Our 2023/24 business plan – NHS England

NHS England – 12th September 2023

In 2023/24 the NHS has three key tasks. The immediate priority is to recover our core services and productivity. Second, as we recover, we need to make progress in delivering the key ambitions in the NHS Long Term Plan. Third, we need to continue transforming the NHS for the future.

This business plan sets out NHS England’s work in leading and supporting the NHS to respond to these three key tasks, as well as a fourth task in creating a new organisation following the legal merger of NHS England with NHS Digital on 1 February 2023, and Health Education England on 1 April 2023.

Our 2023/24 business plan

NHS partners with Morrisons to put vital cancer awareness messaging on underwear labels

NHS England – 21st August 2023

Morrisons and the NHS are working together to put advice on underwear labels urging people to contact their GP practice if they spot potential symptoms of breast or testicular cancer.

The Nutmeg-branded underwear featuring NHS advice will be in 240 Morrisons stores nationwide, initially in men’s boxer shorts and followed by crop top bras in the coming months.

The NHS guidance will be displayed on the fabric labels alongside the standard sizing and care information. There will also be a QR code on the packaging and tags linking customers through to more detailed information on breast and testicular cancer on the NHS website.

Morrisons is the first UK supermarket to roll-out the new labels and the first-of-its-kind partnership for the NHS is the latest move in a significant drive to ensure people are aware of the signs and symptoms of cancer.

If people notice symptoms that could be cancer, they should contact their GP and come forward for checks as early as possible so they can get the all-clear, or in some cases, a cancer diagnosis sooner to give them the best chance of surviving the disease.

Further information – NHS partners with Morrisons to put vital cancer awareness messaging on underwear labels

The NHS in England at 75: priorities for the future

NHS England – June 2023

Ahead of the NHS’s 75th birthday, the NHS Assembly has developed an independent report: The NHS in England at 75: priorities for the future. This will help the NHS, nationally and locally, respond to long term opportunities and challenges. 

The Assembly found a growing consensus that the NHS should now focus on three key areas for long term development: better preventing ill health, personalising care and delivering more co-ordinated care closer to home.

The report draws on the feedback of thousands of people who contributed to a rapid process of engagement (NHS@75 engagement), and the Assembly’s huge breadth of experience. 

The Assembly will continue to draw on the insights gained from the NHS@75 engagement to explore the key developments outlined in more detail. The findings will help inform the work of NHS England to develop strategies for the years ahead in partnership with Integrated Care Systems. 

Read the Report – The NHS in England at 75: priorities for the future

Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

NHS England | 19 April 2022 | Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

Hundreds of people have been diagnosed with lung cancer earlier through NHS mobile trucks, as part of the biggest programme to improve early lung cancer diagnosis in health service history.

Today, NHS cancer chiefs are urging those most at risk of lung cancer to come forward as soon as they are invited for a life-saving health check, to help even more people benefit from early diagnosis.

The call comes as new figures show only a third (35 per cent) of patients go to their lung health check when invited by the NHS.

A further 20 NHS lung truck sites are due to go live shortly with the capacity to invite 750,000 more people at increased risk for a check, in efforts to catch thousands more cancers at an earlier stage.

So far, the 23 existing truck sites have issued up to 25,000 invitations every month.

Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

In the news

Guardian NHS urges people to attend vital lung cancer check-ups in England

Celebrities join forces with the NHS to encourage cancer checks

NHS England | March 2022 | Celebrities join forces with the NHS to encourage cancer checks

Famous faces have come out in support of a new, first of its kind NHS campaign aimed at tackling fears and concerns about cancer.

Further details about the campaign are available from NHS England

See also:

New campaign to combat the fear of Cancer

Life-extending injection for blood cancer available on the NHS

NHS England | March 2022 | Life-extending injection for blood cancer available on the NHS

A life-extending injection for a fatal form of blood cancer will be available to around 350 patients per year in England, the NHS chief executive has announced.

The drug, which can extend the lives of patients with a recurring and incurable cancer of the bone marrow cells – known as multiple myeloma – by an average of nine months, has been given the green light for routine use by NICE after it was made available for a limited period through the Cancer Drugs Fund.

Multiple myeloma is a debilitating cancer that affects the bone marrow in several areas of the body, including the spine, skull, pelvis and ribs, causing sufferers to have weak and painful bones, unusual bleeding, fatigue and weight loss – as well as weakening their immune system, leading to recurrent infections.

Myeloma cannot be cured and treatment is usually about keeping the cancer at bay for as long as possible with the least side-effects from treatment.

This NHS treatment will be offered to patients with recurring multiple myeloma who have tried at least three other treatments will help multiple myeloma patients live longer lives whilst improving their quality of life. It also gives patients a greater chance of accessing further treatments that may help them live even longer, healthier lives (Source: NHS England).

Full details from NHS England

New life-extending drug for advanced womb cancer to be rolled out on the NHS

NHS England | 8 February 2022 | New life-extending drug for advanced womb cancer to be rolled out on the NHS

A 30-minute treatment, the first of its kind for advanced womb cancer, is being rolled out for women across England, the NHS announced earlier this month.

Around 100 women with advanced and often incurable endometrial cancer every year will be offered this life-extending drug after the NHS agreed early access to the treatment through the Cancer Drugs Fund.

The drug, called Dostarlimab, is the first of its kind for womb or endometrial cancer, and works by attaching to a specific protein on the surface of the cancer cells, helping the immune system to detect and attack it.

It will give eligible patients with this specific form of cancer, who would otherwise quickly deteriorate, a greater chance of survival.

NHS England New life-extending drug for advanced womb cancer to be rolled out on the NHS

New screening pathways could improve NHS England’s bowel cancer programme

NIHR | 13 September 2021 | New screening pathways could improve NHS England’s bowel cancer programme

 NHS England’s Bowel Cancer Screening Programme aims to find warning signs in people aged 60 to 74. This population are invited to take a faecal immunochemical test (FIT) every two years. FIT measures blood in faeces and people with levels above a certain threshold are invited to have their bowel tissue examined for signs of cancer. Growths which could become cancerous (polyps) are removed and cancers prevented.

The research team set out to

1. Explore the relationship between FIT results and bowel pathology using truncated regression, in both a univariate and multiple regression model, with demographic factors including age, sex and area-based socioeconomic status; and
2. Use these results to estimate proportions of bowel abnormalities the screening programme would fail to diagnose at different FIT thresholds (false negative rates);
3. Generate hypotheses for fuller exploitation of quantitative FIT measures.

Researchers were surprised to find that the FIT threshold for further investigation is set at a point that may miss more than half of bowel cancer cases. This highlights a need to improve the NHS screening programme.

They suggest that the programme could make better use of FIT’s ability to provide the exact concentration of blood in faeces (rather than only whether it is above or below a cutoff level).

A new, multi-threshold strategy would mean referring people different follow-up according to their results. Screening intervals could be varied, and different ways of examining the bowel could be used (for example, sigmoidoscopy examines only the lower bowel). This could reduce the number of cancers missed while minimising the demand on services (Source: NIHR & Li et al, 2021).

Full details are available from NIHR

Primary paper Faecal immunochemical testing in bowel cancer screening: Estimating outcomes for different diagnostic policies

Li, S.J. et al | 2021| Faecal immunochemical testing in bowel cancer screening: Estimating outcomes for different diagnostic policies| Journal of Medical Screening | 28 | 3 P .277-285. doi:10.1177/0969141320980501

Abstract

Objectives

The National Health Service Bowel Cancer Screening Programme (NHS BCSP) in England has replaced guaiac faecal occult blood testing by faecal immunochemical testing (FIT). There is interest in fully exploiting FIT measures to improve bowel cancer (CRC) screening strategies. In this paper, we estimate the relationship of the quantitative haemoglobin concentration provided by FIT in faecal samples with underlying pathology. From this we estimate thresholds required for given levels of sensitivity to CRC and high-risk adenomas (HRA).

Methods

Data were collected from a pilot study of FIT in England in 2014, in which 27,238 participants completed a FIT. Those with a faecal haemoglobin concentration (f-Hb) of at least 20 µg/g were referred for further investigation, usually colonoscopy. Truncated regression models were used to explore the relationship between bowel pathology and FIT results. Regression results were applied to estimate sensitivity to different abnormalities for a number of thresholds.

Results

Participants with CRC and HRA had significantly higher f-Hb, and this remained unchanged after adjusting for age and sex. While a threshold of 20 μg/g was estimated to capture 82.2 per cent of CRC and 64.0 per cent of HRA, this would refer 7.8 per cent of participants for colonoscopy. The current programme threshold used in England of 120 μg/g was estimated to identify 47.8 per cent of CRC and 25.0 per cent of HRA.

Conclusions

Under the current diagnostic policy of dichotomising FIT results, a very low threshold would be required to achieve high sensitivity to CRC and HRA, which would place further strain on colonoscopy resources. The NHS BCSP in England might benefit from a diagnostic policy that makes greater use of the quantitative nature of FIT.

1. Exploring the relationship between FIT results and bowel pathology using truncated regression, in both a univariate and multiple regression model, with demographic factors including age, sex and area-based socioeconomic status; and
2. Using these results to estimate proportions of bowel abnormalities the screening programme would fail to diagnose at different FIT thresholds (false negative rates);
3. Generating hypotheses for fuller exploitation of quantitative FIT measures.

NHS launches world first trial for new cancer test

NHS England | September 2021 | NHS launches world first trial for new cancer test

The NHS will today (13 September 2021) launch the world’s largest trial of a revolutionary new blood test that can detect more than 50 types of cancer before symptoms appear.

The first people invited to take part will have blood samples taken at mobile testing clinics in retail parks and other convenient community locations.

The Galleri blood test checks for the earliest signs of cancer in the blood and the NHS-Galleri trial, the first of its kind, aims to recruit 140 000 volunteers in eight areas of England to see how well the test works in the NHS.

The simple test has been shown to be particularly effective at finding cancers that are typically difficult to identify early – such as head and neck, bowel, lung, pancreatic, and throat cancers.

It works by finding chemical changes in fragments of genetic code-cell-free DNA (cfDNA) that leak from tumours into the bloodstream. The NHS is already sending out letters inviting tens of thousands of people from different backgrounds and ethnicities aged between 50 and 77 to take part.

Participants, who must not have had a cancer diagnosis in the last three years, will be asked to give a blood sample at a locally based mobile clinic and they will then be invited back after 12 months, and again at two years, to give further samples. The trial is part of the NHS’s efforts to increase the proportion of cancers detected early by the end of the Long Term Plan.

This quick and simple blood test could mark the beginning of a revolution in cancer detection and treatment here and around the world.

By finding cancer before signs and symptoms even appear, we have the best chance of treating it and we can give people the best possible chance of survival.

NHS chief executive Amanda Pritchard

NHS launches world first trial for new cancer test [news release]

NHS England: NHS to offer new drug that halves the risk of cancer returning

NHS England| 7 May 2021 | NHS to offer new drug that halves the risk of cancer returning

NHS England has announced the roll out of an innovative world-leading treatment that halves the risk of lung cancer patients suffering a return of the disease after undergoing treatment.

In a trial of the drug – the first of its kind – around nine out of ten patients treated, remained alive and disease-free after two years – compared to more than four in ten who hadn’t received the new therapy.

Around 100 patients in England with a rare form of cancer will initially have access to the drug, called Osimertinib, with many more expected to benefit this year.

Lung cancer is the most common cause of cancer death in the UK, accounting for one in five of all cancer deaths. Osimertinib is the first treatment for patients with non-small cell lung cancer whose tumours have a specific type of genetic mutation, to be licensed for use in patients who have just had surgery (Source: NHS England).

Full details are available from NHS England