Report finds disparity in treatment across Britain
MPs have called on the NHS to end the postcode lottery of cancer care after a report found that in some areas five times as many patients are waiting more than two weeks to see a specialist.
The report from the All-Party Parliamentary Group on Cancer found that people’s chances of being diagnosed early and surviving various forms of cancer differ significantly across the country, with a gulf between affluent parts of London and the Home Counties and the rest of Britain.
Premature cancer mortality rates are more than twice as high in Liverpool – 157 deaths per 100,000 people below the age of 75 – as they are in Kensington and Chelsea, west London, where fewer than 78 people die early.
Chair John Baron told the Telegraph: “It is a national disgrace that a quarter of all cancers are first diagnosed as late as A&E – late diagnosis makes for poor survival rates. We need to redouble our efforts at every level to promote earlier diagnosis – cancer’s magic key – so that our survival rates catch up with other countries.”
People living in the North East have more than double the chance of being sent for a targeted form of radiotherapy than those living the South West.
There was also a wide regional variation in urgent referral rates, ranging from under 800 referrals per 100,000 in areas of London to nearly 3,500 per 100,000 population in the North East and East Anglia.
“Where a person lives should not determine whether or not they see a specialist to have potential cancer symptoms investigated,” the report authors said. “NHS England should set out how it will work to improve equitable access around GP ordered diagnostic tests.”
A Department of Health said it was committed to improving cancer survival and mortality rates across the country.
“Every single patient in the NHS has a right to the very best care, irrespective of where they live, to ensure that they have the highest chance of surviving cancer,” a Department of Health spokesperson said.
The report follows figures published by NHS England which suggested that fewer than half of patients who are subsequently diagnosed with cancer were referred to a specialist by their GP.
Another recent study found that survival rates for nine out of 10 common cancers are lower in the UK than the European average.
More than a quarter feel stressed at work all or most of the time
One in five British employees (19.6%) have taken time off work due to stress, a survey shows.
Factors such as unrealistic deadlines, pressure from above and lack of support are cited as the biggest culprits in causing stress.
More than a quarter of workers (28.8%) said they feel stressed at work all or most of the time and one fifth (21%) said they take work home at least one to two times a week according to a survey by serviced office provider Business Environment.
Some workers are turning to unhealthy methods as a way to relax – 3% have a cigarette and 6% turn to alcohol. The most popular tactics used to de-stress at work include taking a short walk to get fresh air (43.67%), calling friends or family (32.66%) and having a rant in private (28.02%).
David Saul, managing director at Business Environment, said stress is having a detrimental effect on employee health and wellbeing and on the wider business with billions being lost in days taken off sick.
“I believe all employers have a responsibility to challenge the status quo and cultivate an office environment where employees feel supported by senior staff and able to voice concerns before stress levels go through the roof. Of course, there will be times when employees are required to go above and beyond, but this should never be at the detriment to their health,” he said.
The findings underline the negative effects stress can have in the workplace. One in 12 (7.87%) said they have shouted at a colleague as a result of stress, while 3.4% have thrown something across the room and 2% have sworn in front of a client or customer.
The back to work blues make Monday the most stressful day of the week for more than a third of workers (36.06%), while Thursday is voted the calmest day in the office.
In the 1960s just three in 10 beat the disease
More than eight in 10 children with cancer now survive, compared to just three in 10 in the late 1960s.
The number of children surviving cancer for five years or more has risen from 79% to 82% in the last decade.
The latest figures from Cancer Research UK show that survival has improved for all children’s cancers, but liver and bone tumours appear to have made particularly good progress in recent years. Within the last decade five-year survival for liver tumours has jumped from 67% to 82% and for bone tumours from 61% to 68%.
However, there is still some way to go with certain forms of the disease such as neuroblastoma (67% five year survival) and medulloblastoma (64% five year survival).
Surviving does not mean that children are completely free of illness. Even 30 years after their diagnosis, 40% of survivors were affected by severe or life-threatening conditions, or had died due to a chronic health condition.
Professor Peter Johnson, Cancer Research UK’s chief clinician, said the charity is funding a range of trials to develop new treatments for cancers where there are currently few treatment options, such as aggressive neuroblastoma.
“We hope these efforts will mean there are even more childhood cancer survivors in the UK in the years to come,” he said.
Health tourists are ‘leapfrogging’ legitimate NHS patients awaiting surgery
Cancer surgery for legitimate NHS patients is being cancelled to make way for health tourists, it has been claimed.
Under NHS rules any patient urgently referred by a GP for cancer surgery must receive treatment within 62 days, but health tourists about to breach the 62-day rule are leapfrogging rightful sufferers awaiting surgery.
Professor J Merion Thomas of London’s Royal Marsden Hospital told MPs that even if he knew a patient was ineligible he could not declare this because of the duty of confidentiality.
“Sometimes I have to cancel a genuine patient to allow a tourist to come through. That really, really bothers me. I know exactly what happens then. They do not attend follow-up appointments. Why? Because they have gone back to wherever they have come from. It really happens so often, weekly I would say,” Thomas said.
Jacqueline Bishop, co-chairman of the NHS Overseas Visitors Advisory Group, said “hospital surfers” switch between locations for treatment to keep costs below the £1,000 threshold at which debt must be reported to the Department of Health.
With the current system of charging overseas visitors so complicated, Bishop said most hospitals were reluctant to identify health tourists because it would leave them out of pocket.
“Every overseas visitor whom I identify I cannot charge the clinical commissioning group for. We therefore have two choices: get it off the patient or write it off. There are NHS trusts out there that do not identify overseas visitors because it is not in their best interests,” she said.
Health secretary Jeremy Hunt wants to impose a £200 charge on some visitors seeking medical treatment.
But Thomas said this would become the world’s cheapest private insurance scheme, offering overseas visitors cheap prices for procedures costing British taxpayers thousands, according to the report in the Sunday Express.
Just 20% of overseas visitors who are identified and charged actually pay.
Thomas is campaigning for a pre-registration system requiring everyone to prove their right to NHS care before they can access it.
It has also been claimed that if a £200 charge is introduced for foreign visitors, the NHS might end up paying the bill when they recruit healthcare workers from overseas.
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Test distinguishes between deadly and less harmful tumours
A prostate cancer test which predicts how aggressive a tumour is could spare men unnecessary operations, researchers suggest.
Early data, presented at the National Cancer Research Institute conference, suggests a genetic test can identify the less harmful tumours which do not have to be immediately removed by surgery or radiotherapy.
Around half of prostate cancer sufferers have a low-risk type of cancer, but it is extremely difficult to distinguish between deadly tumours and less harmful ones. As a result, more than 90% prostate cancer patients undergo surgery or radiotherapy which can cause incontinence and leave them infertile, the BBC reports.
One of the researchers, Professor Dan Berney from Queen Mary University of London told the BBC: “We need a better test as we are over-treating many men; most will die with, not of, prostate cancer. We need to discriminate between the aggressive forms and those that will grumble along and just need monitoring.”
The commercial test, developed by Myriad Genetics but independently assessed by Queen Mary University of London, looks at the activity level of genes inside a sample of the tumour. If 31 genes involved in controlling how cells divide are highly active, it indicates the cancer is aggressive.
The test, called Prolaris, costs £1,700 a time but the academics said it could save the NHS money as expensive radiotherapy and surgery could be avoided.
Prostate cancer is the most common male cancer in the UK. There are more than 40,000 new cases diagnosed and 10,000 deaths each year.
Last week, figures from Cancer Research UK showed that death rates from prostate cancer have fallen by 20% since the early 1990s, although the actual number of deaths has increased.
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Organisation has been losing £0.5m a week since the 111 phone line launched
NHS Direct will be closed down in England by the end of the financial year.
The telephone and online health advice provider, which was launched 15 years ago, got into financial difficulty after winning a number of the contracts for the 111 phone line.
It recently said it is pulling out of those and the latest announcement means its other services, including an information website, GP appointments booking line and complaints service, will be closed or transferred to other NHS bodies.
The organisation has been losing about £0.5m a week since the launch of the 111 phone line in April. It used to be paid more than £20 per call when it ran the old 0845 number, but the payment was £7 to £9 per call for the new 111 service and call volumes were lower than expected. Projections reported earlier this year showed NHS Direct had lost £2.8m from April to June and was heading for a deficit of £26m if it continued until March.
The NHS Direct group in Wales is unaffected.
But income protection complaints rise by 5%
Complaints about critical illness insurance have fallen by 18 per cent year-on-year from 348 to 285.
The latest figures from the Financial Ombudsman Service, which reveal the number of complaints it received between July and September, also show that income protection complaints rose by 5% year-on-year from 336 to 352.
Term assurance complaints rose by 12% from 687 to 784 and, of those, 23% were upheld. Complaints about whole of life fell by 26% from 657 to 487 with 20% of complaints upheld.
Complaints about missold payment protection insurance (PPI) increased by 72% year-on-year from 66,882 to 115,247. The ombudsman upheld 61% of PPI complaints, down from 67% the previous year.
In total, the ombudsman received 143,177 new complaints between July and September – an increase of 39% year-on-year.
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More people dying of disease than ten years ago
More people are dying of kidney cancer than they did a decade ago, according to official figures.
Incidence rates of the disease have increased by 31% over the last 10 years and mortality rates have increased by 7% over the last decade, with around 3,500 people dying from kidney cancer in England in 2011.
The figures, released by Public Health England, shows that of those diagnosed with kidney cancer, approximately 71% will survive for at least one year, with around 54% surviving for at least five years.
However, the earlier kidney cancer is diagnosed the higher the chance of survival. When diagnosed at the earliest stage, one year survival is as high as 92-97% compared to just 25-32% at a late stage.
One of the reasons people do not receive an early diagnosis is due to the public’s lack of awareness of key symptoms.
The figures have been released as a new NHS Be Clear on Cancer campaign launches today to drive awareness of blood in urine as a key symptom of bladder and kidney cancers.
Professor Kevin Fenton, director of health and wellbeing at Public Health England, said: “Receiving an early diagnosis increases the chance of survival for the 16,600 people who are diagnosed with bladder or kidney cancer every year in England.
“Our message is clear – as soon as you spot blood in your pee, visit the GP. It’s probably nothing serious but it could also be a sign of something else that needs treatment, so don’t ignore the symptoms or put off a trip to the doctor.”
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Condition has devastating impact on sufferers’ quality of life and ability to work
One in four people who suffer from back pain have also suffered from depression, according to figures published this week.
A study of 2,000 people carried out for Friends Life shows the devastating impact that back pain can have on sufferers’ psychological wellbeing.
The research, published to mark the start of Backcare Awareness Week, shows that 70% of people with back pain say the constant discomfort made them miserable. More than a quarter (26%) revealed that it made them stressed.
The figures appear to support widely-held views that a person is three to four times more likely to have depression if they have chronic low back pain, when compared to the general population.
The research also reveals the severe impact back pain can have on a sufferer’s ability to work, with serious consequences for both workers and their employers. Overall over one in five (21%) back pain sufferers have taken time off work because of their condition and, of those who had taken time off, 39% had been off work for at least a month, with 6% having taken off at least a year.
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