Agenda item

Stewart Dicker (Clinical Director - Quality and Care, Kent and Medway Cancer Network), Felicity Cox (Chief Executive, NHS Kent and Medway), and Ian Ayres (Accountable Officer, NHS West Kent CCG) were in attendance for this item.

(a)       The representative from the Kent and Medway Cancer Network (KMCN) thanked the Committee for the opportunity to attend. He explained that the questions asked in advance related to the two-year old cancer strategy. Some information was not yet available; this included data on resection rates.

(b)       The general structure of cancer services was given as being a hub and spoke model with specialist services concentrated where appropriate. It was explained that Maidstone was the centre for chemotherapy, but as part of an outreach service, all acute sites in Kent and Medway provided it. In contrast testicular cancer, which mainly affected men up to the age of 26, was centralised at the Royal Marsden hospital.

(c)        There were no plans to change the current sites for services. KMCN would cease to exist after March 2013. Commissioning would move from the Primary Care Trusts (PCTs) to the CCG, or NHS Commissioning Board where the service was a specialist one. There would be a clinical network in the future covering Kent, Surrey and Sussex. This would include cancer along with other conditions in its work. Currently hosted by the PCTs, the future network would be hosted by the providers.

(d)       There was a discussion about reducing health inequalities. It was explained that the KMCN did a lot of work on prevention in the past, particularly around early diagnosis. In the future, the Health and Wellbeing Board (HWB) would have a role in ensuring health inequalities were tackled. The HWB had to approve the commissioning plans of the CCGs. The CCGs had to plan to achieve 4 national outcomes targets along with 2 chosen locally. They would need to demonstrate to the HWB how it was achieving these outcomes. There was an outcomes dataset which would enable progress to be measured, although it was conceded data was not collected on everything. NHS representatives undertook to send a copy of the outcomes dataset to the Committee. In addition, the new public health responsibilities of Kent County Council included prevention.

(e)       There was a debate around screening as a means to prevention, with Members questioning why there was not a national prostate cancer screening programme like there was for breast cancer. It was explained that while breast cancer diagnoses went up, the death rate stayed the same, which begged certain questions. Clinically, a screening programme needed to detect a cancer when there was still an opportunity to change the outcome and it needed a low false negative rate. The PSA test for prostate cancer did not meet these criteria. It was useful once the cancer had been diagnosed, but as a screening programme it would produce a low discovery rate for the number of tests. The biopsy can miss the tumour and potentially cause incontinence and impotence. It was also explained that prostate cancer was something most people died with, but did not die of it. It would also rely on all men going to their GP for the test. The bottom line was that a better test was needed.

(f)         The Chairman proposed the following recommendation:

·        That the Committee thanks its guests and notes the report.

(g)       AGREED that the Committee thanks its guests and notes the report.