This blog explores our nation’s strategic direction for cancer care, focussing on recent developments in policy and workforce.
Improving cancer care is a vital cog in the machine for helping people in Wales live healthier, and happier lives, with a quarter of all deaths here caused by cancer. And with diagnosis rates expected to rise, our healthcare system will also face increasing pressures. Making sure that we’re guided by the right policy and strategy is vital to help address this. And this needs the right workforce in place to support demand and treat patients efficiently and effectively.
To help you understand this important topic, I’ve worked as part of our Sector Intelligence team to research and summarise key insights, statistics and know-how about policy and workforce developments. As part of a series of four reports on cancer care, we’ve summarised their findings into this blog to provide you with a high-level overview. Read on to learn more.
What you need to know about health policy in Wales
Our report details the major recent policies and research strategies from Welsh Government that are shaping the future of cancer care in Wales.
The Quality Statement for Cancer (2021)
This short statement sets out the direction of travel for cancer care in Wales and describes what good quality cancer services should look like. It recognises that health boards and trusts are responsible for cancer care and must stick to standards and quality attributes, such as being equitable, safe, effective, efficient, person centred and timely.
A Cancer Improvement Plan for NHS Wales 2023-2026
The Quality Statement for Cancer’s attributes fed into the Improvement Plan, which emphasised the role of the newly formed NHS Executive (now NHS Wales Performance and Improvement) to enable, support and direct NHS Wales to transform services. The National Strategic Clinical Networks, such as the Wales Cancer Network, are a big part of the NHS Executive and will help deliver a coordinated approach for improving cancer care quality and safety.
It has the following key themes:
- Prevention: Organisations such as Public Health Wales, Health Boards and Trusts and local authorities will implement strategies linked to cancer risk factors and prevention. The Wales Cancer Network will check on progress against this while also working with the National Clinical Framework Leads to drive prevention in primary and secondary care.
- Early diagnosis: The right workforce, facilities and equipment will support the growing demand for cancer treatment. Each Health Board must establish Rapid Diagnosis Clinics for patients with vague, non-specific symptoms. The National Diagnostics Board will also lead on the strategy for diagnosis in primary care to cut waiting times.
- Equitable access to care: Reducing cancer care disparities across geographic regions and socioeconomic groups will make access to cancer care fairer. Health Boards and Trusts will work to better understand their patient populations and set improvement targets for screening uptake.
- Patient-centred care: Health Education and Improvement Wales (HEIW) have a big role in transforming diagnostics and treatment with a patient-centric focus. Other actions include timely treatment pathways for Health Boards, improving end-of-life and palliative care and making rehabilitation more independent for patients through options such as digital solutions for self-management.
- Innovation and research: Public Health Wales, the Wales Cancer Network and Digital Health and Care Wales are drawing up a cancer version of the NHS Digital Strategy with a roadmap for better data capture, management and accessibility.
- Collaboration and integration: Health Boards and Trusts will work together and with the Wales Cancer Research Centre to deliver the Wales Cancer Research Strategy. Collaborations involving health organisations working across Wales will work to improve outcomes. This includes the Cardiff Cancer Research Hub, involving Velindre University NHS Trust, Cardiff University and Cardiff and Vale University Health Board working together under joint governance arrangements.
- Infrastructure improvements and improved outcomes: This includes investing in new equipment, creating cancer services hubs to support care closer to home, and developing surgical centres.
Outcomes measurement to demonstrate improvement is discussed in the report. Welsh Government also state they’ll hold Health Boards to account for waiting and recovery time targets. However, Audit Wales has criticised the existing documents, saying there’s a lack of strong leadership from Welsh Government and the NHS Executive which is needed to deliver system-wide transformation.
Audit Wales have set out recommendations for future policy. This includes Welsh Government setting out a coherent model for system leadership within cancer services and reviewing its own oversight and performance framework with respect to cancer services.
What you need to know about workforce and service capacity
Our report highlights the workforce and service capacity in Wales and how it will impact on cancer care in Wales. It summarises the facilities and equipment at several health boards and investments into this.
The workforce is growing – jumping from 79,125 in 2018 to 94,663 in 2023 - but still isn’t large enough to match the demand. HEIW’s Education and Training Plan details shortages in dermatologists, clinical oncologists, consultant urology surgeons and histopathologists.
The Royal College of Radiologists also highlight workforce gaps, such as a 34% shortfall of clinical radiologists in 2023 – with 100% of clinical directors saying they didn’t have enough radiologists to deliver safe and effective patient care.
The report highlights three key workforce plans in NHS Wales:
1. A Cancer Improvement Plan for NHS Wales 2023-26
Contained within the Cancer Improvement Plan are provisions around workforce planning. This comprehensive workforce plan has monthly and quarterly objectives monitored through audit and peer review. HEIW has a big role, which includes working with Health Boards to review any workforce issues, creating workforce plans for pharmacy linked to cancer and developing a genomics workforce.
Health Boards and Trusts must also make sure that local workforce planning supports clinical and translational cancer research alongside service delivery.
2. National Workforce Implementation Plan: Addressing NHS Wales Workforce Challenges
Welsh Government published this to address workforce challenges facing NHS Wales through education and new models of multi-professional working. It highlights that the future of cancer care will be driven by a digitally proficient workforce.
It details how they’ll continue to drive digital innovation to free up resource for staff and encourage more efficient ways of working. Training and education programmes for digital skills will help future proof.
3. A Healthier Wales: Our Workforce Strategy for Health and Social Care
This a roadmap for NHS Wales’ workforce for 2030 with seven key themes:
- Creating an engaged, motivated and healthy workforce
- Driving recruitment to Wales
- Creating seamless workforce models
- Building a digitally ready workforce
- Investing in education and learning
- Delivering strong leadership and succession
- Having a healthy workforce supply and shape
There are 32 actions to help deliver these priorities covering frameworks, wellbeing, pay, Welsh language, workforce planning, digital innovation and training.
In summary, there’s an extensive range of policy and workforce planning set out by various organisations that highlight how vital the cancer agenda is for health and social care in Wales. Anyone wanting to partner with or work within these systems should understand them in full.
For a deeper dive into these documents and what they mean for cancer care in Wales, read the report’s executive summary and request to download it in full.
