Assessing the impact of COVID-19 on lung cancer services
Whilst the overall outcomes for lung cancer across the world remain poor compared to many other cancers, and survival of patients in the UK has consistently been shown to be worse than in many other countries, the care and outcomes for lung cancer patients in the UK have been steadily improving over the last 15-20 years. The UKLCC has been consistently pushing for a range of efforts to achieve a 5-year survival rate of 25% by 2025[i] – a target that the expert community which it represents felt is entirely achievable.
Felt, that is, before the catastrophe that is the Covid-19 pandemic. Covid-19 has clearly affected every aspect of our lives and our health care systems, so to that extent lung cancer is just one amongst many issues to be faced as a result.
The UKLCC’s new report Covid-19 Matters – a review of the impact of COVID-19 on the lung cancer pathway and opportunities for innovation emerging from the health system response to the pandemic accessible here www.uklcc.org.uk/ is based on feedback from a meeting of the UKLCC’s Clinical Advisory Group in June 2020, follow up interviews with a wide range of experts, plus desk-top research.
The report not only highlights the adverse impact of the pandemic on lung cancer care and outcomes, but also positive changes in practice which we can learn from, adopt and adapt across the UK. In addition, it makes a series of hard-hitting recommendations aimed at NHS bodies, national governments, and the Lung Cancer Clinical Expert Group, to help improve UK lung cancer care going forward.
These are as follows:
We ask that you share this report with your colleagues, networks, managers and policy makers so they reflect on the issues and actions outlined in this report and do all they can to ensure that we recover the momentum that had been building in the lung cancer community.
- Where they are operational, lung cancer screening programmes should be supported to resume at the earliest opportunity.
- Isolation and visiting restrictions in hospital and palliative care settings need to be reviewed urgently to enable critically ill patients to see their families in the final phase of their lives.
- In England, Integrated Care Systems (ICSs) should be provided with the necessary funding to establish Community Diagnostic Hubs to reduce the risk of COVID-19 transmission and accelerate diagnostic turnaround time for lung cancer patients.
- Every NHS Trust should be provided with the necessary IT infrastructure to enable specialists to contribute effectively to virtual meetings and ensure a high-quality discussion.
- The NHS should work with the relevant national Health Technology Assessment bodies to assess the impact that the changes in treatment and delivery schedule have had on lung cancer patients to harness the potential improvements to patient survival outcomes as well as to their quality of life.
- ‘Be Clear on Lung Cancer and COVID-19’ campaigns should be launched to increase awareness of potential lung cancer symptoms and increase the public’s confidence across the UK in engaging with the healthcare system early.
- Within its 2020 Spending Review, the Government should recognise the level of revenue and capital funding required to implement the recommendations of the review of diagnostic and workforce capacity of cancer services across the country, led by Professor Sir Mike Richards.
- The lung cancer clinical community should work together to promote the coherent adoption and implementation of national optimal lung cancer guidelines across the UK to ensure people affected by lung cancer receive optimal care no matter where they live
- To unlock the opportunities offered by the adoption of the remote consultations, research should be undertaken across the lung cancer patient and clinical community to develop best practice guidance to support lung cancer services in optimising the use of remote consultations.
- The Lung Cancer Clinical Expert Group should develop the evidence base for NICE to consider for the adoption of straight to CT GP referral and communicate the findings to support pathway change in all four nations.
- The Lung Cancer Clinical Expert Group should work with the lung cancer clinical community across the UK to review the evidence base for the routine commissioning of liquid biopsy for patients with advanced disease with a high probability of an abnormal gene in their tumour.
Martin Grange – Chair, UK Lung Cancer Coalition
Professor Mick Peake OBE – outgoing Chair, Clinical Advisory Group
Dr Robert Rintoul – incoming Chair, Clinical Advisory Group
[i] UKLCC, The UKLCC, ten-year strategy towards achieving 25% lung cancer survival rate by 2025, https://www.uklcc.org.uk/wp-content/uploads/2017/11/UKLCC-25-by-25-FINAL.pdf