Cancer Care in West, North and East Cumbria

The Cumbria Health Scrutiny meeting on Tuesday 26th Februry received a very important report and presentation on cancer care in the Northern part of the county (including West and East Cumbria.)

You can read the report here.

The report included

1) Details of the current issues around health outcomes for those who suffer from cancer in the northern two-thirds of Cumbria

2) Information on the alarming levels of health inequalities - people in parts of the county have much better chances of surviving cancer for longer and with less devastating consequences.

3) A large part of this is due to issues of lifestyle and also to how quickly people go to their doctor when they have a problem - one of the causes of differential outcomes is that people in the areas with better survival rates tend to present at an earlier stage of the onset of the disease when there is more chance of doing something about it. Similarly, some is due to higher take-up of screening programmes.

4) The report discussed some of the measures being taken to improve take-up of cancer screening. It cannot be stressed too strongly, if you are offered a cancer test, it may save your life to take it up.

5) The report also discussed the new cancer centre at Carlisle. This very welcome new facility is not being provided at the expense of cancer services in the West of the county and we discussed at the meeting how cancer services in the West are being improved too.

NHSX

It was announced today that a new joint unit, NHSX, will be created to bring the benefits of modern technology to every patient and clinician.

It will combine the best talent from government, the NHS and industry. NHSX will aim to create the most advanced health and care service in the world to diagnose diseases earlier, free up staff time and empower patients to take greater control of their own healthcare.

Currently, much NHS technology relies on systems designed for a pre-internet age.

• Patients are not getting the care they need because their data does not follow them round the system. 
• Change has been slow because responsibility for digital, data and tech has been split across multiple agencies, teams and organisations. 
• NHSX will change this by bringing together all the levers of policy, implementation and change for the first time. 

NHSX will work with the NHS and the wider digital economy to build world-class digital services.

These will improve care for patients and enable medical research. The organisation will use experts in technology, digital, data and cyber security to deliver on the Health Secretary’s tech vision and the Long Term Plan for the NHS.

NHSX’s responsibilities will include: 

• setting national policy and developing best practice for NHS technology, digital and data - including data-sharing and transparency setting standards – developing, agreeing and mandating clear standards for the use of technology in the NHS 
• ensuring that NHS systems can talk to each other across the health and care system helping to improve clinical care by delivering agile, user-focused projects 
• supporting the use of new technologies by the NHS, both by working with industry and via its own prototyping and development capability 
• ensuring that common technologies and services, including the NHS App, are designed so that trusts and surgeries don’t have to reinvent the wheel each time 
• making sure that all source code is open by default so that anyone who wants to write code for the NHS can see what we need 
• reforming procurement – helping the NHS buy the right technology through the application of technology standards, streamlined spend controls and new procurement frameworks that support our standards 
• setting national strategy and mandating cyber security standards, so that NHS and social care systems have security designed in from the start 
• championing and developing digital training, skills and culture so our staff are digital-ready delivering an efficient process for technology spend, domain name management and website security 

The CEO of NHSX will have strategic responsibility for setting the national direction on technology across organisations. The CEO will be accountable to the Health Secretary and chief executives of NHS England and NHS Improvement.

NHSX will work closely with the Government Digital Service and other central government functions to learn from their experiences and ensure there is continued alignment with the Digital, Data and Technology profession across government.

Health Secretary Matt Hancock said:

"Modern technology has an incredible potential to change people’s lives for the better and revolutionise the care they receive.

Because I care about patients getting the best treatment, I care about the NHS getting the best technology. But everyone knows how hard it’s been to get the NHS to adopt the best in digital.

We’ve set out a clear tech vision for the NHS, which underpins our NHS Long Term Plan. Now we’re bringing together the tech leadership into NHSX, which will be responsible for harnessing the true potential of technology to transform care, save lives, free up clinicians’ time and empower patients to take greater control of their own health. 

NHSX will combine some of the best minds from among the NHS, leading innovators, and government into one unit to set national policy, remove red tape and create a culture of innovation to allow the best innovations to flourish. This is just the beginning of the tech revolution, building on our Long Term Plan to create a predictive, preventative and unrivalled NHS."

February meeting of the Cumbria Health Scrutiny Committee

The February meeting of the health scrutiny committee responsible for democratic scrutiny and challenge of the NHS in the county of Cumbria will take place at County Hall in Kendal from 10.30 am on Tuesday 26th February 2019.

The meeting will be open to the public. The agenda and reports for the meeting are available in the County Council website here.

I am more that a little surprised at the way the agenda for the meeting has panned out. These meetings approximately alternate between Carlisle and Kendal. Mostly they contain a mix of North Cumbria and South Cumbria/Morecombe Bay items.

This time, except for the boilerplate agenda items like declarations of interest, committee briefing report, data of next meeting, every single major item on the agenda is wholly or almost entirely about North Cumbria. 

To be precise, there are five major items on the agenda, of which four are entirely about the NHS in North Cumbria with no relevance to the Barrow and South lakes area at all, and the fifth is mostly about North Cumbria with some potential knock on effects in the south of the county. 

And it's one of the meetings held in Kendal.

Almost certainly too late to change the venue now without causing disruption which is more trouble than it's worth, but I will be suggesting that next time we have an agenda which is this heavily weighted towards one side of the county we make that meeting one of the ones held in that part of the county.

On Vaccination

There is overwhelming evidence that the majority of vaccination programmes have between them saved millions of people from premature death, improved the quality of life for millions more and massively improved public health.

A healthy democracy needs to be able to have robust debate about the effectiveness of vaccination programmes like any other aspect of health policy. There are particular patients who may have an adverse reaction to specific vaccinations; they are usually a small minority but they do exist. Anyone who has concerns about the safety of vaccination can and should discuss those concerns with their doctor.

It is however, important to recognise that vaccination programmes are one of the main reasons that infant and child mortality was massively reduced in Britain in the 20th century. For example, five diseases in particular - pneumonia, tuberculosis, diphtheria, measles and whooping cough - between them used to kill in infancy more than a quarter of babies born alive a hundred years ago, and tens of thousands more in childhood. Between the second decade of the last century and the 1970's, infant and child death rates from these diseases had been dropped by a factor of more than ten for pneumonia and factors in the hundreds for the others, with antibiotics and vaccination the most important among a range of improvements in healthcare which drove these improvements.

Overall in England and Wales between 1901 and 1974, infant mortality dropped by 91% and child mortality at ages 1 to 14 by 94%. (Source: Office of Health Economics report 1975.)

I have quoted the figures for the drop in mortality between the early 20th century and the 1970s because, although vaccination was discovered and it's benefits proved to the scientific community by Sir Edward Jenner in 1796, it was in the 1920's that vaccines against diphtheria, tetanus, whooping cough and tuberculosis (TB) became widely available and widely used, and therefore it is in the 50 years from that decade that very widespread vaccination is likely to have made it's greatest contribution to the reduction in infant and child mortality.

Between 1956 and 1980 a programme of vaccination by the World Health Organisation eradicated smallpox - one of the greatest achievements in the history or medicine.

It is the view of many medical professionals - and the NHS - that vaccination has saved more lives than any other medical product or procedure.

The belief that vaccination has saved millions and millions of lives and done vastly more good than harm is perfectly consistent with recognising that not every vaccination is the right prescription for every patient and accepting that a proper, grown-up and honest discussion of the impact of vaccines needs to be possible.

A few days ago, the Word Health Organisation reported that measles caused the premature death of 72 children and adults in the European region in 2018,

That's 72 avoidable tragedies. There ARE a small number of people who should not take the measles vaccine but if 95% of every community were immune from measles through vaccination or being a survivor of the disease it would rapidly go the way of smallpox 

Anyone who has any concerns about vaccine safety or whether a particular vaccination is right for you or your child should seek professional medical advice and treat anything you read on social media on the subject with extreme caution unless you know exactly where it came from. Talk to your own doctor or genuine experts whose identity you know and whose interest is your good health.