Are patients satisfied with NHS cancer care?
An easy way to drive a health secretary to apoplexy is to remind them of NHS satisfaction surveys. Ever since governments started asking people what they think of this hallowed institution, the results have largely been the same. That is, if you ask a person in the street what they think of the NHS they will invariably say it is going to the dogs, care is appalling, you can never get to see a doctor. But ask a patient what their experience has been and they are full of praise and are, indeed, largely satisfied.
And this is, today, reflected in the figures from the second annual National Cancer Patient Experience Survey. It shows that 88 per cent of patients rated their care as very good or excellent.
The survey also found that 94 per cent of patients said they were treated with dignity in 2011, a rise from 93per cent in 2010. And 83 per cent of cancer patients said they were seen by a hospital doctor quickly compared with 81 per cent in the previous year.
Without a doubt cancer treatment has improved hugely over the past couple of decades. Obviously there are better drugs and diagnostic techniques. But having gone through the system with my sister, the first and most important improvement was getting to see a consultant within two weeks and then treatment starting with no delay.
The Cancer Czar Professor Sir Mike Richards has been at the forefront of this under both this and the previous governments and rightly deserves plaudits for his efforts.
But the pressure is increasing on the system as funding grows evermore tighter. There are also concerns that GPs, who are about to take over the majority of the NHS budget, do not have the expertise necessary to sustain the improvements.
Indeed, data from the National Cancer Intelligence Network showed that the rate of urgent GP referrals to hospital for patients with suspected cancer ranges from under 830 to more than 2,550 in every 100,000 patients a year.
The Network said that the number of people referred by GPs was not on its own an indicator of how good they are at spotting the early signs of cancer. But it said that the range of the variation was so wide that, at the extremes, it probably reflected differing standards of care.
What’s more, Cancer networks have had their funding almost halved. These networks work by hospitals collaborating, so where one is good at surgery, and another better at chemotherapy, they come together for the good of the patient. They have been shown to be enormously successful.
And in an NHS where private providers can bid for services it is a legitimate question to ask whether they would be in favour of collaboration?
Finally, there are reconfigurations of hospitals with services being moved from one trust to another in order to save money. So this week, a friend went to a well-known London hospital for a breast examination. The service had been moved from one hospital to another in this large trust.
The service was fine except for one vital element. Her notes had not been moved (nor, it seemed had any other patients’ notes). So, my friend spent valuable time once again explaining that her mother has had breast cancer, as has her half-sister, and that she herself has already had a biopsy for an existing lump.
It was a waste of her time, of staff time, inevitably costs money and is something that need not happen.
Still, off the back of the NHS satisfaction survey the DH has now sent each trust an individual report so they can identify areas of improvement. With luck, this large London trust will take note.
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