#OneCancerVoice and the devastation of cancer services due to Covid-19

29th June 2020 Clinical Negligence

 

Times are worrying and uncertain for most of us but for those living with cancer, be it diagnosed or as yet undiagnosed, that worry and uncertainty is amplified.

Cancer and COVID-19

COVID-19 has placed a huge strain on many areas of the NHS as some staff have either been told to stay at home or moved to work in other departments. Cancer care, however, has been devastated.

With one in two of us likely to get cancer at some point in our lives, this is something that we should all be incredibly concerned about. As the number of coronavirus cases decrease, cancer is once again the leading cause of death in the UK.

Screening has been put on hold in many parts of the UK with around 200,000 people per week no longer being screened. This is a particular concern for those with as yet undiagnosed breast, bowel, or cervical cancer as routine screening often detects the disease before a person shows any symptoms.

Diagnosis levels for all types of cancer have dropped. People are not going to their GP to discuss their symptoms. Furthermore, some GPs are reluctant to refer their patients on due to the risk of that patient either spreading or contracting COVID-19. An estimated 2,300 people are going undiagnosed every week (1). 

Delays in detection mean delays in treatment and a reduction in the efficacy of those treatments. Surgery, which is often carried out with curative intent, is not taking place due to the lack of Intensive Care Unit beds and ventilators. Chemotherapy, which can be used palliatively or to ‘mop up’ cancerous cells after surgery, has been put on hold due to both a lack of staff and the fact that it weakens a person’s immune system. Some NHS Trusts have been working innovatively and moving cancer patients to ‘cancer hubs’, which are areas away from the main hospital and designated COVID-19 protected spaces. However, this approach has not been taken consistently across the country, likely due to a lack of funds and general resources.

As clinical negligence solicitors at JMW, we are all too aware of the consequences of a delayed cancer diagnosis. We’ve represented the families of many patients who have died as a result of an avoidable delay in diagnosis and/or treatment. The sheer number of individuals who are likely to suffer fatal consequences as a result of COVID-19 is, therefore, both concerning and heart breaking in equal measure.

One Cancer Voice

One Cancer Voice was started in November 2019. It is a manifesto supported by over 20 cancer charities and was created with a view to improving the UK’s survival rates and the care afforded to those living with cancer. The manifesto focuses on staffing, early diagnosis, treatment and psychological support, post-cancer care, the UK’s status as a world leader in cancer research, and cancer prevention.

Last week those charities came together once again to call on the government to restore cancer services safely and effectively in line with a ’12-point plan’. The plan has been formulated based on data and analysis, and sets out the action that the government needs to take in order to prevent a cancer crisis from forming whilst we are still recovering from the coronavirus crisis. The plan covers everything from the provision of services and diagnosis, to support, guidance, and clinical trials.

As a first step, the plan calls on the government to ensure transparency with regards to the scale of testing and treatment so that doctors can anticipate the extent of the backlog and plan accordingly as we work towards returning to normality. It also calls for the establishment and maintenance of more cancer hubs and for staff and patients alike to be afforded adequate protective equipment.

With regards to diagnosis and referrals, the plan notes that referrals under the ‘two  week wait’ rule are steadily starting to increase, but the numbers remain far below pre-COVID levels. One Cancer Voice is asking the government to develop a ‘catch up’ strategy and fund public awareness campaigns. It is also asking for GPs to be provided with clearer guidance and support when making referrals.

The plan also recognises that hundreds of thousands of people living with cancer are shielding due to being in the ‘extremely vulnerable’ category. These people need clear and unequivocal advice on how they can access services. The report is also calling for these people to be empowered to make their own decisions about the care that they receive.  

One Cancer Voice also notes that people living with cancer are likely to need psychological support, particularly those who have been denied access to palliative care or face uncertainty as to when they will start treatment and whether that treatment will still be able to cure them after a period of delay. The government must, therefore, make sure that mental health services are available both during and after the pandemic. Poor mental health is, however, likely to have increased throughout society as a whole and so, unfortunately, the sector is likely to face demand from people of all backgrounds, not just those living with cancer.  

The plan also notes that the staff who normally care for cancer patients must also be borne in mind. One Cancer Voice is calling for staff to return to their pre-COVID cancer caring roles. It is also asking for the government to bear in mind the wellbeing of staff, including general morale and burnout, and address these issues accordingly. 

The One Cancer Voice initiative is something that we should all get behind. Cancer doesn’t stop because of the coronavirus pandemic, but it risks becoming the forgotten ‘C’.

You can join in the conversation on twitter using the hashtag #OneCancerVoice

 

1. https://www.standard.co.uk/news/uk/thousands-cancer-cases-undetected-coronavirus-a4420986.html

 

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Lucy Mellor is a Solicitor located in Manchesterin our Clinical Negligence department

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