#CCSC2015 Welcome and introduction Adrian Newland Professor of Haematology, Barts and the London NHS Trust Chair, London Cancer Drugs Fund Vice-chair, Chemotherapy Clinical Reference Group (CRG)
Context for today’s NHS The NHS is one of the most valued institutions in the country. There have been significant improvements in the outcomes for patients and the public over the last decade. However there is a challenging backdrop… Past failures e.g. Rising Demographic Comparative Financial constraint Winterbourne, expectation pressures outcomes Stafford The challenge for the NHS is to improve against the backdrop of that context. And that means it can’t stay the same if it is to be sustainable as a nationally tax-funded system, free at the point of use, available to those in need. The ongoing challenge of sustaining and improving outcomes, quality, and tackling inequalities, within constrained resources, will be with us for many years.
Today’s challenges • NHS Five Year Forward View Cancer Vanguards • Spending Review £3.8b (or £6.0b depending on source!) No new demands on NHS but – • Promise of 7-day working • Impact on Public Health • New Cancer Strategy • Future of Cancer Drugs Fund
Since the Cancer Plan 2000 • Death rates from all cancers have reduced by 15.7% between 1996 & 2004 • NHS Waiting Time targets for access to consultants, diagnosis and 1 st treatment have been met • The experience of treatment and care has improved significantly But • Inequalities in cancer services still exist between Regions • Need to access to new and existing cancer drugs
CDF – Budget and expenditure Budget: • 2013/14 - £200m • 2014/15 - £280m • From April 2015 - £340m • Current projections for expenditure - £ 410m • This is without further prioritisation or delisting
What is the future for cancer drugs? • Specialist Commissioning Budget ~ £12b (10% of NHS spend) • Cancer Drugs Budget ~ £1.4b (£1.7b with VAT) Can the drug budget be controlled? How do we do this while introducing innovations and improving the quality of the service? How do we fund appropriate supportive care? • NICE to take over process • Future of CDF now out for consultation • What will happen in April 2016?
Medicines utilisation in practice 14 Total NHS Drugs Spend, £bn Primary care 12 Hospital & community 10 health sector Gross spend £bn 8 6 4 2 0 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 Medicines still most common therapeutic intervention and biggest cost after staff, but: • 30 to 50% not taken as intended • 5 to 8% of hospital admissions due to preventable adverse effects of medicines • Medication errors across all sectors and age groups at unacceptable levels Relatively little effort towards understanding clinical effectiveness of medicines in real practice •
What could the opportunity costs fund? • Early diagnosis • Acute Oncology Service • Clinical Nurse Specialists • Supportive care • Community care • End of Life care
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