The team leading the National Prostate Cancer Audit has identified major gaps in personal support services for men living with prostate cancer in England and Wales.
The project runs for five years and, when complete, will give us a clear picture of what prostate cancer treatment and care services men receive across England and Wales, and how they respond. This will help us ensure that men receive the best care possible. But the first results, released in a report on 10 November, are already making interesting reading.
This year the audit has looked into how closely the treatments and care provided by the NHS follow the National Institute for Health and Care Excellence (NICE) guidelines for prostate cancer care. Overall, it found that NHS providers in England and Wales are following the guidelines. But some results are more worrying and show that improvements are needed in treatment and care.
Only 50 per cent of NHS trusts in England and 60 per cent of hospitals in Wales provide all the personal support services a man needs after prostate cancer treatment. And not all men have access to the right level of support from clinical nurse specialists (CNSs). While urological CNSs (those with expertise in general urology) are available in almost all NHS trusts in England (97 per cent) and all NHS hospitals in Wales, men only have access to oncological CNSs (those with specialist cancer knowledge) in less than half of these.
The authors of the report are calling for personal support services, like cancer advisory centres, sexual function and continence services, and psychological/counselling services, to be more widely available. And they want more men to be able to see a nurse specialist with a uro-oncology background. That is someone with a background in both urology and oncology, who can provide the level of expertise and understanding that men with prostate cancer need.
If we are to tackle this disease head on, it is imperative that the recommendations made in the audit are used to drive improvements without delay
In terms of treatment, the authors recommend that multiparametric (mp) MRI should be made more widely available for men after their first biopsy. (This form of MRI can be used to determine whether a man needs a second biopsy if his first didn’t detect any cancer and is vital in helping to avoid unnecessary procedures or treatment.) And they suggest that high-dose brachytherapy should be made more widely available so that more men with intermediate and high-risk localised or locally advanced prostate cancer can choose this.
Owen Sharp, our Chief Executive, said: “This is an incredibly important piece of work. One of the key ways we can improve outcomes for men with prostate cancer is through good quality data which allows us to identify the pressure points and weaknesses in the system that need to be addressed. This audit of treatment and care delivery in England and Wales (alongside research currently underway looking at how patients experience it) will for the first time help build up a clear picture of the situation – warts and all.
“Although there have been some improvements in access to the more sophisticated diagnosis and treatment techniques, the audit reveals a worryingly vast variation in availability of these options, and that around half of men with prostate cancer do not receive all the support services they should. Such findings cannot be ignored. If we are to tackle this disease head on and improve the quality of life of those living with it, it is imperative that the recommendations made in today’s audit are heeded by commissioners and used to drive improvements without delay.”
The next report, due in late 2015, will look in more detail at how men diagnosed with prostate cancer from April 2014 had their cancer detected. It will also look at what treatments they were given and what results they had from the care they received.
The audit will tell men exactly what to expect when it comes to prostate cancer care services in England and Wales. It will also make clear where care falls short of the gold standard. We’ll be using the results to ensure health providers give men the support and care they need. Read more about the audit here.