer therapy research opportunities.
In less than 12 months, Outreach Research & Innovation Group have expanded the number of clinical sites which offer systemic anti-cancer therapy trials, allowing: more patients to access innovative new treatments as they are developed; give oncology teams more treatment options for patients and confidence to use these once approved; accelerate the time for new treatments to enter practice and elevate the standards across the NHS, not to mention economic benefits for all of those involved.
By taking an integrated network approach to cancer care in the UK, Outreach Research & Innovation Group plugs the gaps currently present in the UK’s healthcare system, by brining cancer specialists and transformation strategist together to improve patient care and outcomes while lifting innovation and research.
https://www.nboca.org.uk/content/uploads/2019/07/NBOCA-Adj-Chemo-Final-Short-Report-PDF.pdf https://ascopubs.org/doi/full/10.1200/JOP.17.00088 https://www.abpi.org.uk/media/4650/clinical-trials-in-the-uk-report-jan-2018.pdf https://www.rcr.ac.uk/publication/clinical-radiology-uk-workforce-census-2019-report