National Perspective

1. National Perspective Kathy Elliott National Lead for Prevention, Early Diagnosis and Inequalities Cancer Early Detection & Prevention Performance Review Event October 2008 National Cancer Action Team

2. Cancer Reform Strategy Preventing cancer • Over half of cancers could be prevented by changes to lifestyle • Smoking, obesity, alcohol, sun & sun beds, vaccination Diagnosing cancer earlier • Late diagnosis is the major factor contributing to poor cancer survival rates in England • Screening – cervical, breast, bowel Reducing cancer inequalities • Major inequalities in cancer incidence, access to services and outcomes National Cancer Action Team

3. Initial Priorities • Building links with Cancer Networks and PCTs • PCT Strategic Commissioning Plans • Cancer mortality reductions • Early detection agenda • Input to Commissioning Guidance and Darzi alignment • Skin cancer – 08/09 procurement decisions • National Initiatives – NAEDI and NCEI National Cancer Action Team

4. 08/09 CAT Work programme Preventing Cancer • Study of sun bed use • New local & national approaches for skin cancer prevention • Dissemination – pilots to assess cancer genetic risks Diagnosing Cancer Earlier • Support Networks to • Review the local indicators to early diagnosis • Set out commissioning intentions in PCT Strategic Plans • Develop at least one new initiative for implementation locally • Use new tools and good practice Reducing Cancer Inequalities • Equality Impact Assessments • Cancer mortality National Cancer Action Team

5. New ways of working Local priorities reflecting local needs & services Top down National targets Local & national leadership National experts Short term projects Sustainable effective services The Importance of Dialogue National Cancer Action Team

6. National Awareness and Early Diagnosis Initiative (NAEDI) • Co chairs: Harpal Kumar and Mike Richards • 7 work streams • Review of evidence base on awareness and early diagnosis • Measuring awareness • Interventions to promote early presentation by patients • Interventions in primary care • International benchmarking • Prospective research • Key messages on individual cancers • Launch conference: 21st November 2008 • Newsletter

7. Reducing Cancer Inequalities • National Cancer Equality Initiative • Co chairs: Joanne Rule and Mike Richards • Steering group with experts from each of the inequality strands (e.g. race, age, gender, disability, religion, sexual orientation and social deprivation) • Working closely with National Awareness and Early Diagnosis Initiative (NAEDI) and with National Cancer Intelligence Network (NCIN) • Developing a matrix of local initiatives • Please contribute • Will then focus on: • Spreading good practice where this exists • Developing and evaluating new models to reduce inequalities

8. Cancer Networks • Understanding and communicating local need • Joint Needs Assessment (JNAS) • Providing leadership for prevention, early detection and inequalities • Influencing • PCT Strategic Plans • Monitoring and assuring quality and outcomes • Vital Signs and Local Area Agreements • CRS commitments – mortality; inequalities • Development • Early detection initiatives • Network expertise and work plan • Good practice – spread of community engagement in early detection • Development needs • Challenges National Cancer Action Team

9. Diagnosing Cancer Earlier Every PCT should have one early diagnosis/ detection initiative. • To have reviewed information • One year survival rates against international benchmarks • Screening uptake, overall and by general practice • Referral rates, by general practice • Emergency admission • In PCT Strategic Commissioning Plan • At least one initiative implemented • National Awareness and Early Diagnosis Initiative National Cancer Action Team

10. Cancer Mortality • What local progress has been made towards achieving the cancer mortality target? • How does this compare with the England progress, other Networks/ PCTs? • What is my local commitment to meet the 2010 standard? • ‘Have PCTs agreed challenging goals for reducing cancer mortality in every cancer network area by 2012?’ (CRS) • Are these goals in the PCT Strategic Commissioning Plans - and resourced? • Do local plans reflect variations between PCT needs and health inequalities? National Cancer Action Team

13. Relative change in cancer mortality by cancer network since 1997 "Good" "Good" Relative change in mortality rates and the level of change in mortality rates since 1997 (compared to England level) by cancer network. 5 year rolling age-standardised mortality rates (2001-2005) for all cancers for 0-74 years age group; % change in mortality rates since 1997 National Cancer Action Team

14. Emerging Good Practice Themes • Priority within local plans, including pledges • Leadership commitment and ownership, with clarity on why it matters • Reductions in mortality • Fair access to services • Strong public and patient involvement • Relationship management and communications • Close working with other networks, with explicit commitments • Building a relationship with public health – engagement, influence and work programme • Importance of all health professionals understanding their role and implementing their contribution • 2 year action plan National Cancer Action Team

15. Kathy Elliott National Lead for Prevention, Early Diagnosis and Inequalities National Cancer Action Team Blackberry and Mobile 07799095779 kathy.elliott@gstt.nhs.uk Office 0207 972 4816 kathy.elliott@dh.gsi.gov.uk Note – please use both email addresses National Cancer Action Team