Cancer Reform Strategy - NHS Cancer Screening Programmes

CHAPTER 4: ENSURING BETTER TREATMENT 65usage further, the report clearly showed that theNICE process is working ensuring increasedaccess to drugs and less variation in their use,but we need to keep on top of this. TheNational Cancer Director will thereforerepeat his evaluation of NICE-approvedcancer drug usage during 2008 to ensurethat patients across the country continueto have access to cancer drugs positivelyappraised by NICE.4.52 Current audits do not collect sufficientinformation to understand why thesevariations occur. We will therefore ask allchemotherapy service providers to collectand return an agreed dataset on all patientsreceiving chemotherapy. Further informationon data collection is provided in chapter 8.4.53 Trusts providing chemotherapy are alreadyrequired to collect the outpatient commissioningdata set and reference costs to support theintroduction of Healthcare Resource Group 4(HRG4, the latest national currency system, isalready being used for costing purposes).However, chemotherapy cost data submitted inJune 2007 as part of the 2006/07 reference costcollection were not robust. The introduction ofHRG4 for chemotherapy payment will begreatly facilitated by e-prescribing andtrusts that have not already done so wouldbe wise to invest in these. PCTs shouldincentivise this through commissioningcontracts and monitoring.Supporting better local planningfor chemotherapy4.54 Better data collection on chemotherapyactivity will also aid PCTs in their planning.As expenditure on cancer drugs continues toincrease, financial and capacity planning isessential both before and after NICE appraisals.4.55 PCTs, working through cancer networks,are responsible for planning the introduction ofnew treatments for cancer. The ChemotherapyPlanning Oncology Resource Tool (C-Port) hasrecently been developed through a partnershipwith industry, the Cancer Action Team and theNHS to support local planning. PCTs will expectproviders to demonstrate that they haveplanned for the safe introduction of newdrugs in a thorough and cost-effective way.Use of the C-Port tool will enable Trusts todo this.International comparisons of drugutilisation4.56 Usage of new anticancer drugs isestimated to be considerably lower in Englandthan in other developed countries, with usage atapproximately 60 per cent of that in other majorEuropean countries. An analysis by theAssociation of the British PharmaceuticalIndustry (ABPI) indicates that the usage ofanticancer drugs across Europe will continueto increase. The actions set out above willincrease the use of anticancer drugs in thiscountry. As this strategy is implemented,we will work with our partners in thepharmaceutical and biotechnology industriesto continue to monitor how use ofanticancer medicines in the NHS in Englandcompares to other European countries.The National ChemotherapyAdvisory Group4.57 The Department of Health has establisheda National Chemotherapy Advisory Group(NCAG) which is considering all aspects ofchemotherapy using a care pathway approach(assessment; decision making; prescribing;dispensing; delivery; reassessment andmanagement of complications). The NCAGreport which is due in spring 2008 willrecommend next steps for chemotherapyservices in general. In particular it will highlight:●●●●The year on year increases in chemotherapyactivity;Potential new service models;Out of hours management and theimportance of information about anindividual’s care being available across anetwork, especially as patients may presentas an emergency at a location separate fromthat in which their treatment was delivered;Governance structures;