This week, the Government unveiled its new 10-year plan for the NHS in England. We scrutinised all 136 pages of it to find out what impacts it could have for men being treated or diagnosed for prostate cancer, and how it could help – or hinder – our own plans.

HSCP St Barts
8 Jan 2019

Producing a 10-year plan that sets out how the NHS will improve the health of millions of people in England is no small task. Obviously, we immediately flicked through its 136 pages to find out how prostate cancer fared.

Our conclusion: the NHS Long Term Plan provides a basis for us to achieve our ambition to save more lives from prostate cancer, despite potentially missing a trick on faster access to new treatments and there being no accompanying plan to address workforce shortages over the long-term.

Striving to diagnose cancer earlier

Like us, NHS England wants to diagnose more cancers early. We would have liked the Long Term Plan to have included a more specific commitment to this for prostate cancer, but think that their intention to include risk factors as part of their cancer diagnosis initiatives offers a possible route for us to achieve earlier diagnosis for men at risk of the disease. These would include age, black ethnicity and family history.

We want to combine this risk-based approach with our work to improve use of the PSA test, especially in areas of England where we know too many men are being diagnosed late. The Long Term Plan will require GPs and other primary care networks to improve early cancer diagnosis in their neighbourhoods by 2023/24 – and we'll work with them to achieve this.

We can also use this focus on risk factors to help us push for any new genetic tests for prostate cancer to be made available on the NHS, when our research identifies more and more genetic mutations that could cause the disease. And we’ll continue our research to develop a new testing approach for prostate cancer so that we achieve a prostate cancer screening programme in the future, which will ultimately make the biggest difference.

Getting the equipment needed for more accurate diagnosis

The plan also gives a boost to our work improving the accuracy of prostate cancer diagnosis using the latest mpMRI scans before biopsy. It commits to providing extra funds for more MRI scanners this Spring. There’s also investment promised for new CT scanners, which will help more cancers that have spread outside the prostate to be diagnosed accurately. They can then be given the most effective treatments and a better opportunity of being cured.

More tailored, post-treatment support

Another ambition of the Long Term Plan is to 'digitalise' support for men living with prostate cancer, which can make it more likely that they receive services that meet their needs. We’re already pioneering an online Supported Self-Management system that does this. Created by the Movember Foundation's global TrueNTH initiative, it's currently helping hundreds of men access tailored support in eight NHS Trusts in England, and talks are ongoing to roll out the system to other trusts across the UK.

Missing a trick on treatments?

Unfortunately, we’re not convinced that the treatments side of things has got the attention it needs. The Long Term Plan promises to speed up the process of getting the next generation of treatments implemented rapidly across the NHS. But the success of this cannot only hinge on the new investment the plan mentions. Work is urgently needed to understand and address the often slow uptake of new treatments that can cause variation in men’s access to them across England.

What is good, though, is that in future we should know where these variations are happening. The Long Term Plan makes capturing clinical data and data from patients a priority for the NHS. This can show us where men are not getting access to treatments so we can take action. We'll also be able to build our knowledge of which treatments work best for which types of prostate cancer, enabling us to make sure men get the treatment that will be the most effective for them.

Workforce shortages remain unaddressed

We know NHS England is waiting for Government to announce a budget and strategy for training new doctors and nurses later this year. But if this doesn’t do enough to address the current significant workforce shortages, the NHS will struggle to achieve its ambitious Long Term Plan. What’s more, men will likely struggle to access a mpMRI scan or have to wait longer for the results. Access to a Clinical Nurse Specialist will also get harder.

We'll continue to work with the NHS to develop innovative ways to overcome current workforce shortages, while working with other cancer charities to call for the workforce funding the NHS needs to be fit for the future.

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