MS, Cabinet Secretary Health
and Social Care: Audit Wales last week published its Cancer
Services in Wales report, which followed a review by the
Welsh Government of the national leadership of cancer service
improvement. This statement sets out the changes we are making to
leadership and governance to improve cancer care in Wales.
I welcome Audit Wales' finding there is a clear commitment to
improving cancer services in Wales and the Welsh Government and I
want to pay tribute to all those NHS staff who are delivering
high-quality care for the people of Wales. As the report
acknowledges, there has been a significant increase in spending
on cancer care over the past decade and an improvement in
outcomes. As our population ages, and the capability of what the
NHS can do continues to evolve, the sustainability of services
will depend on how we can create the capacity to investigate and
treat people in a timely manner – this a challenge faced by the
NHS throughout the UK.
I agree with the breadth and complexity of the work to improve
cancer care and outcomes, I accept the Auditor General's view
that greater clarify is required about how the Welsh Government
leads these improvements. I am therefore setting up a National
Cancer Leadership Board, chaired by the Deputy Chief Medical
Officer, to better coordinate this activity and to deliver
greater pace through the various programmes that are involved in
making service improvements.
These actions build on work already undertaken to strengthen
cancer services in recent weeks.
We set out our expectations for cancer services in the
2021 Quality Statement for
Cancer. This has 22 planning expectations and a series of
detailed, nationally agreed pathways and service specifications
for the NHS to implement through its local planning processes.
The annual NHS Planning Framework requires NHS organisations to
implement the Quality Statement. This has been reinforced every
year through a national cancer summit. The
priority for the NHS is to improve performance against the
national target of at least 75% of people starting first
definitive treatment for cancer within 62-days; reducing the
backlog of people waiting more than 62-days and implementing the
nationally agreed pathways of care. To provide clarity about how
the NHS responds to the Welsh Government's expectations,
an NHS Cancer Improvement
Plan was published in January 2023.
Since the pandemic, there has been an unprecedented focus on
improving access to cancer care. Every month, senior Welsh
Government officials – supported by experts in the NHS Executive
– meet every health board to focus on cancer performance and
improvement. This is in addition to the standard monthly and
six-monthly accountability meetings. NHS managers and senior
cancer clinicians also come together in national meetings to
share intelligence, good practice and learning.
Performance against the 62-day target has stabilised and there
are some signs of progress in some parts of Wales, such as
Cardiff and Vale University Health Board which exceeded 70% in
October. But there is still too much variation in performance
between health boards and between cancer types. My discussions
with Health Board Chairs routinely focus on cancer
performance.
We have allocated £2m to the NHS Executive to deliver a package
of support for health boards. This involves expert clinicians and
programme managers working with health boards to change how
cancer pathways and service models work. The initial phase
focuses on breast, skin, gynaecological, lower gastrointestinal,
and urological cancer to improve productivity and efficiency in
how health boards deliver care, such as sending people straight
to test without an outpatient appointment.
We are also improving the pace of innovation and have set up the
Making It Happen programme to bring government, NHS and
industry together, led by the Life Sciences Hub. We have also
published Wales' first national approach to cancer research, supported
by investment in the Wales Cancer Research Centre.
A wider range of service improvements are underway, which will
also help to improve cancer outcomes, services, or care – from
reducing smoking and tackling obesity to HPV vaccination and
our diagnostic
and genomic strategies.
The Welsh Government is responsible for setting the priorities
and expectations for the NHS in Wales. The NHS is responsible for
delivering those cancer priorities, with national support from
the NHS Executive. Welsh Ministers hold the NHS to account for
delivery of services and are, in turn accountable to the Senedd
and the public.
I will update the 2021 Quality Statement for Cancer to provide
greater clarity about the respective roles, the relationship
between various national programmes, and the metrics used to
oversee delivery
I will also be taking a number of key decisions in the coming
months, I have asked for advice from Public Health Wales on the
implementation of a national lung cancer screening programme to
be brought forward by six months to the spring, and I will
expedite agreement of a data development roadmap for cancer.
Despite the action we have taken in recent years, but our own
analysis and that of Audit Wales tells us there is more to do and
I will continue to focus NHS organisations on improving access to
high-quality cancer care so we can achieve the best possible
outcomes for our population.
