What are the key inequalities?

• Smoking prevalence remains higher than the national average - reflecting our socio economic landscape.  Whilst we are targeting resources at the most deprived areas, smoking prevalence is not reducing as quickly as we would like.
• There is a variability between GP practices in screening coverage
• There is a variability in access to services;
• We need to improve access to radiotherapy and reduce waiting times for radiotherapy treatments;

What are they keys gaps in knowledge/services?

• Inadequate data and intelligence to inform commissioning, monitor inequalities,  assess quality and promote choice
• The Cancer Reform Strategy will have major implications on the delivery of the service.  The planned expansion of the programme and the move to digitalised mammography will have workforce and funding implications
• Lack of resources - staff/physical infrastructure/ finance - for the expansion of the breast screening programme;
• Improving access to radiotherapy and reducing waiting times for radiotherapy treatments;

What are the risks of not delivering our targets?

The primary target for cancer is a minimum 20% reduction in cancer mortality by 2010 from the 1995/97 rate and that fewer people will die prematurely from cancer, heart disease and stroke before the age of 75. Thus the risks of not delivering in other areas, such as smoking and physical activity and diet obesity, will have an impact on cancer outcomes. In particular,

• Smoking prevalence remains higher than the national average - reflecting our socio economic landscape.  Whilst we are targeting resources at the most deprived areas, smoking prevalence is not reducing as quickly as we would like;
• Our culture impacts on late presentation of cancer.  Innovative social marketing combined with community engagement approaches are required otherwise this will impact on early diagnosis;
• Further decline in screening coverage, particularly in relation to cervical screening and a further reduction in variability between GP practices in screening coverage. Also difficulty in achieving the 14-day turnaround for cervical screening results.
• Not reducing variability in access to services

What is coming on the horizon?

The potential impact of the Bowel screening programme on resources with the anticipated increase in colorectal cancers.

What should we be doing next?

1. Reducing variability between GP practices in screening coverage and access to services.

2. Improving outcomes (not just survival) regarding quality of life, palliative care, support for families, support to patients and carers;

3. Improving access to radiotherapy and reducing waiting times for radiotherapy treatments;

4. Improve data collection and analysis to inform commissioning, monitor inequalities

5. Our culture impacts on late presentation of cancer. Innovative social marketing combined with community engagement approaches are required to increase early screening.