Cancer Reform Strategy - NHS Cancer Screening Programmes

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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 <strong>NHS</strong>. 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
CHAPTER 10: FUNDING WORLD CLASS CANCER CARE 12110.9 Some variation in PCT spending may beexplained by factors such as incidence, length ofhospital stay and emergency admissions.However, these factors are unlikely to be the fullstory. Good PCTs will wish to benchmark theirexpenditure on cancer services with that ofother PCTs with similar health needs. Theyshould use the resources published alongsidethis strategy and the improved information onoutcomes which will be generated by theactions we are taking, to critically appraisewhether they are spending appropriate levels oncancer services in order to appropriately meetthe needs of their local population.Comparison of spend with othercountries10.10 Record investment in the <strong>NHS</strong> since 2000has been mirrored by substantial increases in thefunding for cancer services. However, thisfollows a prolonged period of low investmentin health services compared to the rest ofEurope and significant amounts of thisinvestment have been dedicated to addressingthis historic shortfall.10.11 Spending per capita on cancer servicesremains low compared to some other Europeancountries. Spending on cancer in England is £80per capita, compared to £121 per capita inFrance and £143 per capita in Germany. Overall,England spends 5.6% of its public healthcarebudget on cancer, compared to 7.7% in France,9.2% in the United States and 9.6% inGermany. 5110.12 There is no consensus on the correct levela country should spend on cancer services.This strategy marks a shift towards assessing theperformance of cancer services using measuresof outcomes and outputs rather than simplyinputs. However if outcomes fall below theaspirations set out in this strategy then it will beFigure 17: Estimated cost per head of NICE-approved cancer drugs used in hospitals in Jan-Jun 2005, by cancer network4.54.03.5Cost (£) per head3.02.52.01.51.00.50Method: Calculations based on volumes dispensed (from IMS-Health) and on lowest list prices foreach NICE-approved cancer drug.
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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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10 CANCER REFORM STRATEGYWe will al
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What the Cancer Reform Strategy mea
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14 CANCER REFORM STRATEGY●●●R
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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 139 and 140: 135Annex 2:References1 Cancer is ou
Page 141: ANNEX 2: REFERENCES 13737 K. Moser,
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Cancer Reform Strategy - NHS Cancer Screening Programmes

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