The announcement follows the Coalition Government’s commitment to create a Cancer Drugs Fund to commence from 2011 to help thousands of patients get increased access to innovative new cancer drugs that extend life or improve quality of life. Following the Spending Review, £200 million a year in funding will be available for cancer drugs from April 2011 to the end of March 2014.

In addition to this commitment, £50 million has been available since 1 October, until the end of March 2011, with clinically led panels now set up in each region. These panels put doctors in charge of deciding how this funding is spent for their patients locally, together with advice from patients’ cancer specialists.

A consultation launched today seeks the views of healthcare professionals, patients, carers and the public on these arrangements and other proposals for the Fund’s operation such as:

• ways to support patients and their clinicians in making the best treatment decisions;
• the need for guidance to support the operation of the process; and
• what the precise scope of the fund should be.

All drugs recommended as clinically and cost effective by NICE will continue to be funded by the NHS. The additional £50m of interim cancer drugs funding and the £200m a year funding set out today will help cancer patients get drugs that their clinicians think they need.

NICE continues to play a pivotal role in ensuring patient access to clinically and cost effective drugs and treatments. NICE has a well-deserved reputation as an international leader in its field and, as set out in the White Paper, it remains at the heart of our plans for liberating the NHS, including significant expansion of its role on quality standards. NICE will continue to appraise most significant new drugs, and will have an important part to play in our longer-term plans to introduce value-based pricing for new medicines.

Health Secretary Andrew Lansley said:

“I pledged to create a cancer drugs fund so that cancer sufferers and their families could benefit from drugs that their doctors believe could improve their quality of life. This £200 million a year funding over three years for cancer drugs is a crucial step forward in addressing the disparity in patients’ access to cancer drugs in England compared to other countries.

“My aim is to truly empower patients. I want to give them more control over their healthcare and ensure no decisions are made ‘about them, without them’. Our longer-term plans will change the way we pay for drugs so that patients get better access to drugs and the NHS and the taxpayer get better value for money.

“This fund is just one example of how we are putting the clinical experts in charge of making decisions. They are the ones who know what their patients need and it makes sense that we give them control of budgets for local people.”

The Cancer Drugs Fund is in addition to what Primary Care Trusts already spend, and clinicians can still apply locally to Primary Care Trusts for exceptional funding of drugs not normally available. The Government’s longer term plans will ensure that patient access to drugs is improved by changing the way the NHS pays for branded drugs in 2014.

The consultation will run until January 19th 2011.

Source: nds.coi.gov.uk

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The new service, launched in part of the North East of England, marks the first step towards a national roll out and is the beginning of a White Paper commitment to make care more accessible by introducing a single telephone number for every kind of non-emergency health care.

The 111 service is free to call and is staffed by a team of fully trained call advisers, supported by nurses, who are on hand to assess callers’ needs and ensure they receive the right service as quickly as possible.  It guides patients to a locally available service or provides appropriate advice and information 24 hours a day, 365 days a year.

The number can be used when you need help fast but it is not life threatening, or when you do not know who to call. This will be particularly useful outside of GP surgery hours and for people who are away from home.

When someone calls 111, they will be assessed straight away.  If it is an emergency, an ambulance will be dispatched immediately without the need for any further assessment.  For any other health problems, the NHS 111 call advisers will be able to direct people to the service that is best able to meet their individual needs. For minor illnesses and injuries, the 111 service will be able to provide immediate medical advice.

Visiting the very first operational 111 call center in the North East to talk to staff and patients about how the service is working, Health Secretary Andrew Lansley said:

“It is essential that we improve access to, and understanding about, urgent care services, which includes out-of-hours care.  At present, too many people are confused about who to contact and how to do so.

“By putting in place one, easily memorable 111 number for all urgent inquiries to run alongside the emergency ‘999’ number we will simplify NHS services for patients.  111 will be free to call and available 24/7, putting patients in touch with the right NHS service, first time.

“I am delighted that people in County Durham and Darlington  are to be the first to benefit from this new service. Later this year we will launch the service in Nottingham City,  Lincolnshire and Luton. Ahead of national roll-out, this will help us understand what model works best for patients and delivers value for money.”

Yasmin Chaudhry, Chief Executive of NHS County Durham and Darlington said:

“The NHS 111 service will make it easier for the public to access urgent healthcare and will drive improvements in the way in which the NHS delivers that care. We want to make sure the right care is delivered in the right way for patients as well as ensuring NHS resources are used in the best way.

“By better understanding what people really need from different local services, 111 will help improve efficiency across the whole health care system by reducing unnecessary waste and making sure people get access to the right service, first time.”

Further pilots are planned for the East Midlands in Nottingham City and Lincolnshire and the East of England in Luton. Both regions have been chosen to test different ways of delivering the 111 service using various NHS providers that include the Ambulance Trust, an Out-of-Hours service and NHS Direct.

Source: nds.coi.gov.uk

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More dialysis at home and chemotherapy in the community will mean patients can benefit from more convenient services that help produce better outcomes and can be more efficient.

Focusing on providing care at home can also have a significant impact for social care.  A report out today (Thursday 18 Feb) from the Audit Commission shows that older people who have the opportunity to be looked after in their own home if they want to are happier and there are less costs to the taxpayer.  There are already examples of how being innovative can have significant outcomes and save money – for example, for the cost of just one month’s care package, a home can be equipped with sensors and pagers to help a family look after a relative with dementia.

Other measures include providing more services at home for children and young people who have acute or long-term conditions or disability or palliative care needs, and giving more people the option to die at home if they wish to.

Around 7000 patients across England could benefit from home dialysis – cutting out the need for regular long visits to hospital and allowing patients to lead more normal lives.  Providing haemodialysis at home means that patients can tailor their dialysis sessions around their lifestyle, which can lead to benefits such as:

- better blood pressure control
- less reliance on medication
-patients being able to lead a more normal life and spend less time away from their family
- fewer admissions to hospital
- greater freedom from dietary restrictions

As well as benefits to patients, the annual costs of home haemodialysis could be up to 25% less than providing dialysis in a hospital or renal center, and can lead to long term savings once initial set-up costs are recovered.

Health Secretary Andy Burnham said:

“The time has come for the NHS to make a decisive shift in providing more care out of hospitals and in the patient’s community and home.

“For too long, services have been organized to fit the convenience of the system.  A great NHS will put the convenience of the patient first, and move services towards them where it is safe to do so.  But care in the home can also achieve better results and save money.

“So this is the right move at the right time.  Evidence shows that we can now do far more out of hospital and the NHS needs to move confidently in this direction.  Fears about changing services should not stand in the way of improving care for patients.  Transforming the NHS from good to great will mean becoming more people-centered and productive at the same time.

“NHS patients have already seen significant improvements in the care they receive in hospital, with shorter waits and more choice over how and where they access treatment.  But the NHS needs to do more to plan services around patients – even taking services into their home.  Dialysis at home is a perfect example, which can mean patients no longer have to worry about long trips to their nearest hospital three times a week while also enjoying better clinical outcomes.

“We are already seeing Lord Darzi’s vision to put quality at the heart of care becoming a reality across the country, but we can go further.  By making NHS services truly people-centered and ensuring that patients have access to high quality, integrated and efficient community services, the NHS could save up to £2.7bn a year – meaning a better service for patients, and a more productive service for taxpayers.”

Jane Macdonald, President of the British Renal Society and Lead Nurse for Renal Services at Salford Royal Foundation NHS Trust said:

“The need for long term dialysis undertaken either thrice weekly or in some cases daily has a significant impact on the lives of dialysis patients, their families and carers.  To be offered the choice, if clinically appropriate, to undertake dialysis at home is a major factor in eliminating frequent travel, maximizes time spent with family, and plays an important role in remaining in employment.

“Increased access to home haemodialysis could be achieved through improved commissioning and local implementation policies, so that those able to can chose to be treated at home supported by their specialist kidney care teams.”

Fiona Loud, Chair of the Kidney Alliance said:

“The Kidney Alliance is firmly in favor of offering dialysis patients the best possible options.  We believe that everyone whose kidneys fail should be offered a choice of therapies, including, where clinically suitable, dialysis treatment at home.  Kidney failure is difficult and challenging for patients, and to be able to dialyse at convenient times and more frequently can mean a great improvement in quality of life and future outcomes.

“By allowing patients to manage their own dialysis treatment, they can not only be more in control of their condition but can also feel better emotionally and physically.“

The Department of Health has also published a guide for the NHS on developing chemotherapy services closer to home.  Giving cancer patients the option of having chemotherapy at or closer to home where clinically appropriate can benefit patient experience and contribute to better outcomes.  This follows the recent announcement that all cancer patients will have one to one support within five years.

Children and young people who have acute or long-term conditions, or disability or palliative care needs, should be able to spend less time in hospital and receive care at home or the community instead. Providing services for children and young people at home can mean fewer unplanned visits and shorter stays in hospital, reducing distress for children, young people and their families.

As part of this, we want to move to a situation where families can expect:

- 24/7 access to advice and support from Community Children’s Nursing Teams;
- a single lead professional for the family, who can liaise with the various agencies involved in delivering NHS care;
- the choice to die in their preferred place for those children nearing the end of their life; and
- an integrated package of care in a chosen location.

As a next step, the Department of Health will be publishing the final version of the National Framework for Children and Young People’s Continuing Care very shortly. This will help with assessing the continuing healthcare needs of children and young people, and with considering the bespoke packages of care that will be required to meet those needs.

The Health Secretary also confirmed plans to review progress on End of Life Care by 2013, with the intention of setting out proposals for a right to choose to die at home in the future.  Marie Curie is already piloting a range of models through their Delivering Choice program.

Transforming how the NHS treats patients with long-term conditions by providing more support in people’s homes and local community settings means that people are able to better manage their health and avoid unnecessary hospital visits.  Improvements in the management of long-term conditions have already led to efficiencies and savings of £2.1bn.

Source: Department of Health

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The joint vision between the Department of Health and Macmillan Cancer Support commits to taking steps by 2012 to ensure that cancer survivors receive the support and services to meet their needs.

The vision sets out that all cancer survivors should have:

* A personalised assessment and care plan;
* Support to self-manage their condition;
* Information on the long-term effects of living with and beyond cancer; and
* Access to specialist medical care for complications that occur after cancer.

Health Minister Ann Keen said:

“The massive investment and improvements that we have made over the last 10 years mean that an increasing number of people are living beyond cancer.

“This is great news, but the impact of cancer does not end after treatment.  This growing group of cancer survivors, their carers and families need support and services to meet their needs.

“That is why we have joined forces with Macmillan Cancer Support and are making a firm commitment that by 2012 all cancer survivors will receive the support and services they need.”

National Cancer Director Mike Richards said:

“For many of the 1.6 million people living with and beyond cancer in England, we need to improve follow-up care to meet their medical, psychological, social, spiritual, financial and information needs.

“We need to create services that are tailored to meet the needs of the individual, rather than the “one size fits all” model which has been the traditional pattern of follow-up cancer care.

“To do this we are providing £1.6 million to Macmillan for this vital work and we have created 38 pilot sites around the country which are currently testing improvements to care.”

Macmillan Chief Executive Ciaran Devane said:

“Cancer is changing and the NHS must change to meet this new challenge. In the past patients felt abandoned when their treatment ended, but the NHS should now support them through all their health and care related needs.

“There’s no doubt in my mind that providing assessment and a personalised care plans will benefit people after their cancer treatment. It will also save the NHS money.

“Our partnership with the Department of Health, to produce this ambitious vision, has been a strong and productive one. We look forward to working with them on the larger challenge – to get our new vision adopted and implemented across the whole country.”

Evidence in the vision document around the current experience of care by adult cancer survivors includes a survey by the Picker Institute.

The survey found that 43% of respondents would have liked more information and advice, 75% did not have, or did not know if they had, a care plan. However it also found that 96% felt they had been treated with dignity by health professionals.

The vision document includes examples of innovative practice and piloting work already underway in 38 test communities around the country to improve the quality of care.

The pilot studies are looking at a range of improvements to care for survivors such as telephone based support services staffed by trained cancer nurses and a three month wellness and exercise programme for cancer survivors.

At the end of 2010 we will publish a set of principles for service commissioners based on these tested models of care so that they can be adopted across the NHS.

Source: Department of Health

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The proposals, set out in ‘The NHS Constitution: A consultation on new patient rights‘, will mean that from 1 April 2010, patients will have the legal right to maximum waiting times to start treatment by a consultant within 18 weeks of GP referral, and to be seen by a cancer specialist within 2 weeks of GP referral.

If the NHS is unable to meet this commitment, it will be required to take all reasonable steps to find a range of alternative providers that can.  This will enable a patient to receive their care more quickly, if this is what they want.  The alternatives could include private providers at NHS prices.

In addition, everyone aged 40-74 will have the right to an NHS Health Check every five years to assess their risk of heart disease, stroke, diabetes and kidney disease.  Identifying any risk early should help to reduce the incidence of these diseases and the damage they cause.

Prime Minister Gordon Brown said:

“None of us can ever know what’s around the corner and it’s one of the best things about being British that the NHS will be there for us whatever happens.  My own parents could never have afforded all the surgery needed to save my sight if they’d had to pay, and every day I hear from people whose lives have been saved or transformed by the NHS.  Today we’re reforming the NHS to secure its future – ensuring that patients get a guarantee not a gamble by empowering them with new legal rights.

“These measures build on the high standards and rightly rising expectations of patient care.  Every single person who has to go into hospital or go through the difficulty of cancer will have clear rights and real power guaranteeing them quick access to care, or the offer of going private or to another NHS provider if these standards are not met.”

Health Secretary Andy Burnham said:

“The NHS Constitution lets people know what they can expect and what they can demand.  But, like the NHS, the Constitution must evolve if it is to remain relevant.

“Waiting times are the shortest they have ever been but I want to build on this and give patients a legal right to maximum waiting times.  Turning targets into legal rights will empower patients and guarantee them the same high standards of care, regardless of where they live.

“In the next decade, the NHS must make a decisive move towards being a more preventative service and a more people centred service.  So I want to give all patients aged 40-74 the legal right to have an NHS Health Check every five years.  And we’re also seeking views on whether there should be a legal right in future to choose to die at home and to personal health budgets to give people power over their own care.

“A decade of investment and reform has seen the NHS go from poor to good.  Now, in striving to move from good to great we need to take a new approach – less about central targets, more about rights and entitlements.  These proposals will mean that patient rights, enshrined in the NHS Constitution, will safeguard the NHS for the future.”

Joe Korner, Director of Communications for The Stroke Association, said:

“We could save up to forty thousand people from having a stroke every year if we could make sure that their blood pressure and other risk factors for stroke were kept under control.  That is why The Stroke Association believes these NHS Health Checks are so important.

“Stroke is the biggest cause of severe adult disability and the third biggest killer in the UK.  NHS Health Checks will help to identify those at a higher risk of stroke and how to do something about it – whether that’s through medication or taking steps to eat more healthily, get more exercise or give up smoking.”

Including these rights in the NHS Constitution would ensure that the NHS will never return to the days of patients waiting 18 months for treatment and offers people a quick and straightforward means of redress for the small number of cases where their rights are not met.

The consultation also seeks views on going even further and including more rights in the future.

These could include:

* the right to choose to die at home;
* the right to access to NHS dentistry;
* the right to personal health budgets;
* the right to choose a GP practice offering extended access to evening and weekend appointments; and
* the right to key diagnostic tests for suspected cancer patients within one week of seeing a GP, with an interim milestone of 2 weeks.

Source: Department of Health

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