This autumn, the chancellor Rishi Sunak will go to Parliament and set out the UK Government’s spending priorities in the Comprehensive Spending Review (CSR).

It will be a big moment for the whole of the UK, detailing what the coming years of UK Government spending will look like across the board. And it will be pivotal for the future direction of the NHS, research and cancer care.

The challenge ahead is immense, but must be faced head on.

The last big spending review was in 2015, followed by smaller one-year plans that haven’t tackled the fundamental challenges facing cancer services.

Since then, cancer waiting times have worsened and people with cancer in the UK still face lower survival rates than similar countries around the world.

In the 2019 General Election, the Conservatives committed to increase cancer survival rates and boost early cancer diagnosis. NHS England has a more specific ambition – to see 3 in 4 cancers diagnosed at an early stage by 2028.

Sadly, we weren’t on track to meet these ambitions even before COVID-19. And the pandemic has only increased the pressure on cancer services and made it even more vital to accelerate progress now, to make sure that people with cancer can get the diagnosis and treatment they deserve, today and in the future.

To get on track, the UK Government needs to use the CSR to invest in key areas we know will make the most difference for cancer patients, by:

• Giving our NHS the investment it needs to recruit and train enough staff to diagnose and treat every cancer patient and relieve growing pressures on cancer services
• Invest in more diagnostic equipment, so that Government can deliver on its commitment to diagnose more cancers earlier
• Help medical research charities protect their life-saving research from the impact of COVID-19 with a Life Sciences Charity Partnership Fund

Here’s why these areas are so important.

Growing the cancer workforce to meet demand

A leap forward in our ability to diagnose cancer at an early stage is critical to improving survival. People diagnosed at the earliest stages of cancer have the best chances of accessing curative treatment, which dramatically improves their chances of long-term survival.

Put simply, early diagnosis saves lives.

But in the UK, we only diagnose just over half of patients at an early stage, and right now we’re way off track to meet NHS England’s ambition to diagnose 3 in 4 cancers at an early stage by 2028.

Copy this link and share our graphic. Credit: Cancer Research UK

This means there’s still a lot of progress we need to make.

And crucial to making this progress will be investing to recruit and train more staff to diagnose, treat and care for people with cancer. Last week, we published new estimates for how many more staff the NHS in England will need to diagnose and treat cancer in the next 10 years.

Health Education England (HEE) – the organisation responsible for workforce planning and training – estimates that we need 45% growth in the number of staff in 7 roles key to diagnosing and treating cancer to meet cancer ambitions.

Copy this link and share our graphic. Credit: Cancer Research UK

To see that growth and make sure the NHS has the cancer workforce it needs, we estimate that HEE will need at least £142 million but possibly as much as £260 million more than it already invests over the next 3-5 years.

This investment would not only help to ‘future-proof’ cancer care, but because many of these professions work on other conditions too, the whole NHS would benefit.

Giving the NHS the kit it needs to diagnose and treat cancer patients

In early October, NHS England published a review of diagnostic services. The report made clear that without a major expansion and reform of how we diagnose diseases like cancer, efforts to improve cancer outcomes would be put at risk.

The UK is well behind other similar countries when it comes to how much diagnostic kit we have. For example, we have the lowest number of CT scanners – vital for diagnosing many cancers as well as other conditions – per million people compared to 23 major economies.

The impact of COVID-19 has only made the challenges greater, with diagnostic services hit hard and important new infection control measures making it difficult to see the same number of patients as before.

NHS England’s review suggested setting up new ‘Community Diagnostic Hubs’, a great idea that could not only be implemented in a COVID-19 safe way, but could also build on current work to create ‘one stop shops’ for cancer patients to get all of their diagnostic tests at once.

To make these changes, be it having enough equipment or implementing new models for diagnostic services, we’ll need Government to significantly invest.

Invest to protect life-saving research

Medical research charities like Cancer Research UK invest around £1.9 billion a year into life-saving research, playing a vital part in improving outcomes for people with cancer and a range of other diseases. Just in the case of cancer, charities fund half of all publicly funded cancer research.

But the impact of COVID-19 has been devastating. The Association of Medical Research Charities (AMRC) estimates that this year alone, medical research charities will spend between £252 to £368 million less on research.

The picture is just as bleak for cancer research.

New figures from the National Institute of Cancer Research estimate charities will spend £167 million less on cancer research this year due to the financial impact of COVID-19. In our case, a 30% reduction in fundraising income this year has meant we’ve already been forced to cut £44 million of planned research. In the very worst case, we could have to cut our spending on research by £150 million a year by 2024.

Our vision for beating cancer is underpinned by funding life-saving research into the causes and treatment of every type of cancer. And the reality is that, without Government support, our shortfall in income, will set our research back by years, with fewer scientists supported and fewer clinical trials being funded.

That’s why, along with the AMRC and other members, we’re calling on the Government to set up a 3-year Life Sciences-Charity Partnership Fund. The Fund would protect medical research charities through the worst of the impact of COVID-19 by investing at least £310 million in the first year to maintain ongoing research projects. The investment would then gradually reduce as charities strive to recover and build back stronger in later years.

A ‘cancer reset’

The Comprehensive Spending Review is an opportunity for a ‘cancer reset’.

An opportunity for the Government to make good on its 2019 manifesto commitments, and to give each part of the UK the funding they need to improve cancer outcomes.

An opportunity to give the health system the people and the kit it needs to reduce the heartbreak of lengthening cancer waiting times and growing demand for cancer diagnosis and treatment.

An opportunity to drive investment in future medical breakthroughs.

Now it’s up to Rishi Sunak and the Government to seize this opportunity to deliver for people with cancer and invest to dramatically improve cancer survival across the UK.

Matt Sample is a policy advisor at Cancer Research UK

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