NORTHERN IRELAND SKIN CANCER PREVENTION STRATEGY AND ACTION PLAN 2011-2021

1. NORTHERN IRELAND SKIN CANCER PREVENTION STRATEGY AND ACTION PLAN 2011-2021 July 2011 Karen Oldham Department of Health

2. Minister/ Department PHA HSCB (including LCGs) BSO RQIA Trusts PCC Special Agencies/NDPBs Key Stakeholders including: Users, carers, communities, Family Practitioners, Independent Sector and Local Government Health and Social Care System

3. HSC Strategic Objectives • The Department of Health Social Services and Public Safety (DHSSPS) has a statutory responsibility to promote an integratedsystem of health and social care (HSC) designed to secure improvement in: •  the physical and mental health of people in Northern Ireland; • the prevention, diagnosis and treatment of illness; and • the social wellbeing of the people in Northern Ireland

4. Department • Develop policies; • Determine priorities; • Secure and allocate resources; • Set standards and guidelines; • Secure the commissioning of relevant programmes and initiatives; • Monitor and hold to account its ALBs; and • Promote a whole system approach.

5. In terms of service commissioning and provision, the Department discharges this duty primarily by delegating the exercise of its statutory functions to the Health and Social Care Board (HSCB) and the Public Health Agency (PHA) and to a number of other HSC bodies. All these HSC bodies are accountable to the Department which in turn is accountable, through the Minister, to the Assembly for the manner in which this duty is performed.

6. Public Health Agency (PHA) Functions • Improvement in health and social well-being • Health protection • Service development • In exercise of these functions, the PHA also has a general responsibility for promoting improved partnership between the HSC sector and local government, other public sector organisations and the voluntary and community sectors to bring about improvements in public health and social wellbeing

7. 1997 “A Strategy for the Prevention, Diagnosis and Treatment of Malignant Melanoma and other skin Cancers in NI.”

8. Review of 1997 Strategy in 2006 – key recommendations • a new strategy should include actions to raise awareness of melanoma amongst the general public and professionals • a continued focus on early detection • that questions should be included in health surveys relating to public behaviour • the strategy should set out clear aims and objectives with both long and short term targets • implementation structures should be clearly defined with clear roles and responsibilities.

9. Aim- To reduce the incidence of skin cancer and deaths from it among people in NI.

10. 2011 strategy development took account of • several new developments: • -Climate change • -Scientific research was clarifying the relationship between sun exposure and vitamin D • -Cheaper air travel had seen people in NI taking more frequent trips to sunnier climates • -International Agency for Research on Cancer reclassified UV emitting tanning devices into the highest cancer risk category and highlighted the risk of exposure early in life. • -Service framework for Cancer prevention, treatment and care • -The Sunbed (NI) Act 2011

11. 2 priority groups: • Children and young adults • and • People who spend a significant amount of time outdoors

12. OBJECTIVES: • To increase public awareness regarding the dangers of overexposure to UV radiation from sunlight and from artificial tanning devices. • To reduce overall use of artificial tanning devices • To increase individual and organisational wide practice of sun safety behaviours • To increase awareness about the early stages of skin cancer and the need for prompt attention. • To encourage earlier detection and treatment of malignant melanomas • To promote further research into knowledge, attitudes and behaviours and the epidemiology of skin cancer.

13. ACTION PLAN • These objectives form the basis of the action plan • Delivered through a multi-agency implementation group, jointly chaired by the PHA and Cancer Focus NI, and 4 sub-groups. • The Public Health Agency (PHA) is responsible for overseeing the progress of the group with support from Cancer Focus NI.

14. MID TERM REVIEW- 2017- Recommendations • Enhanced membership to include Local Government Health and Wellbeing Officers and a representative with personal involvement • Further exploration of the potential for a complete ban on commercial sunbed use • National Institute of Clinical Excellence (NICE) guidance on risks and benefits of sunlight exposure to be incorporated into messages • Ways to increase the general public’s understanding of the correlation between UV levels and the need for skin protection should be considered • An economic analysis of the costs to the Department of Health of treating skin cancer against the cost effectiveness of skin cancer prevention programmes should be commissioned. • Consideration should be given to rebranding “care in the sun” to incorporate the wider message around protection against artificial UV exposure- Be UV Aware is now the brand we use.

15. INDICATIONS OF PROGRESS?: • Cases of skin cancer continue to rise • Significant work in relation to action plan- results might not be evident for some time