This World Cancer Day, the OUTpatients team welcomes the Department of Health and Social Care and NHS England‘s launch of the National Cancer Plan for England and the vision it sets out for patients to live well with and beyond their cancer. There’s no avoiding it, this is the first Cancer Plan we have seen in a decade, and this has left many of us in the sector eager to see its release. Now that it is published, we wanted to share our initial reflections as we consider what this means for our work and our community.
What does the Cancer Plan say?
It is positive to see that the Cancer Plan makes a real effort to centre the voices of people affected by cancer. The Plan was shaped by over 11,000 responses to the public call for evidence, 7,000 of which came from current or former patients. It has also included charities and patient representatives on multiple expert reference groups during its development. OUTpatients were proud to attend these groups to advocate for our community and an intersectional lens on inequality. We are heartened to see some of these contributions reflected in the plan, and thank the DHSC for making good on their commitment to reflect the voices of patients, and the organisations who represent us.
The Plan sets out ambitious goals to reduce waiting times, increase 5-year survival, and improve patient-centred care. These are expanded upon across six chapters that prioritise innovation, access, and outcomes. We are pleased to see the plan’s focus on local diagnostics, modernising screening access, giving patients more choice through the NHS app, and introducing standards for prehabilitation and rehabilitation. Together, these actions can ensure that patients start their cancer treatment journey in the best possible position.
We are pleased to see that LGBTIQ+ people have been included in the Plan, where we are named in relation to screening disparities, access to clinical trials, modifiable risk factors (i.e. drinking and smoking), and improving workforce training. These are all areas which OUTpatients is proud to already be working in, including:
- Our award-winning campaigns in cervical and breast screening, HPV vaccination and smoking cessation that have reached millions;
- Our sector-leading LGBTIQ+ cancer education sessions that train thousands of professionals each year; and
- Advising researchers and large industry partners on inclusive approaches to trial planning and participation.
We also celebrate there being a chapter dedicated to rare and less common cancers. This is an area that we are keen to see progress in, particularly following data from a recent US survey that shows that LGB+ people may have a higher incidence of some rare and less common cancers compared to heterosexual people.
What does it not say?
While we are glad to see these challenges named, we believe that the Plan can go further for our community. LGBTIQ+ disparities in cancer care sadly reach far beyond prevention and screening. In particular, we would like to have seen greater recognition of the differences in experiences reported by LGBTQ+ patients in the Cancer Patient Experience Survey, and how the Plan would reduce this inequality. Likewise, new ONS data shows that LGB+ people are 12% more likely to die from their cancer than heterosexual people. If the Government is to hit its target of 75% of patients diagnosed from 2035 being cancer-free or living well after five years, improving care for LGBTIQ+ must be a part of their strategy.
Renewing our call for data
As always in LGBTIQ+ health, we need more data. We welcome the development and introduction of new patient reported outcome measures that help patients communicate their experiences of care to their professionals. At OUTpatients, we have long-relied on this self-reported data as a core metric of LGBTIQ+ patient experience, as sexual orientation and gender identity (SOGI) data is not routinely available in patient records or the National Disease Registration Service.
Embedding SOGI data in a safe and respectful way will help us to better understand the scale and cause of the differences we see for our community in screening, incidence, staging, outcomes, and survival. Until we have this data, we remain a hidden population that is overlooked and underserved by our cancer care. This is an issue we hope that the incoming Inequalities Lead on the national Cancer Board will champion with us.
Working together
It is encouraging to see that inequalities remain an important consideration for Cancer Alliances. We have had tremendous success working closely with Cancer Alliances across the country and are encouraged to see that this relationship can continue to grow. In coming years, we want to explore how our impact can be extended across the cancer pathway, including in prehabilitation and rehabilitation, social prescribing, and supporting patients to live happier, healthier lives.
This plan gives us a vision, but it will take everyone in the cancer sector coming together to make it happen. Together we can set out an evidence-led path to improvement for all LGBTIQ+ people living with and beyond cancer. We have already seen the power of sector allyship in our letter to the Secretary of State. We thank everyone who joined us in this action, advocating for inequalities to be meaningfully addressed in the Plan. We made this happen together, and there’s so much more ahead of us we can achieve.