My Lords, sitting on the same side as the Minister does not mean that I am on her side. I thank all noble Lords taking part in the debate and look forward to their contributions. There is a formidable array of talent, so the Minister should get a good response. I thank her for making time to respond to the debate, although, at the end, she might wish that she had not done so.
No one can be in any doubt that poor outcomes for patients with cancer in the UK need urgent attention. Today is World Acute Myeloid Leukaemia Day, which observes a blood cancer with low survival rates, primarily because of late diagnosis. One in two people in the UK—
Thank you. One in two people in the United Kingdom will develop cancer. Being born with cancer is rare, but a new cancer diagnosis is made every 75 seconds. The UK consistently ranks near the bottom of the table for survivals and deaths from cancers. That is despite several cancer plans and strategies for change, which are often heralded as world class. In 2011, we had Improving Outcomes: A Strategy for Cancer; in 2015, we had Achieving World Class Cancer Outcomes; and in 2019, we had a plan to make cancer a priority. None of those plans delivered the promises made. The result is that cancer outcomes have not improved much in England for nearly two decades.
Cancer care is a touchstone of the wider NHS, which itself is also delivering poor performances. It is in that environment that we will discuss the plan. We now have the Government’s National Cancer Plan for England: Delivering World Class Cancer Care. What is different about this plan? The Government say that
“it heralds a full modernisation of our approach to cancer care … fit for the future”.
The report is ambitious but lacks detail on implementation plans, which I hope the Minister will tell us about today.
What are the key commitments? The first is to improve five-year survival rates, so that, by 2035, three in four people with cancer will live more than five years, either cured or living well. The second is to restore performance in meeting cancer waiting-time standards by 2029. The third is to expand screening programmes, including lung cancer screening, by 2030. The fourth is to increase genomic and genetic testing, so that genetic tests are to be reported within 10 days for 96% of patients. The fifth is to accelerate the use of AI, robotics and modern imaging for early diagnosis. The sixth is to reduce variation in accessing new treatments and technologies and to address inequalities. The seventh is to strengthen cancer alliances among system leaders and to boost research and clinical trials.
My Lords, I thank the noble Lord, Lord Patel, for securing the debate and pay tribute to his indefatigable commitment to improving health outcomes and championing research and to his powerful and moving speech. I am pleased to have the opportunity to contribute to the debate. I know that I will not be the only speaker whose family has been touched by cancer. Seeing much-loved family members or friends suffer is the reason we can all agree that patients deserve timely diagnosis and the best possible treatment. In the past, I have spoken about pancreatic cancer and brain cancer from my own family perspective. I will focus my remarks on these and other cancers, including cancers of the liver, lungs, oesophagus and stomach, which are grouped, rather grimly, as the least-survivable cancers.
I warmly welcome the recently published national cancer plan, which has brought these rarer cancers into focus. For the first time, we have a national plan that makes specific commitments to less common cancers and I commend the Government for that. The plan aims to have three out of four people diagnosed with cancer survive five or more years by 2035, as the noble Lord, Lord Patel, pointed out. It recognises that progress for people affected by less survivable cancers is key to this aim. As the Less Survivable Cancers Taskforce notes,
“these cancers account for a disproportionate number of cancer deaths and require focused action if overall survival targets are to be met”.
Earlier detection and faster diagnosis for all forms of cancer are critical to improving people’s access to treatment and, ultimately, their chance of survival, but progress on the rarer cancers still lags behind progress on others. Survival rates for these cancers have remained largely static over the last 25 years, partly because their often vague and non-specific symptoms can make early diagnosis very difficult. Just 28% of less survivable cancers are diagnosed at stages 1 or 2, compared to 54% of all cancers. A large proportion of people with less survivable cancers are diagnosed in A&E, so the national cancer plan’s strong focus on early diagnosis is welcome.
My Lords, I, too, most warmly congratulate the noble Lord on securing this debate. I always think health matters should be handled by a former president of a royal college, and it is excellent that we have another former president of a royal college with us today. This should be a criterion for joining the Lords, and we should have far more of them. I declare my interests. Many noble Lords know that I have been involved in the appointment of key leaders of eminent health and academic institutions for the past 26 years or so. I should also say that I am the mother of a gynaecologist and the grandmother of a medical student.
Cancer is one of those issues that tells us quickly and clearly whether a health system can turn scientific excellence into public benefit. The Government are right to call cancer performance a tide on which all ships rise. They are also right to say that science and innovation will be the engine of our reinvention. I thought the noble Baroness was going to talk about universities and academic research, which she would have had greater right to do.
These are not casual phrases; they are statements of national ambition and they are fully justified. England remains a country of distinguished scientific and clinical strength. We are capable of world-class discovery, trials and research leadership. The challenge now is whether that strength is translated reliably into public benefit—faster diagnosis, quicker access to treatment and more equal outcomes, as the noble Lord said, for patients across the country.
There is much in the national cancer plan that deserves genuine welcome. It is more serious than many previous strategies about research, clinical trials and innovation. It commits to research remaining
My Lords, I congratulate my noble friend Lord Patel on securing this important debate, to which it is a pleasure to contribute. I declare my interest as a fellow of the Royal College of Nursing, and I am delighted that I will be followed by a previous president of the same organisation—making at least three in the Room. I intend to cover elements of the themes identified in the plan on community services, the value of screening, the workforce necessary to deliver for patients and the worried well, and an emphasis on psychological support, as well as the protection of patient data and the control of its use for UK-led research and prevention of cancer.
I join others in welcoming the ambitious plan, which will require cultural change across the workforce to improve the communication between assessment, diagnostic and treatment teams, as well as the use of AI and digital information. The aim is to provide seamless delivery of care closer to patients’ homes. This, of course, should be cost effective. The plan has been described as a revolution, and it is vital that the strategy for implementation and delivery is clearly led and monitored to ensure that the change actually happens. With the emphasis on community-based care, the current workforce will, in many instances, need the opportunity to refresh and enhance its skills and knowledge for delivering care outside acute hospital settings. As many people know, I help lead some of that, closing a large mental hospital into community care. The challenge may be similar to achieve this plan—not that I am suggesting we can shut the Royal Marsden.
Clinical staff often work alone in the community, which can be challenging for staff who spent most of their careers with easy access to other multi-professional team members for support and guidance, particularly when a patient’s condition suddenly rapidly deteriorates. Staff must be confident and skilled to provide care in the community, which will call for professional development and dedicated preparation time. The King’s Fund argued that a persistent shortage of radiologists, pathologists and severely overstretched nursing teams often results in haphazard organisation and innovation, rather than planned organisational change. The cancer plan highlights some excellent examples of innovation from the Humber and North Yorkshire Cancer Alliance pilot, using nursing and pharmacy teams to introduce home-based delivery of some subcutaneous chemotherapy drugs. The Christie supportive oncology services demonstrate the value of integrated care provision, from psychology support to dietary advice and symptom management.
My Lords, it is a pleasure to follow the noble Baroness, Lady Watkins, a fellow nurse. I add my congratulations to the noble Lord, Lord Patel, on securing such a timely debate. There is a lot to commend in the National Cancer Plan for England, but, speaking as a nurse and a workforce researcher, I think that there are definitely challenges, as we have heard, to be met in ensuring that services meet the physical, psychological and social impact of cancer care.
Cancer detection rates are increasing alongside survival rates and complexities of diagnostics as well as care pathways in a population with growing co-morbidities. The national cancer plan advocates for every cancer patient to have access to a clinical nurse specialist, as we have heard. However, it is uncertain how likely it is that this will be achieved with the lack of nurse specialists currently available in the workforce, as the noble Lord, Lord Patel, highlighted.
There is strong evidence that specialist and advanced practice nurses are cost-effective and clinically effective. These highly skilled and educated nurses lead clinical services and the administration of complex chemotherapy protocols. Anyone in contact with chemotherapy services will be aware that this is nurse-led and stressful work, as the pressure is on to ensure that high volumes of patients are treated safely. Burnout rates for chemotherapy nurses remain high. Specialist and advanced practice nurses are a precious human resource that needs to be supported.
One of the challenges to accessing treatment is the availability of training and education for specialist nurses, as highlighted by the noble Baroness, Lady Watkins. According to a recent survey by the UK Oncology Nursing Society, training and education is patchy across the country. Two factors constrain the expansion of this highly skilled cancer workforce: the limited supply of supervisors to support advanced practice nurses and funded opportunities to develop their capacity. Access to training and education is essential to build the necessary confidence and competence in delivering ever more complex care. Core to these skills are expertise in advanced communication, psychological support skills, which the noble Baroness, Lady Watkins, highlighted, and symptom assessment and management.
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I have mentioned but a few. All of that and more is being promised when cancer services are under immense pressure. Demand continues to rise, with a complex case mix. Most importantly, staff shortages persist, particularly in radiology, oncology, cellular pathology and cancer specialist nurses.
The shortfall in workforce in critical areas of cancer care is significant. In radiology, it will be 39% by 2029; in oncology, it will be 19%. For nursing and specialist nurses in cancer care, there is a 10% shortage in most trusts. There is a shortage of 4,000 specialist cancer nurses and 6,000 nurses in community diagnostic centres. In histopathology, only 3% of departments say that they have adequate staffing. The Royal College of Radiologists and the Royal College of Pathologists say that, with the shortage, the workforce will not be able to deliver on the needs in the cancer plan. To do so, the workforce may need to grow by as much as 45% by 2035. In radiology alone, that may cost £1.5 billion a year. I ask the Minister when the Government will publish a fully funded workforce plan for cancer care. We look forward to that soon.
I will now pick up on some of the key commitments, as I do not have time to go through them all. On the commitment for three in four patients to survive five years by 2035, the current average survival for five years is 55% to 60%. Of course, it varies with cancer types: it is good for prostate and skin melanoma, but survival rates are much lower than in many other countries for equivalent cancers across the board. On restoring performance for standards of, for instance, early diagnosis at stages 1 and 2 in 80% of cases by 2029, that is improving: it has now improved to 72.8%. Sixty days from the first referral to treatment is a standard that has not been met since 2015. For treatment in 31 days from diagnosis, the target is 96%; currently, it is not doing badly at 93%.
On expanding screening programmes and eliminating cervical cancer by 2040, the increase in HPV vaccination and self-diagnosis HPV kits is the way that the Government hope to meet that target. The current uptake of the HPV vaccine is 75.5% in girls and 70.5% in boys, with huge regional variation: for instance, in London, it is only about 64%. What plans do the Government have to improve uptake of vaccination and how will the elimination target be met? As far as the HPV kits are concerned, what happens if a woman self-tests and finds that she is HPV positive? The services need to match up to what the patient might need.
Another target is increased genetic and genomic tests. The plan suggests that there might be value in testing whole-genome sequences, the so-called polygenic risk scores aligned with the lifestyle, but they are of no value because the risk is not yet identified or valued. It is different if you are testing for inherited genetic diseases, such as if a patient has a BRCA gene, as then you might follow up with others in families. But the value of whole-genome sequences as polygenic risk scores cannot be right.
Genome testing for mutations in cancer, of course, is important for personalised treatment, and the target is for 98% in 10 days. Currently, it meets this for 68% of patients, because of the workforce issues. What might be the implications if the treatment is delayed because these tests are not reported in time? For instance, a four-week delay in treatment increases risk of death by 6% to 8%, so it is important that these tests are reported quickly. These days, without genomic mutation testing, treatment cannot be started with cancers.
Another target is to accelerate use of AI, robotics and modern imaging for early detection. It is true that in the trials carried out using the triad—it is important to use the triad of AI, robotics and modern imaging—it is quicker to obtain a tissue sample, for instance, but these have to be done together and there are costs of equipment, training and robotics.
The Government hope in the report to increase the use of robotics from 70,000 currently to half a million by 2035. Small studies show benefits, because it fuses metabolic and structural data for better staging and treatment of cancers, but the digital pathology staff remain a key workforce required for this. Can this be standardised across the whole NHS rather than in specialist units alone?
The next issue is funding. Together with staffing, funding is a critical issue. The Government have made a commitment of about £6.5 billion, rising to £15 billion depending on progress. However, estimates from the Health Foundation suggest that, to roll out AI, robotics, modern imaging and digitisation across the NHS, we will need £14.5 billion to digitise the NHS, capital infrastructure worth £5 billion, one-off implementation costs of £2.5 billion and recurring costs of £1.5 billion. Does the Minister think that this is realistic and that the Government will be prepared to fund it?
The main other issue is reducing inequalities in cancer care. We must reduce inequalities in cancer outcomes for deprived populations. The biggest challenge is in the 20% of deprived people, because there is a 60% higher death rate in this population. Late diagnosis is more common in this population, there are low treatment rates, people are more likely to have cancer diagnosed in an emergency in the A&E department and there are low screening rates. Focusing on reducing inequalities in cancer care will be key to meeting the targets set in the plan.
Who is going to do this? The suggestion is that the cancer alliances will be responsible for planning and tracking the delivery of cancer services in deprived areas with an extra £200 million in funding. Is that likely to be adequate funding, knowing that it will require new staff to man these services? I ask the Minister, therefore, what the metrics for the improvement in care of the deprived population will look like.
The developments in technology, drugs and diagnostics in healthcare and cancer care come thick and fast. Many are mentioned in the report. Some of them are not even yet validated. Treatments are very expensive. For instance, CAR T-cell immunotherapy would cost in the region of £280,000 per treatment per patient. The technology is expensive. The current percentage of people getting chemotherapy, radiotherapy, cell and gene therapy and immunotherapy in England is lower than in countries with better cancer outcomes. Implementing what works and improves outcomes for the whole of the population—early diagnosis and prompt treatment, with the workforce to deliver that—will result in better outcomes. I repeat that, knowing what we know, early diagnosis and prompt treatment will improve outcomes well before we use these technologies. They are important, but we need to do that first. Patchy introduction of state-of-the-art technology, early-phase research into the practice of untested diagnostics, science fiction and a promise of personalised nirvana tomorrow will not be the answer.
The plan is thin on the prevention of cancers apart from on tobacco control, which I applaud—and we all applaud. Treatment using GLP-1 and GLP-2 blockers for obese people is not stopping obesity; it is treating obesity, at a cost. In the plan, there is nothing about what the Government will do to reduce obesity, or on the reduction of alcohol consumption, but we know that 40% of cancers are related to lifestyle issues. Can the Minister explain why the report is so thin on prevention?
I will make a comparison to one country. Much of the cancer plan comes from learning from the Danish model. Denmark, some 25 years ago, had similarly poor outcomes for cancers. It embarked on an incremental cancer plan to the point that it is now recognised as the country with the best cancer outcomes. Its latest plan is to focus on helping people living with cancer and those in end-of-life and hospice care. I am sure that the noble Baroness, Lady Finlay, wants to know when England will get such a plan. To invest in this, Denmark is to spend 690 million Danish kroner. It does not sound like big money, although its population is small.
The key feature of the Danish plan and the better results is political consensus. The noble Earl, Lord Howe, might remember that, in a debate that we had about the long-term sustainability of the NHS, I said that the NHS’s survival depends on a political consensus. The then opposition Health Minister, the noble Lord, Lord Hunt of Kings Heath, laughed and said, “Dream on”. I guess that that is still the problem. If we do not have political consensus, we will just have more problems.
Funding was the other issue. All the five-yearly plans in Denmark were funded. Importantly, there was a promise to the people that the service would deliver early diagnosis within 14 days or less and that treatment would start within 14 days or less. The promise was that, if you did not get that, you could go to any other region in Denmark for your treatment or even another country. Would the Government make such a promise to the population of England?
The Government’s plans are ambitious, but will the Government maintain a consistent commitment to delivery no matter what it takes? Otherwise, in three to four years’ time, we will debate a new cancer plan that will be even better and world-class. However, I wish the plan well and I hope that we begin to get results quickly.
It is an excellent and ambitious plan informed by cancer professionals, patients and their families but, as ever, it will take funding to secure real improvement and change. Like others, I am aware that this plan is launched at a time when there seem to be substantial economic growth problems and demand on public spending is being stretched in all directions. We need to be realistic about what can be done here and now. Our efforts must be focused on what will have the greatest impact. I was therefore very pleased to read last week that we are making progress in our efforts to cut set-up times for clinical trials. Approval processes in the UK have been slow and bureaucratic, so faster access to new treatments and medicines can be only a good thing. Will the Minister say more about how we can now encourage people to access clinical trials and tackle historically low patient recruitment?
We need to prioritise research, particularly into the less survivable cancers. We know that rare cancers account for some 47% of UK cancer diagnoses and some 55% of cancer deaths, yet they receive a fraction of research funding and clinical trial work. The Rare Cancers Act, passed last month, is a huge step towards addressing this imbalance, and I pay tribute to Scott Arthur MP, who saw it through its passage in the House of Commons, and my noble friend Lady Elliott of Whitburn Bay, who steered it through its final stages in this House. It will drive research innovation to improve treatments and survival for rare cancers, including brain tumours and pancreatic cancer. Can the Minister give us any encouragement on moves to appoint a national clinical lead for rare cancers, as called for in the Act and in the National Cancer Plan for England? I am very conscious of the substantial funds made available only eight years ago, following the death of our noble friend Lady Jowell. A very small proportion of that money has yet been spent, and that was eight years ago.
In finishing, I want to highlight some encouraging developments in diagnosing a cancer that currently has a UK survival rate of just over 8% and that has affected my family particularly. Innovative diagnostic tests and emerging AI technologies have real potential to help GPs triage patients with vague symptoms. For example, the VAPOR breath test for pancreatic cancer being developed at Imperial College and part funded by Pancreatic Cancer UK can detect volatile organic compounds released from tumours at an early stage. Results are showing that this quick test, which involves breathing into a bag at the GP’s surgery, can pinpoint whether a person is likely to have pancreatic cancer, with the results available to GPs in three days. This would put an end to the patient going backwards and forwards to the GP many times with non-specific symptoms and allow for earlier treatment. The test is now undergoing national clinical trials, and it could be in GP surgeries within the next five years. I end by saying: we live in hope.
It promises annual progress reporting and sets out in-depth three-year reviews, which is the right direction. It also sharpens the real test before us: it is no longer simply whether England can produce excellent cancer research, which we can; the tough question is whether we are as good at adoption as we are at discovery. It is whether Ministers can show, in practical terms, who is responsible for each research priority, by when and by what measure of success they will be judged.
As noble Lords are aware, the central issue is translation. We know that this country can lead in genomics, diagnostics, cancer biology and trial design. The harder test is whether innovation travels quickly enough from the laboratory bench to the clinic, and then from the great research centres to the district hospitals and the patient, who is anxiously and often fearfully waiting. This is the point at which scientific strength either becomes public benefit or remains trapped as potential.
The Institute of Cancer Research puts this with admirable clarity. Professor Kristian Helin warns:
“Cancer research cannot succeed in isolation. It relies on a strong life sciences and higher education ecosystem, underpinned by world-class infrastructure, sustainable investment and access to the best skills and talent”.
Can the Minister say who, across government, is responsible for making sure that research, universities, immigration, infrastructure and NHS reform are pulling in the same direction? I quickly pay credit to the noble Lord, Lord Vallance, who has been the most wonderful advocate and leader in this sector. Ministers of whichever department would pay respect to his contribution.
Cancer Research UK—I pay tribute to its chair, who will have much more to say on this, or he may talk about his experience as chief executive of the NHS—makes a similar point in more practical language. Will this plan be the turning point for cancer that patients deserve? It will require much faster progress. The next step must be translating it into delivery—a telling phrase: delivery, not declaration. Have we heard it before? We have, but this time it needs to happen. When will we see the full implementation architecture behind the research and innovation elements of the plan? In plain English, when will we know where responsibility sits, what resources are attached and what would count as success or failure by the midpoint of the plan?
We have been warned before that the problem is not only strategy but consistency. I was interested in what the noble Baroness said about Denmark. Summarising research from the International Cancer Benchmarking Partnership, Professor Ellen Nolte said that
“sustained and consistent strategic planning and investment are crucial”.
That is not a throwaway line; it is one of the clearest lessons from comparative success. Countries that improved did not merely publish attractive plans. They backed them, refreshed them and stayed with them. Can the Minister assure noble Lords that this cancer plan will be treated not as a launch but as a governing discipline? What protections are there against the familiar pattern in which bold strategic language is followed by uneven implementation and fading attention?
Clinical trials are crucial, and this is where it becomes real for patients. The plan says that
“every cancer patient gets the opportunity to access relevant clinical trials quickly, fairly and easily”.
I pay tribute to my noble friend Lord O’Shaughnessy’s important review, which set out 27 recommendations and argued that the NHS should become
“the world’s leading platform for health and life sciences research”.
There has indeed been genuine progress, for which I pay tribute to the Government.
The Government report that the average set-up time for commercial, interventional, clinical trials has fallen from 169 to 122 days. That is dramatic. The latest UK clinical research delivery data shows that 71% of commercial contract CTIMPs applying between April and September 2025 recruited a first participant within 150 days. These are steps in the right direction.
The MHRA and the wider system also deserve credit. The Government say that trial applications received rose by 9% between January and November last year, compared with the previous year. Scientific advice meetings on clinical trials rose by 75%. This is real improvement and should be acknowledged, but of course speed is only one part of the story; fairness also matters. Who hears about the trial? Who lives near enough to join it? Who can manage the travel, time off work and family pressures that participation involves? Can the Minister commit to publishing participation data by geography, deprivation and ethnicity—the noble Lord made this point—so that the House can judge whether access is truly widening?
The question becomes sharper still. Cancer Research UK warns that around 90% of patients are recruited to non-commercial studies. The plan gives too little assurance that these trials will not be left behind. The ABPI’s latest report shows why that matters. The number of new industry trials initiated in the UK encouragingly rose last year.
I see that I need to speak faster. I want to say something about workforce, because the Minister has been asked very clearly about that. Obviously, it is a critical factor. I cite the Royal College of Physicians, the Society of Radiographers and many others. We need the people to make it happen. Were the Minister able to have another debate, I could give the rest of my speech.
England’s cancer challenge is less about what we can discover and more about what we can translate. We know that this requires the NHS, industry, academia and charities working together, and I believe that, with determination, we can see real progress.
The issue at hand is how such innovation can be rapidly and efficiently scaled up nationwide. One patient using the Christie service said:
“The cancer treatment helped, but it was the wider support that”
the service
“gave and continue to give that had the most impact on my quality of life … The team saw me as a whole person, not just as someone with cancer”.
Yet age-standardised premature cancer mortality is twice as high in some areas of the UK than in the best performing ones. The plan acknowledges the need to increase investment in research and open clinical trials more widely, so that patients who want to do so can have the opportunity to participate. Patients from deprived areas, particularly in rural and coastal parts of the country, such as where I live, are less likely to be offered the opportunity to be in trials, as are those from Black, Asian and other ethnic minority groups, who remain underrepresented.
With NHS digital systems advancing and patients’ individual records stored in their NHS app, protecting personal data is crucial. Data should be used only for British research to drive new knowledge and enhance care. The future workforce plan aims to equip managers and clinical and support staff for effective delivery. Staff need dedicated time for training and research, particularly in fields such as nursing. This protected time would support professional growth, boost morale and help retain staff.
Action 23 states that
“every patient will have a clinical nurse specialist or other named lead to support them through diagnosis and treatment”.
As such, clinical nurse specialists will need to be more central in workforce models and must be adequately trained in psychological support for patients with long-term physical and mental health care needs, because people now live with cancer for long periods. Many people who live with cancer fear recurrence, so it is important to focus on living happily and productively for the best quality of their lives, including working, where it is feasible to do so, as the plan states.
The NHS is, rightly, free at the point of delivery for screening, diagnosis and treatment, yet there is little mention in the plan of the need to consider withdrawing some screening programmes at a certain age—for example, for breast cancer over the age of 70—because the cost benefit, many would argue, is unjustifiable. A small cohort would of course benefit, so the NHS allows an opt-in mechanism. However, that has the potential to increase health inequalities, with the worried well requesting the service, which the private and contributory healthcare systems of many other countries would not pay for as a benefit.
Withdrawal of treatment is always a difficult issue and requires delicate conversations between the patient, their family and significant others and the clinical team involved. Such withdrawal must be decided on sound guidance based on relevant research knowledge. British universities are central to cancer research, but there is very little information about their role in this plan.
It is estimated that nearly 40% of cancers are preventable by reducing tobacco and alcohol use, increasing exercise, improving diet and lowering obesity. The Government must be congratulated on the Tobacco and Vapes Bill but, as the noble Lord, Lord Patel, said, the plan makes no reference to the fact that a minimum unit price for alcohol could make inroads too.
Will the Government consider mandating protected time for continued professional development for clinical healthcare staff to support their adoption of the new technologies, the faster treatments and the vision of this plan? Can the Minister say whether screening programmes will be reviewed to ensure cost-effective investment for specific cohorts, and whether appointing a named national lead for screening innovation should be considered? In addition, can she confirm that the use of patients’ clinical records for research will be led by British universities, in partnership with the NHS, using clinical trials that recruit from the whole country, and that they will not be sold for commercial use?
Nurses are also integral to cancer research, especially the running of clinical trials, as the noble Baroness, Lady Bottomley, highlighted. The MRC trials infrastructure demonstrates a high reliance on research nurses for patient recruitment, and the review conducted by the noble Lord, Lord O’Shaughnessy, into commercial trials showed a worrying decline in the number of such trials conducted in the UK. This has profound implications for our standing as a life science destination and the part that that plays in our economic growth.
Oncology nurses are also researching patient outcomes and filling important gaps in the evidence base of symptom management through their research. I shall provide some examples from my experience as a supervisor of doctorates—one of my students happens to be here today, which is brilliant. One student undertook a co-design study with patients who had developed peripheral neuropathy from chemotherapy, which is a horrible side effect. She was intent on mitigating some of the further complications of this painful—terribly painful, in fact—and debilitating condition. Another is currently examining the sexual recovery of women after bladder removal for cancer. It is quite staggering that this remains largely a hidden problem yet has profound impacts on the women concerned and their partners, often traumatising women in the process. Another student pioneered a new way of measuring workload for cancer nurses. Strong evidence links patient mortality and education in acute care, so it is not inconceivable that the same principles might apply to cancer patients.
Despite the value placed on specialists and advanced practice nurses, it is worth noting that the British Medical Association has recently raised concerns about the expansion of advanced practice nurses substituting for medical roles, arguing that some employers are using them to replace doctors and that that poses a threat to patient safety. It is unclear what the specifics of this evidence might be but, based on my own and colleagues’ research, nurse autonomy poses no threat to multidisciplinary teamwork. On the contrary, it is an essential underpinning for enhanced interprofessional working between nurses and doctors.
Turning the plan into a reality requires a workforce that is supported, skilled and enabled to work differently. The Government’s forthcoming NHS long-term workforce plan refresh will be a pivotal moment to set the direction for cancer care. It must set out how nursing roles will be funded and supported to deliver the plan. Can the Minister confirm what support the Government are putting in place to enable the professional career development of cancer nurses?