Cancer in a post-Covid landscape: the chance for a reset towards truly integrated care
At the start of 2020, when the world looked very different, one of Macmillan’s longstanding priorities was to promote the integration of health and care services to support delivery of the best quality personalised care for people with cancer. Then the pandemic hit, and our focus turned to supporting the NHS and the Government to protect cancer services during the worst of times.
As we fast forward a year and the vaccine roll out promises to ease the pressure on our health systems, the impact Covid-19 has had on services for people with cancer is clear to see. But so too are the opportunities to refresh our ambitions for people living with cancer, and the experiences and learning shared with us last year should be at the centre of how services rebuild and recover. That is why we are publishing our new report Caught in the Maze: Delivering personalised, integrated care for people with cancer.
At Macmillan, we believe that effective integration and personalised care can be the solution to many of the challenges cancer services now face to restore services and reduce the backlog, learning too from progress that has been driven by the pandemic itself. Our programmes have repeatedly demonstrated the value of a ‘whole-system’ approach to cancer care.
People with cancer told us that they feel ‘caught in the gaps’ between primary and secondary care and that care is often organised around the provider not the patient. Our research also found that systems across the UK are too geared towards measurement of diagnosis and treatment, and personalised care is often seen as an ‘add on’.
As our Forgotten C campaign has highlighted, 2020 saw far fewer cancer diagnoses than 2019, as well as fewer people starting treatment, with many seeing delays and disruptions to care and support because of the response to Covid-19, and many more accessing their care and support in very different ways. The pandemic shone a light on, and often exacerbated, some of the existing challenges facing people with cancer. These include inequality in experiences and outcomes for people from BAME communities, major gaps in the workforce at a time when people’s need for support with the of the mental and physical effects of cancer diagnosis and treatment has increased.
But the pandemic has also opened the door to integrated ways of working. Organisations are expected and encouraged to work more closely and collaboratively across traditional boundaries, reducing bureaucracy and duplication and driving improvements in care. Testing and treatment is being delivered in new community diagnostic hubs and mobile units; technology has enabled services to join up in a way that system leaders have long been attempting.
We are at a crucial moment for making good on longstanding rhetoric to deliver integrated care. Cancer services are under huge pressure; however we can use the pandemic as an opportunity to reset. We originally intended to show how integration can support the delivery of personalised care, but it has become is so much more than that: it provides a framework for rebuilding and restoring cancer services after Covid-19 across the UK health systems
Macmillan is calling on UK governments to urgently review the funding, commissioning and targets for cancer services. We need a ‘whole system approach’ not just around the delivery cancer services but also the wider health and care services that people with cancer rely on. The report also calls for fully costed workforce strategy across all UK nations addressing major staff shortages, including in the vital specialist nursing workforce. Tackling these priorities will enable cancer care to be delivered more efficiently, and more importantly, to make a huge personal difference to the individual people who need it.
