[NHS England Consultation] Children’s Cancer Services

NHS England | June 2019 |Children’s Cancer Services

NHS England has launched a 60-day consultation to seek views on proposed changes to children’s cancer services. These are used by children aged between 0 and 16. In some cases, and with the agreement of Teenage and Young Adult’s Cancer Services, they may also treat teenagers up to the age of 18.

The aim of the service specifications is to improve the outcomes and experience of children and young people with cancer.

This consultation guide sets out:

  • How care is currently provided.
  • The proposed changes and reasons for these.
  • How the proposed changes will be implemented.
  • The consultation has been open from Wednesday 5 June and will run until Sunday 4 August 2019

See also:

NHS England blog 

India’s childhood leukaemia survival rate leaps to 80%, thanks to Manchester scheme

University of Manchester |June 2019 | India’s childhood leukaemia survival rate leaps to 80%, thanks to Manchester scheme

A paediatrician from the University of Manchester, Professor Vaskar Saha has helped cure children diagnosed with acute lymphoblastic leukaemia (ALL) by 15% during the five years he has led the ICICLE (Indian Childhood Collaborative Leukaemia Group) clinical project, in partnership with Tata Medical Centre, Kolkata.

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Survival rates of most cancers in India are usually 15-25% lower than the United Kingdom. However, with Professor Saha’s work challenging the stereotype that cancer cure is a prerogative of affluent nations, his research has increased survival rates in Kolkata from 65% in 2014 to 80% in 2019.

Vaskar Saha, Professor of Paediatric Oncology at The University of Manchester and Senior Paediatric Consultant and Director of Translational Cancer Research at the Tata Medical Centre, Kolkata, said: “In the UK, 450 children are diagnosed annually with ALL, of which 400 will survive. In India, 9,000 of the 15,000 children diagnosed annually will survive.

“Not so long ago, four in ten Indian children would die because of poor treatment and relapse. The former was mainly due to the absence of standardisation in testing and treatment.

“If we can improve outcomes in India by 10%, then an additional 1,500 children a year grow up to lead normal lives.”

Professor Saha divides his time between Manchester and Tata Medical Centre

Before the ICICLE project launched, excellent medical centres across India were common and most children with acute lymphoblastic leukaemia were able to get the drugs they needed.

Historically, hospitals in India often work in isolation without exposure to the international research community. Travel costs to faraway hospitals were also difficult for poor families or those on low incomes.

Once clinicians started sharing their knowledge and standardised systems were put in place, change began to take root. (Source: University of Manchester)

Read the full story from the University of Manchester India’s childhood leukaemia survival rate leaps to 80%, thanks to Manchester scheme

 

New report shows more young people surviving cancer

Teenage Cancer Trust | January 2019 | New report shows more young people surviving cancer

A new report from Teenager Cancer Trust uses data collected by NCRAS  (National Cancer Registration and Analysis Service) which has been analysed to identify trends and share finding with partners to improve cancer services and awareness.  Now Teenage Cancer Trust report 13-24 years old who were diagnosed in England up to the end of 2015. The publication marks the first time a detailed analysis has been conducted of cancer rates of the 13 to 24-year age group and shows an encouraging increase in survival rates.

 

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Some of the report’s key findings:

  • Mortality rates of all cancers combined in 13 to 24 year olds have decreased from 42.9 per million in 2001 to 32.3 per million in 2015.
  • The largest reduction in mortality by diagnostic group in England between 2001 and 2015 has been in Leukaemias. There were also reductions seen in mortality from Central Nervous System tumours, bone cancer and in lymphoma.
  • Five-year survival rates for cancer in 13 to 24 year olds have risen from 83% females / 80% males in (2001-05) to 87% in females / 84 % males (2007-11).
  • There are statistically significant variations in incidence and survival rates of cancer in 13 to 24 year olds based on geography and deprivation.
  • The incidence of cancer in 13 to 24 years olds in England has increased from a crude rate of 233.1 per million in 2001, to 299.7 per million in 2015 (Source: Teenage Cancer Trust).

News release Teenage Cancer Trust New report shows more young people surviving cancer

The report is available to read and download from Teenage Cancer Trust 

BMJ Cancer: more young people in England are surviving

In the news: BBC News Teenage cancer survival ‘on the up’ in England, report finds

Childhood cancer burden: a review of global estimates

Bhakta, N.|(2019| Childhood cancer burden: a review of global estimates| The Lancet Oncology| 20|1| e42|e53.

A new article in the Lancet Oncology analyses 4 studies of the global cancer burden that included data for children and adolescents, with the aim that these data could help stakeholders to develop plans for national and institutional cancer programmes.

The Review provides guidance on improving future estimates of the childhood global cancer burden, as the data in low-income and middle-income countries is scarce. As such the researchers propose several recommendations to strengthen data collection and standardise analyses.

Summary

5-year net survival of children and adolescents diagnosed with cancer is approximately 80% in many high-income countries. This estimate is encouraging as it shows the substantial progress that has been made in the diagnosis and treatment of childhood cancer. Unfortunately, scarce data are available for low-income and middle-income countries (LMICs), where nearly 90% of children with cancer reside, suggesting that global survival estimates are substantially worse in these regions. As LMICs are undergoing a rapid epidemiological transition, with a shifting burden from infectious diseases to non-communicable diseases, cancer care for all ages has become a global focus. To improve outcomes for children and adolescents diagnosed with cancer worldwide, an accurate appraisal of the global burden of childhood cancer is a necessary first step. In this Review, we analyse four studies of the global cancer burden that included data for children and adolescents. Each study used various overlapping and non-overlapping statistical approaches and outcome metrics. Moreover, to provide guidance on improving future estimates of the childhood global cancer burden, we propose several recommendations to strengthen data collection and standardise analyses. Ultimately, these data could help stakeholders to develop plans for national and institutional cancer programmes, with the overall aim of helping to reduce the global burden of cancer in children and adolescents.
Rotherham NHS staff may request this article from the Library 

Genome sequencing of children promises a new era in oncology

Wise J.| 2019|Genome sequencing of children promises a new era in oncology  doi: https://doi.org/10.1136/bmj.l105

All children with cancer in England will be offered whole genome sequencing from this year in a move that will enable more comprehensive and precise diagnosis and access to more personalised treatments.

According to NHS England’s long term plan, this will reduce the use of harmful drugs and interventions, support increased access to clinical trials, and reduce the number of young patients who have health problems caused by chemotherapy and radiotherapy

Darren Hargrave, honorary consultant paediatric oncologist at Great Ormond Street Hospital for Children and a member of the paediatric cancer task group which advised NHS England  says there are three major benefits:

  • precision medicine
  • refinement of diagnosis
  • and screening for family members

It was also announced that children who need proton beam therapy will be able to access it in England rather than having to travel abroad. New proton beam facilities have been commissioned in London and Manchester, and will come online in the next couple of years (Source: BMJ)

Read the full, unabridged article at BMJ

Medical & Surgical Review Programme: Cancer in Children, Teens and Young Adults Report

Healthcare Quality Improvement Partnership | December 2018 | Medical & Surgical Review Programme: Cancer in Children, Teens and Young Adults Report

HQIP (Healthcare Quality Improvement Partnership) has produced a review of the quality of care provided to patients aged 24 years and under who were receiving systemic anti-cancer therapy and subsequently died or were admitted to critical care. 

 

on the right course
Image source: hqip.org.uk

This report deliberately focuses on a sample of patients who were a high-risk group who died or who had an unexpected admission to intensive care. The rationale being that this is where care-planning, service provision and communication should excel. Any remediable factors in care for this group would benefit all children, teenagers and young adults receiving systemic anti cancer therapy (SACT).

The findings focus on:

  • Organisation of services
  • Management of systemtic anti cancer therapy
  • Final admission to hospital

On the right course 

On the right course [summary document]

Cancer in children and young people

Medical & Surgical Review Programme: Cancer in Children, Teens and Young Adults Report | Healthcare Quality Improvement Partnership

Cancer outcomes in children and young people have improved dramatically over the last few decades with over 80% of those diagnosed now being cured of their disease. Of those who die, approximately half will do so from treatment related complications many of which are avoidable.

HQip
Image source: http://www.hqip.org.uk

This report deliberately focuses on a sample of patients who were a high-risk group who died or who had an unexpected admission to intensive care. The rationale being that this is where care-planning, service provision and communication should excel. Any remediable factors in care for this group would benefit all children, teenagers and young adults receiving SACT.

One of the recommendations from this report is that the audit and quality improvement methods, with action plans, are essential for on-going improvement but require access to data. Electronic prescribing was not universal at the time of data collection and many hospitals had no ready access to information on which patients had received SACT and their outcomes.
Along with adequately trained staff, good team working and clear local leadership, such implementations are key drivers for improving care for this vulnerable population.

Full report: On the Right Course? A review of the quality of care provided to patients aged 24 years and under who were receiving systemic anti-cancer therapy and subsequently died or were admitted to critical care | Healthcare Quality Improvement Partnership