Category Archives: Public Affairs

What we’d like to see from the Cancer Strategy: one year on

It’s a big week for the All Party-Parliamentary Group on Cancer (APPGC). Ahead of today’s Britain Against Cancer conference and Thursday’s much-anticipated Backbench Business debate on cancer in Parliament, Ayesha Ahmed, Secretariat to the APPGC, reflects on the inquiry held by the group earlier this year into the progress of the 2015 Cancer Strategy in England.

Cancer services in England are at a crucial turning point. It is estimated that by 2030, 3.4 million people will be living with cancer in England and this figure continues to increase.  Transforming cancer services is no longer an option but a necessity, and is why implementation of the England Cancer Strategy is so important. This is an issue that Macmillan have been working on in our capacity as Secretariat to the All-Party Parliamentary Group on Cancer (APPGC), a position we have held for over seven years.

 

What is the APPGC?

The APPGC was founded in 1998 with the aim to keep cancer at the top of the parliamentary agenda, and to ensure that cancer policy remains evidence based and patient centred. The group consists of cross-party MPs and Peers, who monitor government initiatives, produce briefings for parliamentarians and campaign and debate on key issues in order to bring about improved cancer services for all those people affected by cancer.

appgc-inquiry-report

September’s inquiry report

In May this year, the APPGC held an inquiry looking into progress made since the publication of the report, Achieving World-Class Cancer Outcomes: A Strategy for England 2015-2020 (‘Cancer Strategy’) by the Independent Cancer Taskforce in July 2015, including a focus on the implementation plan published by NHS England in May 2016, Achieving World Class Outcomes: Taking the Strategy Forward (the Implementation Plan) which set out how the recommendations would be rolled out over the next five years.

The APPGC received written submissions from over 30 stakeholder organisations, from charities, pharmaceutical companies to Royal Colleges and patient representatives, and hosted oral evidence session to hear from key decision makers.

Having collated all the oral and written evidence, the APPGC published a report, Progress into the implementation of the England Cancer Strategy: one year on.

 

What needs to happen?

Whilst welcome progress has been made on delivering certain recommendations within the England Cancer Strategy since its publication, the APPGC’s inquiry highlighted concerns regarding the Implementation Plan and lack of visible progress made in other areas.

The APPGC therefore put forward three key recommendations to the Government and NHS England:

  • Firstly, the government needs to give further clarity over how it intends to fund the England Cancer Strategy each year, over the next four years.  Many contributors expressed their disappointment over the absence of detail on funding in the Implementation Plan, and sought specifics about how available funding would be used to deliver improvements across the entire cancer pathway.  Whilst some of this detail was set out in the Cancer Transformation Board’s one year on report, further clarity is still needed on how funding will be allocated to the six strategic areas outlined in the Strategy.
  • There needs to be further transparency regarding progress from NHS England and other Arms-length Bodies on how each of the recommendations as outlined in the England Cancer Strategy are being delivered. In addition, more detail is needed to explain how the Department of Health intend to hold these bodies to account and measure success of the delivery of the England Cancer Strategy by 2020.
  • Thirdly, the APPGC called on the National Cancer Transformation Board and the National Cancer Advisory Group to ensure greater involvement and collaboration with charities, other arms-length bodies and patients in the delivery of the England Cancer Strategy, locally and nationally.

 

What next?

The APPGC’s annual flagship event, Britain Against Cancer, is in its 18th year. As part of the conference today, we will be highlighting the Inquiry Report recommendations, calling on Government and NHS England to respond to the report and discussing how the cancer community can come together and work to ensure improved cancer outcomes. Follow the conference at #BritainAgainstCancer and Macmillan’s updates @MacmillanPA

The APPGC have also secured a Backbench Business debate on Thursday, titled Cancer Strategy: one year on, which also serves as a timely and welcome opportunity to discuss cancer services in the NHS today.  The debate will be a crucial opportunity for MPs to question the Minister on how the Strategy is progressing, and we look forward to monitoring the contributions on Thursday.

 

Why it’s vital that carers of people with cancer are supported through the Carers Strategy

Macmillan’s new report, Cancer Then and Now, shows that more people than ever are living longer following a cancer diagnosis and often with the complex consequences of treatment. There are now an estimated 2.5 million people living with cancer in the UK, a figure that is expected to rise to 4 million by 2030.

The implications of this are significant. More and more people are taking on caring responsibilities for a friend or family member with cancer. Since 2011 we’ve seen the number of carers of people with cancer in the UK rise from 1.1 million to nearly 1.5 million, an eye-opening increase of nearly 27%. Without this vital support, many people with cancer would have to face it alone.

As the story of cancer changes so too has the role of carers of people with cancer, who are now providing more hours of care than ever before and undertaking tasks which are more complex in nature. With carers taking on increased levels of responsibility, their support needs have also grown. The contribution of unpaid carers across the country is invaluable and without them the health and social care systems would be under impossible pressures. But no-one who looks after someone should have to face it alone, and we need to ensure that there is adequate support to meet their growing needs.

It’s therefore extremely welcome that the Government has committed to developing a new Carers Strategy for England to ensure that carers are supported to live well whilst caring.

What do cancer carers want to see in the Carers Strategy?

Macmillan’s response to the Carers Strategy call for evidence was informed by new research and the experiences of over 400 cancer carers living in England.

Through our response we wanted to raise awareness of carers of people with cancer and the huge contribution they make, but we also needed to challenge the common misconception that cancer is an acute and terminal illness. Around half of those diagnosed with cancer today live for at least ten years after diagnosis. Despite this, many people aren’t aware of the impact and long-term consequences of the condition and how this can affect friends and family members who become carers.

It’s therefore essential that the Carers Strategy recognises the unique role and the significant contributions that carers of people with cancer in England make to our society.

Since 2011, the nature of the support that carers of people with cancer provide has become increasingly varied. Carers are now more likely to provide hands-on personal care, undertake healthcare tasks and help the person with cancer navigate the complexities of the health and social care system. Yet many carers are still receiving little or no support.

Macmillan’s research found that whilst almost a third of carers of people with cancer are providing vital healthcare support for the person they’re caring for – including changing dressings, giving medication and managing infection control – 40% of them have not received any training or support to do this.

Whilst the experience of caring is different for everyone, there are many similarities in the issues which cancer carers face. This includes the important role of health professionals in identifying carers and signposting them to support, and the need for health and social care professionals to involve carers as equal members of the cancer care team when the carer chooses this.

And, at present there’s a disconnect in the system; many carers don’t come into contact with their local authority or the voluntary networks where much of the available support can be accessed. Instead they will typically interact with health professionals, such as when attending appointments alongside the person they care for. But our research has found that only 1 in 5 healthcare professionals say that they always identify carers and signpost them to support.

What is Macmillan calling for?

Macmillan is calling for the strategy to recommend mechanisms which will improve the identification and signposting of carers to the right support. This could include placing a statutory duty on health bodies requiring all health professionals in these settings to identify and signpost carers to support. Unless this is routinely done, carers will continue to miss out on having their needs assessed and having adequate support put in place to address these.

We should also be moving towards making carers a more integral part of the cancer care team; valuing their expertise, sharing information more readily between professionals and carers, and training carers in how to provide care safely. Furthermore it’s vital that the strategy recognises the need to support health professionals to support carers through appropriate training.

There’s an important role for the strategy to recognise and support the rights of carers of people with cancer who are currently in employment. And finally, it’s essential that the strategy also recognises the role of the welfare system which many carers rely on whilst caring.

What happens now?

In early July the Minister leading the strategy, Alistair Burt MP, announced that he was stepping down as Minister for Community and Social Care. His replacement David Mowat MP brings the carers and the cancer brief together at the Department of Health, presenting a new opportunity to take a holistic approach to supporting carers and the people they care for.

It’s essential that the Westminster Government now prioritises the development and alignment of policies that promote better cross-working between health and social care professionals, the voluntary sector and carers to ensure that appropriate and easily accessible support is put in place.

And whilst the strategy will only determine future policy affecting carers in England, Macmillan continues to influence on carers issues throughout the UK.

In Wales, Macmillan is working as part of the Wales Carers Alliance to help refresh the Welsh Government’s Carers Delivery Plan and Carers Strategy, raising concerns around how local authorities will meet new enhanced duties to identify and meet the needs of carers through services delivered locally.

In Scotland, Macmillan welcomed the emphasis on support for carers within the Scottish Cancer Strategy, as well as the new support measures promised to all carers in the Carers Act. Our focus now is on ensuring the promised improvements to carer support are delivered. We will monitor this closely and continue to ensure the needs of those caring for someone with cancer in Scotland are recognised.

Whilst Northern Ireland is the only region of the UK without recent legislation to improve support for carers, Macmillan has joined forces with other charities in a new Carers Coalition to raise awareness of the huge contribution made by people caring for family members and friends. And we will continue to push the Northern Ireland Executive for progress.

In England, Macmillan will be working closely with the Department of Health in the coming months to ensure that the voices of cancer carers are heard and represented in the development of the strategy.

For more information about Macmillan’s work to support cancer carers across the UK, please contact Ben Parker (beparker@macmillan.org.uk)

Why we can’t be daunted by the workforce challenge

The NHS employs around 1.5 million people (around 1.2 million of these in England), putting it in the unlikely company of McDonalds, the US Department of Defence and the Chinese People’s Liberation Army as one of the largest employers in the world.  It’s perhaps no wonder then that workforce has always been one of the hardest questions for the NHS to tackle – how best to use 1.5 million people to deliver healthcare to a population of 64 million?  With the NHS seeming to constantly lurch from one crisis to another on workforce, is the question just too difficult to answer?  At Macmillan, we think it can’t be, and that starting with the cancer workforce could be a way to start unlocking some of the trickier questions around how to manage one of the world’s five largest workforces.

Since the announcement of the Independent Cancer Taskforce last January and the subsequent publication of the Cancer Strategy for England in July last year, the cancer community has been working hard to decide what cancer care should look like in the future.  We know that the number of people living with cancer is growing and that their complex and changing needs have to be addressed.  We know that care needs to be more personalised, and that improvements need to be made to patient experience right across the pathway.  But we also know that none of this can be achieved without the right workforce with the right skills in the right place.

At Macmillan, we understand just how important the workforce is to someone with a cancer diagnosis.  Workforce planning and its associated focus on capacity, skills-mix and retention, may sound fairly dry but the stories we hear from patients about the crucial role played by both the salaried and unsalaried workforce – from the consultant who diagnosed them, to the Clinical Nurse Specialist who supported them through treatment, to the volunteer who provided them with information and support – remind us why this is such a crucial part of delivering the ambitions set out in the Cancer Strategy for England.

But it also reminds us of why it is such a huge challenge.  The needs of the 2 million people currently living with or beyond cancer in England are complex and varied, and whilst many people with cancer have a positive experience of their care, too many people do not have the support they need.  Data shows us that there are gaps in key professions including Clinical Nurse Specialists and General Practitioners, and professionals across the health service are still hampered by organisational boundaries and silos.  Add into this mix the unprecedented financial challenges facing the NHS, the need to deliver the changes set out in the Five Year Forward View, and uncertainty around what impact the EU referendum result may have on the NHS workforce, and the challenge of developing a sustainable cancer workforce that is fit for purpose can seem a daunting prospect.

It is vital however that we don’t shy away from this challenge.  The Cancer Strategy for England recognised how integral workforce is, and included a number of recommendations, with the key one being that Health Education England should work with NHS England and other bodies to conduct a strategic review of the cancer workforce.  We believe that this is one of the most important recommendations in the strategy and offers a huge opportunity to think differently about what the cancer workforce needs to look like in the future.

The scope of this recommendation means that it will require the support of the whole cancer community to deliver.  That’s why earlier this year we worked in partnership with Cancer Research UK to bring together around 30 organisations including charities, professional bodies, Royal Colleges and Health Education England themselves, to discuss what the strategic review should look at.

The output of this event is a set of eight principles which those organisations, along with Macmillan and CRUK, believe should underpin the workforce review.  For example, principle one states that the review should look both at the current and future cancer workforce, whilst principle four states that the review needs to demonstrate how the workforce can be educated and supported to develop the right skills, training and behaviours to deliver high quality and compassionate care.  We believe that all of them are equally important, and all need to be considered if the review is to set out a meaningful vision for what the cancer workforce of the future should look like.  However, they should be just the start of the conversation and we’d like you to get in touch and tell us what you think – is there anything else that should be prioritised?

What ultimately underpins these principles is a shared consensus that there is an urgent need for change. We must be ambitious when thinking about when, where and by whom care is delivered.  It is no longer possible to plan for the future workforce by thinking soley about numbers of current professionals. We need to start with the needs of the patient and decide how the workforce can best meet the challenge, not just of a rising population but of a changing demographic with more and more people living with cancer as a long term condition (something which we highlighted in our report released earlier this month on how cancer care has changed over the last few decades).

Importantly, we also need to think about how strategic workforce planning should work in future.  A number of think tanks have highlighted the challenges around workforce planning in the NHS more widely, with data gaps and a lack of clear roles and responsibility in relation to workforce strategy being two key issues.  These challenges are all borne out in the current challenges facing the cancer workforce, and as cancer involves a wide variety of professions, specialisms and settings we believe it can be an effective test bed, with lessons that can be applied across the NHS.

At Macmillan, we’re excited about the opportunity to start tackling some of these big questions, and we’re inspired by the drive, commitment and consensus of the cancer community on this important issue.  If the Cancer Strategy is to make a real difference to the experience of individual patients by 2020, it is important that this momentum is retained and that workforce is at the heart of the Cancer Strategy implementation.  Over the next few months, we’ll be continuing to think about what the future workforce should look like, so why not get in touch and tell us what you think.

Rebecca Leech, Senior Public Affairs Officer

Contact: RLeech@macmillan.org.uk or NKennedy@macmillan.org.uk

@MacmillanPA

 

Don’t underestimate the value of a good experience

Last year the number of people living with cancer in the UK was estimated at 2.5 million. And assuming that all existing trends continue, this number is projected to increase to 4 million by 2030. At Macmillan, we think this makes it more important than ever to ensure cancer patients not only get the most appropriate treatment, but that they also have a good experience of care.

All patients should have a positive experience of care and be treated with the highest levels of dignity and respect throughout their cancer journey, regardless of who they are or where they live. While an extreme example, the shocking events at Mid-Staffordshire NHS Trust showed that too many people were not being treated with dignity and respect: patient experience was not a priority. This is despite the NHS Mandate clearly stating that it aims for a health service ‘where compassionate care and patient experience are as important as clinical outcomes’.

Because support for people affected by cancer is central to everything that we do at Macmillan, we want to see patient experience as a priority. Unfortunately, our evidence shows that across the NHS, patient experience is still not regarded as having equal importance as clinical outcomes and that there is unacceptable levels of variation in patient experience.

Experts we’ve spoken to tell us that this is because patient experience is not meaningfully prioritised at all levels of the system.  For example, when hospital boards raised patient experience as an agenda item, only 5% of these items had further actions attached to them.

We can see the knock-on effects of this in the results of the National Cancer Patient Experience Survey (NCPES) for England. This survey is an opportunity for patients to voice how they felt about the care they received and in so doing, provide valuable feedback to hospitals about what is working well and what isn’t. This can then be used to drive meaningful improvement on the ground.

Unfortunately, what recent survey data has shown is that there is a lot of room for improvement. A snapshot of the 2015 NCPES found that 1 in 5 did not have a good overall experience of care and more than one in 10 patients felt they weren’t always treated with dignity and respect.

The Independent Cancer Taskforce published its Cancer Strategy for England in July last year, setting out its recommendations for how to improve cancer care over the next 5 years. One of the recommendations was that a metric, or set of metrics, was developed “that would encourage providers and commissioners to focus more consistently on improving people’s experiences of their care, treatment and support”.

Macmillan lobbied for this recommendation on the basis that embedding a metric in accountability mechanisms sets out clearly that patient experience is a national priority, and pushes NHS England, hospitals and others to do more to improve how people living with cancer experience their care.

This is the first time that it has been recognised at a national level that how someone experiences their care can be just as important as the result of their treatment. Patient experience now sits alongside other key indicators of cancer care quality – such as one-year survival and cancer waiting times – in the CCG Local Improvement and Assessment Framework as well as the Cancer Dashboard.

We believe this is a critical first step in being able to reach the aim set out in the NHS Mandate to make compassionate care and patient experience as important as clinical outcomes.

Now we want to see this become a reality for every cancer patient. That means NHS England needs to start thinking about how it can go beyond the metric and use the data and information on patient experience to drive meaningful year on year improvement in patient experience. This requires action at all levels – from each individual healthcare professional, to hospital boards and trusts, commissioners and system leaders and only then will patients really experience an improvement in their care.

Victoria Woods, Senior Public Affairs Officer, @vgwoods

George Osborne

Five thoughts on what the Chancellor’s spending review means for people affected by cancer


1 December, 2015
James Shield, Senior Policy Analyst  |  @jshield
Victoria Woods, Senior Public Affairs Officer  |  @vgwoods

It was widely reported last week that George Osborne has committed billions of pounds of ‘extra’ money for the NHS over the next five years as part of his Comprehensive Spending Review. But what is the bigger picture for healthcare, social care and welfare, and what will the announcements mean for people affected by cancer?

1. Extra funding for the NHS is welcome – but it needs to be spent wisely

It is good to hear the government is investing in the NHS’s plan for the next five years, and that £3.8bn extra will go into the NHS next year; our creaking health service badly needs this money now.

But three quarters of England’s hospitals are now running a deficit, which by the end of the year is expected to hit £2bn. We have seen the impact of this pressure on frontline cancer services: cancer waiting time targets have now been missed for seven quarters in a row. In the short term, the extra money will help to plug the black hole in NHS balance sheets, which we hope will mean getting back on track with meeting existing targets.

It is now crucial that the government spends wisely and fully funds and implements the cancer strategy for England which will be transformational for cancer care. Although the cancer strategy was mentioned in the Spending Review, this was only to reiterate a commitment to implement the previously announced recommendations on a new 4-week target for diagnosis and improved diagnostic capacity through £300m in funding.

As we said in October, time is running out: by 2020, there will be half a million more people living with a cancer diagnosis in England than in 2015. The strategies and solutions to support this growing population and avoid further crises have been agreed – what we need now is action. Macmillan will continue to push for the cancer strategy to be implemented in full.

2. We often hear that to have a strong NHS we need a strong economy – but despite extra funding, the NHS is not receiving its fair share of the proceeds of growth

The Government has often said that we need a strong economy to have a strong NHS. The reverse is just as true – we need a strong NHS and a healthy population to have a strong economy. As the economy returns to growth, we should invest in the long-term health of the nation. But on the evidence we saw in the Spending Review, it looks as though health and social care funding are going in the opposite direction.

Billions of pounds of extra money is a big investment, but as the population ages, more treatments become available and more people survive diseases such as cancer, the demand for healthcare could still outpace funding. Even with the additional money, we are now mid-way through the longest decline in NHS funding as a percentage of GDP since the war:

What does this mean for cancer services? The picture is unclear: we don’t yet know how the NHS will use its funding allocation, and will find out more when NHS England’s plans are published in early 2016.

What we do know is that between 2010-2013 spending per cancer patient had already fallen by between 4-10% (the latest figures available).

It can be difficult to know whether healthcare funding necessarily leads to a healthier society, and not all high-spend health services get value for money, but there comes a point where it is clear that more could be done with additional funding, and this is true of cancer.

In comparison with the rest of the world, both our level of healthcare spending and our cancer survival rates fall short. Last week’s announcement means that over the next five years, the share of GDP the UK spends on the NHS will fall even further below European and OECD averages:

3. Cuts to public health and bursaries for nurses are counterproductive

We understand much of the extra £3.8bn for the NHS next year is in fact sourced from a 25% cut to the Department of Health’s non-NHS budget.

It is counterproductive that ‘extra’ NHS money is being sourced from cuts to public health (which includes cancer screening and smoking cessation clinics) and bursaries for student nurses. This precious investment should be used to drive genuine progress – instead, it is being used to paper over the existing cracks.

Local authorities’ public health budgets will also fall by an average of 3.8% in real terms each year. The public health ring-fence will be ‘maintained until 2017/18’, which implies it might not continue afterwards.

This means the Spending Review has failed to meet one of the ‘five tests’ set by the head of the NHS, Simon Stevens, for the Spending Review – to “make good on the public health opportunity”.

4. We’re still concerned about social care funding

Funding the health service is just one side of the coin. The needs of people living with cancer are often life-long, and many require non-medical support to get by.

We are concerned that continuing pressure on social care budgets means that extra funding given to the NHS could end up being spent propping up a cash strapped social care system.

George Osborne announced a new optional levy on council tax of up to 2% per year, which is to be ring-fenced to fund adult social care. But commentators are suggesting that even if this is implemented by every council each year there will still be a substantial funding gap.

Perhaps even more problematic is the risk that access to social care could become more of a postcode lottery and exacerbates health inequalities by disadvantaging councils with weaker tax bases. According to the Institute for Fiscal Studies, councils such as Manchester, Hackney, Liverpool, Newcastle and Birmingham could only raise an extra 4%, while Richmond and Windsor could raise 17-18%. Meanwhile the King’s Fund warned the measures “are not a substitute for sustainable funding”.

No other advanced economy is reducing the share of national income spent on social care, as the UK is doing. We know that during the first few years of the last parliament’s social care cuts, over 360,000 fewer older people received social care than before. It is difficult to be optimistic about the future of social care against this background.

5. The welfare situation has changed less than the headlines suggest – and we will do all we can to be there for people affected by cancer

One of the big headlines after the Spending Review was the government’s supposed u-turn on its controversial proposals to cut Tax Credits. While we welcome this change because we know many people with cancer use this financial support, this is only a short-term gain, as the same cuts will continue to apply to Universal Credit, which is already being phased in.

Despite talk of u-turns, the impact of tax and social security changes over the next four financial years will be the same as first estimated after the July Budget statement (the poorest 20% will still be around 7% worse off). The Chancellor also reiterated his commitment to implement £12bn of savings, part of which is the already announced cut to ESA WRAG, which we are campaigning to stop.

Macmillan believes it is vital people affected by cancer get the support they need through the social security system, so monitoring and responding to the introduction of Universal Credit will continue to be an important part of our work.

What do you think about the impact of the Spending Review? Let us know in the comments below.

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MPs grilled by Cancer Voices at Macmillan Question Time

Luciana Berger MP, Lynda Thomas, Martyn Lewis, Jo Churchill MP, and Norman Lamb MP

Luciana Berger MP, Lynda Thomas, Martyn Lewis, Jo Churchill MP, and Norman Lamb MP

By Nafisa Shk, a Macmillan Cancer Voice

On the 9th of September I was given the opportunity to attend the Macmillan Question Time 2015 at the house of parliament. Having never attended before, I was beyond excited about this opportunity, mainly because cancer has affected me and my family majorly. Having lost my mother 3 years ago to cancer, I decided to dedicate my time and effort being involved in campaigning with Macmillan. The event itself was designed to put forward some key points for the MPs to follow upon.  We the people however played a vital role in not just asserting these points, but also using our own experience with cancer to convince the panel on why these issues are paramount. The aim of this event was to give a platform to people affected by cancer, Cancer Voices and Health Care Professionals from different  backgrounds  to discuss the most vital parts of their journey and what needs changing.

Macmillan’s desires four essential points to be put into action:

  • Integrate local services and share best practice across the NHS by creating new boards of local experts, commissioners, and patients called Cancer Alliances
  • Improve life after treatment by fully-funding a five-year Living with and Beyond Cancer Programme which will roll out new initiatives to improve support. An example would be Macmillan’s Recovery Package which measures quality of life for people living with and beyond cancer to understand how they should be supported
  • To recruit more staff for in-demand roles such as Clinical Nurse Specialists; as well as make sure staff have the right skills, training, and behaviour; that they deliver high-quality care; and support carers
  • Introduction of new measure of patient experience to drive improvements in care more generally.
Cancer Voices

Cancer Voices, Macmillan staff and MPs mingling at the Cancer Voices reception

The panel was headed by Television Presenter Martyn Lewis and consisted of three MPs representing the three main parties: Jo Churchill (the Conservative MP for Bury St Edmunds), Norman Lamb (Liberal Democrat MP), Luciana Berger (British Labour Co-operative MP) and Macmillan’s Chief Executive Lynda Thomas.  Lynda made a very crucial point about how Cancer does not have to be a life sentence and how important it is to give support to people post cancer, particularly going back to work and living a normal life. Most importantly, Lynda resonated what most of us affected by cancer hope for, achieving better cancer outcomes by working on preventive measures first.

The point I most related to was to deliver high quality care by recruiting more staff and providing up to date training for the right skills, and the support for carers. Personally, as my Mother’s carer I could relate to why it’s necessary that carers are given the care and support they deserve. The stress and effects of cancer can affect not just the patient, but the whole family particularly the carers. Amidst being an advocate for my Mother’s cancer, and her treatment, me and my Sister who also was also a carer for my mom, had to deal with a lot of mixed emotions. I felt the care and the support we expected from the system was not enough.  Carers need to feel safe and protected, given the right amount of resources and training to get through this time in their lives.

People chatting at the Cancer Voices Reception

Small groups discuss the Cancer Strategy during the Cancer Voices reception

The main aspect of this event I noticed was how much freedom we the people were given. This not just included the close interaction between the members and the cancer voice who attended, but most importantly, the chance to meet and communicate our thoughts and experiences with various local MPs. There were no barriers of any kind, be it emotional or professional. We were given an opportunity to lay the forefront issues concerning our individual experiences facing cancer and its consequences. For instance, I got the opportunity to speak candidly about my experience of my family’s cancer journey during the time my Mother got diagnosed with Robin Walker, the Conservative Party MP representing the Worcester constituency.  Robin listened to all of us patiently, giving back suggestions and ideas of his own explaining his own personal experience with cancer.

All in all, being a Cancer Voice with Macmillan is something I would highly recommend anyone with a passion to fight this disease. Macmillan’s has a brilliant team, and the ability to bring together people from different backgrounds and cultures, campaigning and advocating for a cause that unites everyone. I have in the past attended many of their events, and have always been treated with utmost kindness and respect. The thing that struck me the most at the Question time event was how everyone was given a chance to tell their story. The Public Affairs team were highly trained, and knowledgeable, but most importantly compassionate and good listeners.

What question would you have asked our panel?

Cancer – a rare area of political convergence?

Ellie Rose
Macmillan Public Affairs Manager
Originally posted on Respublica on 24 April 2015

So manifestos are out and for those working on charities’ general election campaigns, the anxious wait is over.   Of course we know that, even in a typical election, manifestos are only really of interest to policy wonks and the likelihood of a further coalition in May makes them less significant still. Any policies may be tinkered with, watered down or dropped entirely in the tumult of coalition horse-trading.

However, they do provide the clearest mandate and sense of direction for the next government, whatever the complexity of its makeup. For example, the Conservatives’ 2010 manifesto set out their commitment to introduce a cancer drugs fund, which as you will know they followed through with in coalition*.

So, how did cancer do? Pretty well, all things considered. Cancer was mentioned in all three of the main parties’ manifestos, and by the Greens. This was far from certain a few months ago, with parties suggesting this was going to be the ‘mental health election’ and that, anyway, the economy rather than health would be the focus of manifestos.

living well

Macmillan Cancer Support has been campaigning for a year for parties to include three commitments that people affected by cancer told us mattered most to them. These are: cancer outcomes matching the best in Europe, dignity and respect for all patients, and free social care support to enable more people to die in a place of their choosing. So we were delighted to see each of these in the main parties’ manifestos, in some form or another.

Labour committed to best cancer outcomes in Europe, the Conservatives to world class cancer care, and Liberal Democrats to setting ambitious outcomes for cancer. All parties pledged they would do more to address the factors underpinning our poor outcomes in this country, such as late diagnosis (Labour and Conservatives), access to treatments (same), and after care (Lib Dems).

dignity

On dignity and respect, the Conservatives said they would ensure hospital and GP surgeries are places where you are treated with dignity and respect, Labour said they would support NHS staff to deliver the ambition that all patients are treated with the highest levels of dignity and respect, and the Lib Dems said they would set the highest standards in care.

Finally, on end of life care, the Lib Dems pledged to increase choice at the end of life and provide free social care support for those on end of life registers, if it proves affordable, the Conservatives said they would support commissioners to combine health and social care services for the terminally ill, so that more people are able to die in a place of their choice, and Labour said they would support those who are terminally ill to remain at home with home care provided by the NHS.

good death

There were many further commitments that would impact on the lives people affected by cancer, for example, Labour’s one week wait for cancer tests, the Conservatives’ commitment to deliver the cancer strategy, and Lib Dems’ improved support for carers and legal duty on the NHS to identify them (something Macmillan has been told by cancer carers would make a particular difference to them). All parties made commitments on health system and welfare reform.

All in all there was much to be welcomed, and perhaps an indication of the cross-consensus on health that organisations like the British Medical Association have been calling for, and that could make Simon Stevens, CEO, NHS England’s life a whole lot easier.

Perhaps.

In addition to the impact of a minority or coalition arrangement, there may be other factors that mean that people affected by cancer do not see the rapid implementation of the changes they need, come 8th May.

It is a question of priorities. The Conservatives under David Cameron have been committed to the NHS. But unless they win an outright majority, his leadership could be threatened and a new leader could have very different priorities. Added to this, there is the distraction of an in/out referendum on the EU. Labour is said to be drafting a bill to repeal parts of the Health and Social Care Act 2012, which would be introduced in their first 100 days. Could this detract political energy and capital away from frontline improvements? Finally, the Lib Dems will be keen to make their presence felt in any further coalition government, and reforms to mental health are likely to be a red line for them. Indeed they have repeatedly cited cancer care as benchmark for improvements in mental health, suggesting that they believe it is already ‘fixed’.

But cancer is not fixed. By the end of the Parliament in 2020, 3 million people will be living with cancer. Sadly, already too many people are dying too soon, not being treated with dignity, and being denied a good death. If the system is not coping now, how will it support this growing population?

So despite welcome commitments in manifestos, Macmillan and every single person who cares about cancer will continue to call for urgent action to improve cancer care and services. We will be demanding that whoever forms the next government makes an early announcement of a timetable for implementation of their commitments.

For the one in two of us who will soon face cancer in our lifetime, it is now time to deliver.cross

*The wording of this sentence was changed on 12/6/15 to make it clearer that we were stating a fact about the history of the coalition Government. It replaced “For example, the Conservatives’ 2010 manifesto set out their commitment to introduce a cancer drugs fund, something that they of course followed through in coalition.”