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Failure to fully integrate NHS and private hospitals during the COVID-19 pandemic will increase cancer death rates

Failure to fully integrate NHS and private hospitals during the COVID-19 pandemic will increase cancer death rates according to our Chief Medical Officer, Professor Gordon Wishart.

Article written by Professor Gordon Wishart. 

On 27th April, Health Secretary Matt Hancock announced that urgent NHS services including cancer diagnosis and treatment would start to be restored from today. From a cancer perspective, this will require an integrated approach from the public-private partnership.

Current problems

1. The public-private partnership has failed cancer patients in many parts of the country, with 2700 patients not being diagnosed weekly during the lockdown.

2. Patients are reluctant to attend NHS hospitals for fear of contracting COVID-19.

3. Many private hospitals have been empty for most of the lockdown period.

A background of failing NHS cancer services

The NHS is not well prepared to deal with a significant backlog of cancer patients for diagnosis or treatment, with Cancer Research UK (1)  reporting worse survival rates than many Western countries, a shortage of oncologists and radiotherapy specialists and a failure to deliver cancer waiting time targets during the last 18 months for diagnosis and treatment.

Help will therefore be required from the independent sector. My previous reports, published in eCancer on 14th & 20th April 2020 (2/3), raised concerns that the lockdown was contributing to delays in cancer diagnosis and treatment and, that the partnership between the NHS and private hospital networks has not protected cancer patients in all parts of the country, with 2700 patients not being diagnosed weekly during the lockdown.

Variable implementation of public-private partnership

The NHS has reported tens of thousands of empty acute beds, Nightingale hospitals lie empty and Check4Cancer’s review has shown that many independent hospitals have not been used for NHS patients, due to a suspension of NHS surgery and a shortage of anaesthetists who have been deployed to deal with coronavirus patients. Furthermore, patients are reluctant to attend NHS hospitals for fear of contracting COVID-19. There are regions where the public-private partnership is working well, with cancer hubs now established for cancer treatment in London and Manchester, and urgent breast cancer cases are being treated in private hospitals in Scotland. There are also independent hospitals that have managed to maintain face-to-face consultations for patients with urgent cancer symptoms, with 70% of Check4Cancer’s breast clinic network currently active.

Possible solutions

1. Use the Nightingale hospitals to treat cancer patients who require chemotherapy or other targeted therapies.

2. Use the independent hospitals for cancer diagnosis by reinstating face-to-face diagnostic consultations in ALL locations for patients with urgent cancer symptoms.

3. Use the independent hospitals and providers for patients who required surgery, chemotherapy or radiotherapy in COVID-light environments.

References:

1. Cancer Research UK Report April 2019 https://www.cancerresearchuk.org/sites/default/files/state_of_the_nation_april_2019.pdf2.

2. Cancer Treatment delays could increase death rates due to impact of Covid-19 pandemic on UK hospital capacity, ecancer, 14th April 2020 https://ecancer.org/en/news/17643-cancer-treatment-delays-could-increase-death-rates-due-to-impact-of-covid-19-pandemic-on-uk-hospital-capacity.3.

3. Wishart GC. Failure to fully integrate NHS and private hospitals during the COVID-19 pandemic will increase cancer death rates, ecancer, 20th April 2020 https://ecancer.org/en/news/17677-failure-to-fully-integrate-nhs-and-private-hospitals-during-the-covid-19-pandemic-will-increase-cancer-death-rates

 

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