Cancer patients abandoned after treatment

The number of cancer patients being admitted to hospital through accident and emergency has doubled in less than a decade amid claims they are being “abandoned” after receiving treatment.
Cancer patients abandoned after treatmentSuch admissions are meant to be “the exception” but the number has increased from 70,000 in 2000/01 to 140,000 in 2008/09, according to the National Audit Office (NAO).

Macmillan Cancer Support said that showed too many patients were not being cared for properly after being given treatment like chemotherapy and radiotherapy.

According to the NAO’s report, which examines how well the NHS has managed to deliver the last government’s five year Cancer Reform Strategy so far, waiting times have fallen and the number of days cancer patients spend in hospital has dropped.

The strategy, launched in 2007, was meant to make NHS cancer services “among the best in the world” by 2012.

But the NAO report said there was “limited assurance” as to whether the £6.3 billion spent on cancer care annually was money well spent, because such poor information linking spend and outcomes was available.

In particular it illuminated problems caring for cancer outpatients.

Ciaran Devane, chief executive of Macmillan Cancer Support, said: “English cancer services have improved but there is still an incredibly long way to go for the UK to be a world leader.”

She warned: “The NHS won’t be able to support the growing number of cancer patients unless it seriously ups its game.

“The whole NHS needs to realise that cancer is a long term condition for many. If the NHS does not provide appropriate services after patients leave hospital, they can expect to see a massive increase in costs as cancer patients are forced to use emergency services.

“Abandoning cancer patients after treatment is no longer acceptable, nor does it make any financial sense.”

The previous government had pledged to cut the total number of emergency cancer admissions – not just via A&E but also for example by doctors making emergency referrals – but instead the number has been rising steadily.

It has risen from 231,000 in 2000/01 to 300,000 in 2008/09. However, the rate of annual increase has almost halved. Four in five have an existing diagnosis.

Karen Taylor, from the NAO, said there was “poor understanding” of the issue while primary care trusts “don’t appear to be aware of it’s extent”.

Mike Hobday, head of policy at Macmillan, said the reason was clear.

“The traditional NHS approach at the end of cancer treatment has been to say, ‘Go away, you are cured.’ ”

But he explained: “While treatment is in most cases extremely good, people with cancer have ongoing problems. Chemotherapy is toxic – you can’t do it without impacting people’s health.

“Patients aren’t being given the support to manage themselves, so they turn up at A&E.”

A “small investment” in things like better information and dedicated helplines for cancer patients would reap large savings by lowering emergency admissions, he predicted.

With growing numbers of cancer survivors and stretched budgets “the NHS has to do this smarter”, he said.

Dr Jodie Moffatt of Cancer Research UK said the increase could partly be explained by the tripling of cancer patients receiving chemotherapy since 2000. The government was trying to tackle the problem, she argued.

Paul Burstow, the Health Minister responsible for care services, said: “This report is a damning indictment of Labour’s failure to deliver on their promises to improve the quality of cancer care.

“The shocking levels of emergency admissions are the legacy of Labour’s obsession with hitting targets instead of helping patients.

“Under Labour, NHS spending rose to European levels of funding, but they have failed to deliver European levels of quality cancer care. If the NHS was performing at the level of the best in Europe, an extra 10,000 lives could be saved each year.”

Jo Webber, deputy director of policy at the NHS Confederation, which represents health trusts, said: “It is difficult to attribute a rise in emergency re-admissions to any one factor.

“Commissioning appropriate after-care services and providing patients with access to specialist services and home support services all play their part in bringing numbers of re-admissions down.

“Providing patients with access to quality treatment in or close to home, as well as information on local support services, is just as important as the early detection and treatment of the disease when planning an effective cancer strategy.”


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