NHS Cancer Programme: Cancer services recovery plan

NHS Cancer Programme: Cancer services recovery plan
NHS England 14 December 2020

• Phase 3 of the response to the pandemic around cancer services outlines full recovery of NHS cancer services in England.

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study
The Lancet Oncology v 21(8), P1035-1044, August 01, 2020 DOI:https://doi.org/10.1016/S1470-2045(20)30392-2

• The researchers used age-stratified and stage-stratified 10-year cancer survival estimates for patients in England, UK, for 20 common tumour types diagnosed in 2008–17 at age 30 years and older from Public Health England. We also used data for cancer diagnoses made via the 2-week-wait referral pathway in 2013–16 from the Cancer Waiting Times system from NHS Digital.

Third phase of NHS response to COVID-19

Third phase of NHS response to COVID-19
NHS England 31 July 2020

• Update on the latest Covid national alert level; priorities for the rest of 2020/21; and an outline of financial arrangements heading into Autumn as agreed with Government.
• A: Accelerating the return of non-Covid health services, making full use of the capacity available in the window of opportunity between now and winter
• A1. Restore full operation of all cancer services.
• A2. Recover the maximum elective activity possible between now and winter
• A3. Restore service delivery in primary care and community services.
• A4. Expand and improve mental health services and services for people with learning disability and/or autism
• B: Preparation for winter alongside possible Covid resurgence
• C: Doing the above in a way that takes account of lessons learned during the first Covid peak; locks in beneficial changes; and explicitly tackles fundamental challenges including support for our staff, action on inequalities and prevention.
• C1. Workforce
• C2. Health inequalities and prevention.
• Financial arrangements and system working 
• Financial arrangements for CCGs and trusts set out in Annex Two.

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK:

Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study
Lancet Oncol 2020 20 July 2020 https://doi.org/10.1016/S1470-2045(20)30392-2

• During the COVID-19 lockdown, referrals via the 2-week-wait urgent pathway for suspected cancer in England, UK, are reported to have decreased by up to 84%. This research examined the impact of different scenarios of lockdown-accumulated backlog in cancer referrals on cancer survival, and the impact on survival per referred patient due to delayed referral versus risk of death from nosocomial infection with severe acute respiratory syndrome coronavirus.

Abstract

Tele-oncology in the COVID-19 Era: The Way Forward?

Tele-oncology in the COVID-19 Era: The Way Forward?
Trends Cancer. 2020;6(7):547-549. doi:10.1016/j.trecan.2020.05.013

• COVID-19 has had a devastating impact on the care of cancer patients. Thus, tele-oncology has become a necessity to improve cancer care. Several organisations have issued guidelines for its use during COVID-19. Despite certain shortcomings, tele-oncology has great potential to help cancer patients during COVID-19 and in the future.
• Table 1: Summary of the Advantages and Disadvantages of Telehealth Technologies in Oncology

New approaches to cancer care in a COVID-19 world

New approaches to cancer care in a COVID-19 world
The Lancet Oncology v21(7) E339-E340, 1 July 2020. DOI:https://doi.org/10.1016/S1470-2045(20)30340-5

"Cancer is a major cause of morbidity and mortality, made acutely worse by the COVID-19 pandemic, and requires sustained investment and coordinated planning in a COVID-19 world. Health leaders now need to safeguard capacity and regain lost progress in cancer control. Available resources should be directed to those most likely to benefit. National media campaigns should be used to boost screening uptake and help-seeking behaviour for potential cancer symptoms, addressing the current delays and barriers in access to health care. Investment in cancer diagnostic workforces will be key, particularly in building up provisions for tests and biopsy procedures and shortening diagnosis-to-treatment intervals. The pandemic has also created opportunities to improve efficiencies in care, such as virtual consultations and visits. Facilitating multidisciplinary team meetings digitally is one of many potential changes requiring long-term investment in technology and infrastructure."

This article presents a series of recommendations to inform policies which deal with a new cancer burden in a post-COVID-19 environment and to mitigate a potential crisis in excess deaths due to cancer.

Recommendations:

Recovery of surgical services during and after COVID-19

Recovery of surgical services during and after COVID-19
Royal College of Surgeons updated 26 May 2020

• This page is regularly updated with new tools to help put this guidance into practice. 
• Includes Checklist for restarting elective services

Bridging guidance for critical care during restoration of NHS services

Bridging guidance for critical care during restoration of NHS services [after COVID-19]
Faculty of Intensive Care 22 May 2020

• Guidance as we move in to the next phase and recognise the importance of initiating and managing this phase in a methodical and realistic way.
• Enhanced Care may present an opportunity to maintain an upskilled reserve workforce for future pandemics and other significant emergency events.