Is the UK’s new all-in-one health condition strategy another policy misstep?

por John R. Fischer, Senior Reporter | February 27, 2023
European News Rad Oncology

Advocates of the Major Conditions Strategy argue that many conditions, including cancer, share common risk factors and challenges that may be better addressed together. Whereas the Long Term Plan addressed diseases in individual silos, the new strategy could facilitate care and research for associated comorbidities at the same time.

What went wrong?
The Long Term Plan was not meeting desired targets, and a large contributing factor was the pandemic, which pushed back an already severe backlog of waiting times for cancer treatment, and further diminished its declining healthcare workforce with one in ten NHS posts still vacant, as of September 2022.

As of November 2022, only 61% of patients in England started treatment within 62 days of an urgent suspected cancer referral, far below the 85% target the government set. And its goal of diagnosing 75% of cancers early by 2028 was deemed too ambitious by Cancer Research UK, the world’s largest charity and independent cancer research organization, which said it would have required around 100,000 extra patients by stage 1 or 2 each year in England.

The unsatisfactory performance of the Long Term Plan opened the door to alternative plans aimed toward addressing an increasingly dire, post-pandemic national healthcare climate.

“Our workforce model needs to adapt, reflecting that the NHS is caring for patients with increasingly complex needs and with multiple long-term conditions,” said Barclay. “We need greater emphasis on generalist medical skills to complement existing deep specialist expertise in the NHS, supporting clinical professionals to heal with whole person care.”

New plan stirs skepticism
Sullivan and Aggarwal maintain that an effective national healthcare strategy must address post-pandemic backlogs of sicker patients with more advanced cancers, brought on by delays in diagnostic screenings and high vacancy rates in cancer-specific workforce personnel.

“It’s not like diabetes or heart disease, which are really an emergent property of general health systems, said Sullivan. “The drugs and therapeutics we use are highly unique and specialized; the surgery is complex and highly specialized; radiotherapy is only used in cancer; and we now have multiple, complex regimens and treatment pathways for culling cancer, but of course it’s thousands of different diseases we’re essentially treating.”

One concern among cancer research and care workers is that bundling cancer with other conditions will take attention away from addressing care gaps. According to Cancer Research UK, a new plan must have measures for diagnosing cancer early, facilitating care quicker, and preventing cancer in the first place.

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