Cancer Reform Strategy - NHS Cancer Screening Programmes

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118Chapter 10:Funding world class cancer careChapter Summary●●●●●Cancer programme costs are at least £4.35 billion a year, most of which is spent on hospitalservices;We spend less than comparable countries and will need to continue to invest in cancer;Cancer spend varies across the country but cost effectiveness and outcomes are key;Incidence and drug costs will continue to rise and investment will follow; andThere are significant opportunities to save money and deliver better outcomes, freeing upresources for reinvestment in cancer care. In particular, inpatient costs offer significantopportunities for saving.Introduction10.1 When the NHS Cancer Plan was launchedin 2000, the government committed an extra£570 million to meet the cost of extra staff andequipment. In fact, additional spending oncancer came to £693 million over a three yearperiod. The cancer workforce has expandedconsiderably, with around 49% moreconsultants specialising in cancer in 2006 thanin 1997 50 . Major investments have also beenmade in equipment such as CT scanners, MRIscanners, linear accelerators, breast screeningequipment and also in the use of new drugs.10.2 As the incidence of cancer increases andour ability to treat the disease improves stillfurther, so there will be additional cost pressureson cancer services. Significant further investmentin cancer will be necessary to meet thechallenge of cancer and to deliver world classservices for all those affected by it.10.3 There is also scope to make more effectiveuse of existing resources. To deliver good valuefor money and to make the investments whichwill be important to deliver world class cancerservices, it is vital that we maximise theeffectiveness of our current spending. Doing sodoes not need to be at the expense of quality.There is good evidence that streamlined, lessexpensive services can deliver better outcomes.The guiding principle should be to get thegreatest benefit to patients for the moneyinvested.10.4 This chapter analyses current spending oncancer services and sets out how the initiativesannounced in the Cancer Reform Strategy willbe paid for. It also flags up some of the factorsthat good commissioners will want to considerwhen making decisions about futureexpenditure on cancer.Current expenditure on cancerin England10.5 English cancer spend has increased by27% over the last three years and cancer is nowthe third largest disease programme in the NHS,behind mental health and circulatory diseases,costing the NHS around £4.35 billion a year.Approximately 80% of this is spent in the acute
CHAPTER 10: FUNDING WORLD CLASS CANCER CARE 119Figure 15: Estimated total NHS spend on cancer care 1Inpatient costs (excluding those related to surgery) [1]27%Surgery (including day cases and inpatient stays) [2]22%Drugs (cost of medicine, preparation and administration) [3]18%Outpatients (diagnostics, first and follow-up appointments) [4]8%Screening [5]5%Radiotherapy [6]5%Specialist Palliative Care (excluding voluntary sector) [7]5%Other [8]10%0 200 400 600 800 1,000 1,200 1,400Cost (£ million per annum)[1] Source: Hospital Episode Statistics 2005/06 combined with NHS Reference Costs 2005/06.Includes critical care beds and excess beddays[2] Source: Hospital Episode Statistics 2005/06 combined with NHS Reference Costs 2005/06.Includes critical care beds and excess beddays[3] Source: Prescription Cost Analysis 2005/06 (www.ic.nhs.uk) plus Hospital Episode Statistics2005/06 combined with NHS Reference Costs 2005/06 where HRG code is chemotherapy. Notethis excludes other drugs provided in secondary care (which are included in the inpatient costs).[4] Source: NHS Reference Costs 2005/06. Included cancer specific specialties; common diagnostictests for cancer; and assumed one new and one follow up appointment per surgical inpatient.[5] Source: NHS Cancer Screening Programmes[6] Source: NHS Reference Costs 2005/06[7] Source: National Council for Palliative care suggested cancer accounts for 90% of £211-233mNHS palliative care funding[8] “Other” includes: GP visits (Source: Activity from RCGP survey 2003. Unit costs from PSSRU(www.pssru.ac.uk)), Bone Marrow Transplants (Source: NHS Reference Costs 2005/06), A&Eattendances and Observation (assumed 11% of A&E costs are cancer related, equal to theproportion of all emergency admissions that are cancer related. Source: NHS Reference Costs),and a proportion of the overall NHS costs for the following: Paramedic services, Direct Accesstests, Community Nursing, Community Therapy, Rehabilitation, Paramedic services (Source: NHSReference Costs 2005/06. Assumed cancer accounts for 3-6% of each category).*These figures are in 2005/06 prices.
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Cancer Reform Strategy
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DH INFORMATION READER BOXPolicyHR/W
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3Forewordby the Prime MinisterAt on
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6 CANCER REFORM STRATEGY9. Your NHS
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8 CANCER REFORM STRATEGY9. Excessiv
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What the Cancer Reform Strategy mea
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17Chapter 1:The challenge of cancer
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CHAPTER 1: THE CHALLENGE OF CANCER
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33Chapter 2:Preventing cancerChapte
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CHAPTER 2: PREVENTING CANCER 352.15
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CHAPTER 2: PREVENTING CANCER 37Nico
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43Chapter 3:Diagnosing cancer earli
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CHAPTER 3: DIAGNOSING CANCER EARLIE
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CHAPTER 4: ENSURING BETTER TREATMEN
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Page 141: ANNEX 2: REFERENCES 13737 K. Moser,
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Cancer Reform Strategy - NHS Cancer Screening Programmes

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