State of the nation: a comprehensive, retrospective view of NHS data

Wilmington Healthcare – OCTOBER 2023

This report provides a health check for the NHS. The report looks at: hospital episode statistics, including waiting times and length of stay; demographics and disease prevalence – including health inequalities; key statistics on what outcomes the NHS is achieving in major therapy areas; assessment of the NHS on its own KPIs; prescribing insights, nationally and regionally, including the most-prescribed drugs; workforce data – including vacancies and recruitment; regional insights, including performance and challenges of ICSs.

Read the report – State of the nation 2023

Mind the gaps: understanding and improving out-of-hours care for people with advanced illness and their informal carers

Marie Curie – November 2022

This research states that terminally ill people are struggling to access essential care at home during evenings and weekends, which, the charity warns, means people are dying in pain. Among the findings is that out-of-hours emergency department attendance increases in frequency as death approaches, and is more common among people living in the most socio-economically deprived areas.

We found that out-of-hours emergency department attendance increases in frequency as death approaches, and is more common among people living in the most socioeconomically deprived areas; that although all areas have access to telephone lines for general NHS services out-of-hours (e.g. NHS 111 in England and Wales), not all areas
have a designated telephone line for out-of-hours palliative care support; that access to medicines outof-hours can be complicated and time consuming; that there are gaps between what is theoretically in place and what is actually experienced by patients and informal carers; that equipment is hard to access; that care packages are often delayed or
unavailable; and that much out-of-hours care relies on stretched community nursing services.

Full Report – Better End of Life 2022

NHS fast tracks life-extending prostate cancer drug to patients

NHS England – 28 November 2022

Around 9,000 men with one of the most advanced forms of prostate cancer will be eligible for a new life-extending treatment thanks to a fast tracked deal by the NHS.

The NHS in England will become the first in Europe to roll out Darolutamide to patients whose prostate cancer has spread to other parts of the body.

Studies show the chances of living longer are increased by one third in men who were previously left untreated.

The drug works by blocking androgen receptors in cancer cells, which in turn blocks the effect of testosterone that allows the cancer cells to survive and multiply

Full article – NHS fast tracks life-extending prostate cancer drug to patients

Advances in diagnosis and treatment of testicular cancer

British Medical Journal – Chovanec M, Cheng L. Advances in diagnosis and treatment of testicular cancer BMJ 2022; 379 :e070499 doi:10.1136/bmj-2022-070499

This review summarizes recent advances and discusses relevant issues in the biology and management of testicular cancer, noting that current knowledge is still insufficient to overcome the poor prognosis of patients who do not respond to salvage chemotherapy.

Full article – Advances in diagnosis and treatment of testicular cancer

Innovative blood test could revolutionise cancer care

National Health Executive – 18th November 2022

The Royal Marsden NHS Foundation Trust has launched an innovative trial that could detect breast cancer relapses months and even years in advance.

As part of this international undertaking, researchers will first recruit oestrogen receptor (ER) positive breast cancer patients to the trial; the patients will then have a blood test every three months for as many as three years, so the researchers can determine whether a patient’s cancer is returning.

The blood test works by monitoring the levels of circulating tumour DNA (ctDNA) in a given blood sample. The test can detect even the smallest amounts of ctDNA in a sample and can therefore alert researchers to whether a patient is having a molecular relapse – i.e. cancer is returning and patient is going to relapse.

Evaluating patients this way enables clinicians to catch the cancer at the earliest stage possible, with some ctDNA having previously identified relapsing patients months and even years before it would’ve been noticeable on a scan.

Further information – Innovative blood test could revolutionise cancer care

Cancer Research UK report highlights stark cancer inequalities across Scotland

Cancer Research UK – 28th November 2022

 A landmark report on deprivation and cancer launched at the Scottish Cancer Conference today shows that the burden of cancer is not felt equally across Scotland.

People living in more deprived areas in Scotland are more likely to get cancer and are, sadly, more likely to die from the disease than those in less deprived areas. Cancer death rates are a startling 74% higher in the most deprived populations than the least deprived. The report also estimates that around 4,900 extra cancer cases each year in Scotland are due to deprivation. That’s 13 extra new diagnoses per day that could be avoided if the most deprived areas had the same cancer rates as the least deprived.

The report sets out the urgent need to address inequalities across the cancer pathway, from reducing preventable causes of cancer, to removing barriers to early diagnosis and high-quality treatment, whilst also improving data collection to build a stronger understanding of cancer inequalities in Scotland and what is driving them.

Read the full article – Cancer Research UK report highlights stark cancer inequalities across Scotland

Background Report – Deprivation and cancer inequalities in Scotland

Why do non-smokers face delays in getting a lung cancer diagnosis?

Cancer Research UK – November 25, 2022

A group of researchers at University College London (UCL) were faced with a problem.

There was evidence that people who have never smoked were facing delays in being diagnosed with lung cancer, but it wasn’t clear how their experiences differed from those of smokers.

As a starting point, they set out to review the research that was already out there to date.

Over the course of a year, they analysed seven quantitative and three qualitative studies about people’s experiences in relation to symptom awareness, help‐seeking, and the lung cancer diagnostic pathway, comparing people with and without a history of smoking.

This wasn’t just an exercise in finding out what we know. Crucially, this review highlighted what we didn’t know to lay the groundwork for more research into lung cancer in people who have never smoked.

And one of their main findings was that there was a lack of evidence about why there were delays in diagnosis for people who have never smoked. The research indicated that people who have never smoked had a different experience to current and former smokers in getting a diagnosis, but the reasons why were still unclear.

The team, who were part of the group that performed the review, followed up on this review with another study, this time interviewing people with lung cancer to figure out similarities and differences in help-seeking behaviour depending on smoking status.

This is the first time people who have never smoked have been compared directly with current and former smokers with regards to help seeking and experiences in primary care, primary care being, for the most part, their GP.

Further Information – Why do non-smokers face delays in getting a lung cancer diagnosis?

Review – Help-seeking behaviour

Background Research – van Os, S., Syversen, A., Whitaker, K. L., Quaife, S. L., Janes, S. M., Jallow, M., & Black, G. (2022). Lung cancer symptom appraisal, help‐seeking and diagnosis–rapid systematic review of differences between patients with and without a smoking history. Psycho‐Oncology, 31(4), 562-576.

First-of-its-kind app for patients on clinical trials being piloted by Cancer Research UK

Cancer Research UK – November 28, 2022

Cancer Research UK, in partnership with London-based tech company Stitch, are going live with an app for patients to use whilst participating in a clinical trial.

The Trialmap app, which was co-created with patients, is being piloted on a clinical trial run by Cancer Research UK’s Centre for Drug Development.

It will allow participating patients to easily view information on the trial, get reminders about appointments and what they might need to do to prepare for them, and give patients the opportunity to provide real-time feedback regarding their time on the trial, allowing researchers to optimise their clinical trials, both current and in the future.

The aim of the app is to ensure patients feel valued for their participation, and to improve patient experience during clinical trials.

More information – First-of-its-kind app for patients on clinical trials being piloted by Cancer Research UK

Background Report – Setting the Pace: Accelerating the Race for Clinical Research and Drug Development Post-Pandemic

Discovery could lead to new drugs to block protein that fuels bowel cancer

The Institute of Cancer Research – 23rd November

Scientists have revealed the inner workings of a key protein involved in a wide range of cellular processes – potentially paving the way for better and less toxic cancer drugs.

Using Nobel Prize-winning microscopy techniques, the researchers revealed how the tankyrase protein switches itself on and off by self-assembling into 3D chain-like structures.

Their study, published in the journal Nature, reveals crucial structural insights into the elusive but important tankyrase protein, which plays a particularly important role in helping drive bowel cancer.

Further details –Discovery could lead to new drugs to block protein that fuels bowel cancer

Background Research – Pillay, N., Mariotti, L., Zaleska, M. et al. Structural basis of tankyrase activation by polymerization. Nature (2022).

How targeted screening can help the NHS save lives from lung cancer, the UK’s leading cause of cancer death

Cancer Research UK – 23 Nov 22

A targeted lung screening programme is the step-change in care that the NHS needs to catch lung cancer early. So, when the UK National Screening Committee gave the recommendation for it to go ahead, I was thrilled. It’s something that so many of us in the lung cancer research community have been working towards for years.

That said, with cash-strapped governments across the UK prioritising ‘value for money’ and efficiency, this might not seem like the most hospitable environment in which to recommend rolling out a new screening programme.

But the return on investment from lung screening could be massive. Lung cancer is the third most common cancer type in the UK, causing 34,800 deaths every year, more than any other cancer. There is huge potential here not just for saving and improving lives, but also for using money more cost-effectively. That’s because it’s much easier to treat lung cancer when it’s diagnosed early.

Full article – How targeted screening can help the NHS save lives from lung cancer, the UK’s leading cause of cancer death