Cancer Reform Strategy - NHS Cancer Screening Programmes

120 CANCER REFORM STRATEGYsector (including outpatients, diagnostics,treatment and emergency care) and theremaining 20% is spent in the communityincluding screening programmes, GPconsultations and palliative care.10.6 However, this estimate does not includeseveral key elements of cancer services,including:●●Preventative services such as smokingcessation, which contribute to better healthoutcomes across a range of diseases;Assessment, diagnostics and support prior todiagnosis, including for those patients wherecancer is excluded. Pre-diagnosis assessmentand diagnostics represent a significantadditional cost to the NHS. For example, arecent modelling exercise commissioned bythe Department of Health suggested that thecost of investigating potential bowel canceramounts to one quarter of the total cost of£1 billion expenditure on the condition; and●Palliative care provided by the voluntarysector, which is estimated to cost in excessof £200 million every year.Variations in spend on cancerin England10.7 Different areas of the country may havedifferent health needs and it will be importantfor Primary Care Trusts (PCTs) to take this intoaccount when making spending decisions.However a Kings Fund analysis of programmebudgeting data from 2003 to 2005 found thatsome PCTs spend much more on cancer thanothers, even after differences in the healthneeds of local populations and other factorshave been taken into account. The latestProgramme Budgeting data from 2006/07shows there is still wide variation in theproportion of PCT’s overall spend that goes oncancer, ranging from 3.6% to 9.1%.10.8 There is also significant variation inexpenditure on National Institute for Health andClinical Excellence cancer drugs by cancernetwork.Figure 16: Spending on cancer in 2006/07 as percentage total of PCT programme spend6050Number of PCTs4030201003 4 5 6 7 8 9Percentage of total spend across programmes