Cancer Reform Strategy - NHS Cancer Screening Programmes

58 CANCER REFORM STRATEGY4.9 Further guidance on delivering these cancerwaits standards will be issued to the NHS inearly 2008.Improving Outcomes Guidanceimplementation4.10 Part of the purpose of the servicereconfiguration recommended by the ImprovingOutcomes Guidance is to enable complexsurgical procedures to be carried out byspecialists. To see further improvements incancer surgery it is essential that thisreconfiguration is fully implemented nationally.4.11 The timetable for implementation of theImproving Outcomes Guidance is as follows:●Breast, lung and bowel – alreadyimplemented;●Children & young people’s cancer, brain,sarcoma and skin – by 2010/11.4.12 The Department of Health and theHealthcare Commission will continue to worktogether to ensure that implementation of thisseries of guidance is completed.Surgery4.13 Surgery has been the mainstay oftreatment for many types of cancer for manyyears. Surgery cures more patients of cancerthan any other intervention. For most cancers,surgery is the principle treatment for the vastmajority of patients. Exceptions to this includelung cancer, pancreatic cancer, haematologicalcancers and those cancers that present asdisseminated disease without an obviousprimary source.●●Gynaecological, upper GI, urological andhaematological – by the end of 2007;Head & neck and supportive & palliative care– by December 2008; and4.14 For many cancers, surgery is used as thefirst treatment. In these cases, over 99% ofpatients requiring surgery are being treatedwithin 31 days under the current standard.However, for some cancers such as bladder,pancreatic and skin cancer, it is relativelyFigure 7: Changes in surgical activity related to cancerOesophogastric,-28%Lung 8%Bowel (Colon and Rectum), 8%Breast (Mastectomy and Breast), 35%Prostate, 336%Liver (Hepatectomy andDestruction of Liver Lesions),543%-100% 0% 100% 200% 300% 400% 500% 600%Percentage change between 1997/98 and 2005/06