In 2019, the U.K. passed an ambitious strategy bringing together providers and patients to voice their needs with the NHS and help formulate a nationwide strategy for addressing healthcare over the next decade. The Long Term Plan objectives included improving equal access to care, distributing funds more efficiently among different communities, expanding and better supporting the medical workforce, and diagnosing diseases like cancer earlier to increase survival.

In the years leading up to the Long Term Plan, international cancer benchmarks showed the U.K. had a lot of catching up to do. For example, five-year lung and colon cancer survival in England was 15% and 58.9%, respectively, from 2010 to 2014; the same place Australia was 10 years before. And Denmark, which had some of the poorest and lowest survival rate outcomes in 1995, along with Britain, had one of the highest rates for most cancers by 2014, due to a consistent cancer policy.

But four years into the Long Term Plan (and one global pandemic later), the NHS is under immense pressure. Staffers are going on strike, burned out from inadequate working conditions and undercompensated, while patients are waiting months, sometimes years, to receive care.

A controversial change of plans
So on January 24, 2023, Steve Barclay, the U.K.’s secretary of state for health and social care, announced that the Long Term Plan would be scrapped and replaced with a new plan called the Major Conditions Strategy. Described as a “generic chronic disease plan,” the proposal rolls the Long Term Plan into one strategy that addresses all major health conditions together, namely cancer, cardiovascular disease, chronic respiratory disease, dementia, mental health, and musculoskeletal disorders.

The new plan has been met with condemnation from providers and medical experts who argue that it risks deterring affordable, equal, and quality access to care, while failing to account for each condition’s unique complexities, which are already strained by declining funding and COVID-19.

In an op-ed published in the The BMJ, Richard Sullivan, professor of cancer and global health and director of the Institute for Cancer Policy at King’s College London, and Dr. Ajay Aggarwal, a consultant clinical oncologist and associate professor at the London School of Hygiene and Tropical Medicine, described the new plan as “catastrophic.”

“On one hand, you do need some sort of integrating strategy,” Sullivan told HCB News. “On the other hand, all high-income countries, most middle-income countries, and most scholars in this area have agreed for years that with cancer and other specific conditions you need to have a specific stand-alone plan that integrates with general health plans. The reason is the sheer complexity of the services and systems delivering better outcomes.”

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