The Cancer Capacity Challenge [CCC](1) – highlights a growing threat to patient care as chemotherapy infusion suites feel the pressure of increasing demand. Improved diagnosis and better treatment options for patients have meant that more patients than ever are living longer with cancer. While this is welcome news, it has led to an increase in demand for chemotherapy services at a time when the Government is seeking to reduce NHS spending.
Published for the first time within the CCC report,(1) research undertaken by oncology pharmacists and oncology specialist nurses into the opinions of frontline staff(2,3) reveals the following key concerns; 84% of oncology pharmacists and 71% of oncology specialist nurses believe that a deficiency in capacity to deliver cancer care is having either some or a significant negative impact on patient care. Furthermore, 76% of nurses and 68% of pharmacists felt that if capacity issues are not addressed, it could result in longer waiting times for patients who require vital cancer services.
The report also focuses on the need to implement and spread innovation while adapting the way some services are currently delivered, as set out in the government report – Innovation, Health and Wealth.(4)
“The development and success of innovative cancer treatments mean that people are living with cancer for much longer. However, this success has caused its own challenges and is placing huge pressure on the NHS at a time when it’s seeking to reduce, rather than increase, spending,” said Dr Mark Verrill, Consultant Medical Oncologist at the Northern Centre for Cancer Care at the Freeman Hospital in Newcastle, “This means that the need to utilise existing technologies and embrace new ones across the entire NHS is essential for improving patient care as well as reducing the costs to make space for the next generation of treatments.”
Additionally, 67% of oncology nurses said that their day units are full to, or over, capacity while 48% of pharmacists and 49% of nurses surveyed felt that it was very likely that their pharmacy or chemotherapy unit would face issues with staffing or resource capacity in the future. Illustrating the complexity of administering many modern treatments, over a third of the pharmacists claimed that they currently spend more than half of their time on the preparation of oncology medicines.(2,3)
“The steps involved in each patient visit – from taking blood tests and preparing the medicines to setting up the intravenous infusion and administering the treatment – can take as long as seven hours,” said Kate Denby, Haematology Advanced Nurse Practitioner, Royal Exeter and Devon NHS Foundation Trust, “Patients usually prefer shorter visits to hospital for their chemotherapy treatment so it’s essential that we are able to find solutions that help improve the patient experience.”
The CCC report(1) concludes that, while improvements in the chemotherapy suite can be achieved through better planning, this alone cannot deliver sufficient capacity savings. Fundamental improvements can be made by changing the way chemotherapy is delivered, with bottlenecks in the clinics eased by treating some patients in primary care or at home. New developments in chemotherapy delivery – such as new formulations that enable medicines to be taken via subcutaneous injection – have the potential to deliver significant improvements by enabling quicker administration time in hospital and allowing treatment to take place outside the chemotherapy suite.
Meeting the Cancer Capacity Challenge, January 2012
Roche data on file (BOPA)
Denby, K. BOPA/UKONS Poster Presentation [Specialist nursing capacity in today’s NHS: a survey of the UKONS membership] . Presented at UKONS Conference 2012.
Innovation, Health and Wealth: accelerating adoption and diffusion in the NHS, Department of Health, December 2011. Available at:
dh_134597.pdf Last accessed January 2012