For the past three years, the British Lung Foundation (BLF) has been campaigning to introduce a ban on smoking in cars when children are present. Adults can make their own lifestyle choices but children often can’t and with approximately one in five children continuing to be exposed to second-hand smoke in a car, a ban is essential.
Children are particularly vulnerable to second-hand smoke as they have smaller lungs, faster breathing and less developed immune systems. This makes them more susceptible to respiratory illnesses such as asthma, bronchitis and reduced lung function and ear infections, triggered by passive smoking.
Many people do not realise that second-hand smoke in a car can rise to harmful levels even with the window open. Research shows that a single cigarette smoked in a moving car with the car window half open exposes a child in the centre of the back seat to around two-thirds of the average smoke-filled pub.
Government-run awareness raising campaigns are a welcome step, including the campaigns in April and May 2012 and again in June 2013. Yet these alone do not go far enough in achieving real behavioural change and protecting children from second-hand smoke in the car. Children still report being exposed to smoke either in their family car or in someone else’s. Children are often too scared to ask adults to stop smoking . In a BLF-commissioned survey, only 31% of children have asked their parents to stop smoking in a car, with 34% reporting feeling too frightened or embarrassed to do so.
A comparative case which shows the success of introducing legislation alongside awareness campaigns is seatbelt use in cars. After legislation was introduced alongside awareness campaigns, seatbelt wearing rates increased in the UK from 25% to 91%. It is only with a ban alongside awareness raising campaigns, that we will be able to protect as many children as possible from the dangers of second hand-smoke in cars.
Similar bans have already been introduced in 4 US states, 10 of 13 Canadian provinces, 7 of 8 Australian states, and in five countries, including South Africa (for children under 12) and Cyprus.
We need to ensure that the UK government introduces a ban on smoking in cars with children. This autumn, there is a real opportunity to do this via an amendment to the Children and Families Bill.
Actors David Harewood and Linda Robson have lent their voices to two online videos in support of the British Lung Foundation’s smoking in cars campaign.
In a break from their previous acting roles, the two videos see both actors providing voices for toddlers, highlighting the need to give a voice to one in five children in the UK who are regularly exposed to the potentially dangerous concentrations of second-hand smoke in cars.
Read more about how you can support the BLF’s campaign on smoking in cars with children here.
Lung cancer patients can now check information about the care they are accessing, after the launch of a new interactive online map. The Lung Cancer Smart Map, which shows patients how treatment and care, in their area compares against government targets, was launched recently by one of the UK Lung Cancer Coalition’s key members, the Roy Castle Lung Cancer Foundation.
The Smart Map includes the latest regional data from a range of measures recorded in the National Lung Cancer Audit (NCLA). It compares local real-world hospital data to the nationally recommended standards of care.
Hospitals have made consistent progress in treating lung cancer since the NLCA audit began in 2004 but there is still significant room for improvement and it is hoped that sharing this information will accelerate future positive change.
The Smart Map can also encourage improvements in timely referral from primary care. It includes local data from the National Cancer Intelligence Network’s (NCIN) “Routes to Diagnosis” study which showed that lung cancer patients who are diagnosed via a managed referral rather than an emergency admission have improved outcomes.
Please click on the following link to view the map: http://bit.ly/12smaPW
Jesme Fox (Mrs)
Roy Castle Lung Cancer Foundation
Lung cancer nurse specialists provide a vital role in caring for lung cancer patients and their families – yet they are often overstretched and their roles are being squeezed.
The role of the lung cancer nurse specialist changed significantly after the publication of the Calman Hine Report in 1995, which urged cancer services to become more patient focused and more organised.
Today, nurse specialists are engaged in the various stages of lung cancer patient experience. Some meet patients at the point of a suspected lung cancer diagnosis – providing patients with valuable support and information at an early stage, as well as a consistent point of contact through what is an incredibly stressful and uncertain time. Some nurses are very visible throughout the treatment phase – while others focus on end of life care.
However, regardless of where in the patient journey the nurse specialist is tasked, the most significant part of their job is acting as the patient’s advocate. The lung cancer nurse specialist is pivotal in representing the needs of patients at key multidisciplinary team (MDT) meetings as well as within the wider community team.
Sadly not every lung cancer patient has access to a lung cancer specialist nurse. According to the UK Lung Cancer Coalition (UKLCC), there is only one lung cancer specialist nurse (in England) for every 122 people diagnosed – and lung cancer has the second lowest provision of cancer nurse specialists in the country. This can present major challenges as nurse specialists strive to provide quality information and support to newly diagnosed and existing patients.
The value of the lung cancer specialist nurse is unarguable. Recent research has shown that, where patients are seen by a lung cancer nurse specialist within a fully-functioning multidisciplinary team (MDT), patients are more likely to have a good experience of care and this can often lead to better patient outcomes.
Indeed, the lung cancer nurse is often instrumental in mobilising community services and is often involved with symptom management whilst the patient is undergoing tests. Regular telephone contact between the nurse specialist and the patient can help alleviate some of the anxiety in the treatment process. The lung cancer nurse specialist can also ensure that any further changes in care can be put in place prior to the involvement of the oncology or surgical team. This can optimise the patient’s chance of being considered for active treatment. Nurse specialists are also often vital in providing good quality follow-up clinics.
Yet lung cancer nurse specialists do not always receive the support and recognition they deserve – and there is a shortage of this valuable resource across the country. We need to put pressure on those who have influence to ensure the role of lung cancer nurse specialists is maintained and protected.
Macmillan Lead Lung Cancer Nurse
Today sees the launch of the next phase of Public Health England’s Be Clear on Cancer campaign which aims to make people aware of the symptoms of lung cancer and encourage them to visit their GP if they have had a cough for three weeks or more. The UK Lung Cancer Coalition (UKLCC) is highly supportive of this awareness initiative and we have been working with key stakeholders over the last eight years to encourage national campaigns such as this in order to help achieve our vision of doubling lung cancer survival.
Almost 24,000 people a year in England receive a lung cancer diagnosis when the disease is at a late stage – only around 15 per cent of cases are diagnosed at the earliest stage, when treatment is most likely to be successful.
Lung cancer is currently England’s biggest cancer killer, causing around 28,000 deaths each year and with around 33,800 people diagnosed. Those diagnosed at the earliest stage are five times more likely to survive lung cancer for at least five years than those diagnosed at a late stage.
One of the reasons behind England’s low early diagnosis rate is the public’s lack of awareness about the disease and its symptoms. New data shows:
- almost three-quarters (73 per cent) of people are unaware that lung cancer is England’s biggest cancer killer
- despite the fact that lung cancer is most common in people aged over 50, one in four people (26 per cent) think that all age groups are equally at risk of lung cancer
- 40 per cent of people are unaware that a cough that has lasted three weeks or more is a potential symptom of lung cancer.
These figures show that more needs to be done to raise awareness of the signs of lung cancer and ultimately save more lives.
Despite improvements in lung cancer services in recent years, the UKLCC is acutely aware that wide variations in lung cancer treatment and care continue to persist across England and the UK and survival rates lag behind other comparable countries in Europe. To note, patients in the UK are diagnosed with more advanced disease than many other countries and almost 40% first reach specialist care via an emergency admission to hospital.,
TheUKLCC’S vision is to double lung cancer survival during the next eight to ten years, with the co-operation of health professionals, policy makers, local primary care organisations, NHS and Government. By applying the best standards already being demonstrated in the best cancer centres in Europe, we could save 3,500 lives each year
The Be Clear on Cancer campaign will see adverts – featuring real GPs – on TV, print and radio from today until mid-August. Face-to-face events will also take place in a number of shopping centres. To find out more about the campaign, visit www.gov.uk/phe
Mr Richard Steyn
Consultant Thoracic Surgeon, Associate Medical Director – Surgery, Heart of England NHS Foundation Trust
Honorary Associate Professor, University of Warwick
An online survey to gather the experiences of lung cancer patients, including their families and carers, from around the country, goes ’live’ today (5th June 2013).
Launched by the UK Lung Cancer Coalition (UKLCC), the country’s largest multi-interest group in lung cancer, the research hopes to uncover what really matters to people living with lung cancer – and how their experience of living with lung cancer could be improved.
“We need to listen to lung cancer patients,” says Mr Richard Steyn, chair of the UKLCC and consultant thoracic surgeon.“Despite improvements in services in recent years, wide variations in lung cancer treatment and care continue to persist across the UK and our survival rates lag seriously behind other comparable EU countries.”
Lung cancer continues to be the UK’s biggest cancer killer.1 There are almost 35,000 deaths every year,1 which amounts to a greater death toll than breast cancer, prostate cancer, bladder cancer and leukaemia combined.2 It is reported that four people die from lung cancer in the UK every hour.1
The survey is completely anonymous and can be accessed at: www.uklcc.org.uk. Paper copies of the survey can also be downloaded from the website, or requested from selected lung cancer nurse specialists.
TheUKLCC’S vision is to double lung cancer survival during the next eight to ten years, with the co-operation of health professionals, policy makers, local primary care organisations, NHS and Government.
The results of the nationwide survey will be announced later this year.
1. Figures from Cancer Research UK, accessed October 2012 and vailable at: http://info.cancerresearchuk.org/cancerstats/types/lung/mortality/
2. Figures from Cancer Research UK, accessed October 212 and available at: http://info.cancerresearchuk.org/cancerstats/mortality/cancerdeaths/?a=5441
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It is commonly acknowledged that lung cancer patients get a raw deal when compared to other cancer patients. Despite accounting for more than a fifth of all UK cancer deaths, lung cancer receives less than four per cent of all current UK cancer research funding. And despite improvements in services in recent years, wide variations in lung cancer treatment and care continue to persist across the UK. For a number of reasons, outcomes remain poor – with survival rates lagging seriously behind other comparable EU countries.
Since its formation, the UK Lung Cancer Coalition has worked tirelessly with health professionals, NHS trusts, cancer networks, Royal Colleges, parliamentarians and Government to help reduce the terrible death toll of lung cancer. It has been a major driver in encouraging hospitals to submit data to the National Lung Cancer Audit to help drive up best-practice and improve standards of care for patients. It has published a number of ground-breaking, high-profile, national reports into lung cancer. However, there is still much more to be done.
Our latest initiative – in partnership with our charity, health professional and health company members – is a nationwide survey to gather information about patient and carer experiences of lung cancer care and services. Without doubt, the key to improving patient outcomes is to help us understand what really matters to people living with lung cancer – and how their experience of living with lung cancer could be improved. Wherever appropriate, we want to engage current patients – or the friends and family who care for them – to fill in the survey and tell us what they think. We want their voices to be heard and ultimately reach our goal of helping to double UK lung cancer survival.
The survey is now available on our website and the results will be shared later this year. Please share this link www.uklcc.org.uk.
Dr Mick Peake
- Chair, Clinical Reference Group, UK Lung Cancer Coalition (UKLCC)
- Consultant and Senior Lecturer in Respiratory Medicine, Glenfield Hospital, Leicester
- Clinical Lead, National Cancer Intelligence Network and National Lung Cancer Audit
Lung cancer commissioning guide
The current NHS reforms present a range of opportunities and challenges for those involved in the planning and the delivery of lung cancer services. In recognition of this, the United Kingdom Lung Cancer Coalition (UKLCC) has compiled a commissioning guide which highlights some of the key resources available for local commissioners when designing lung cancer services.
These changes will see clinical commissioning groups assume responsibility for planning and purchasing local health services from primary care trusts, and health and wellbeing boards becoming involved in assessing the health needs of local populations. This guide is intended to signpost these new bodies to key information and tools to enable them to commission high quality lung cancer services. These resources include:
- National Lung Cancer Audit which assesses the performance of local lung cancer services and enables areas for improvement to be identified
- Cancer Commissioning Toolkit developed by the National Cancer Intelligence Network
- Lung Cancer Quality Standard produced by the National Institute for Health and Clinical Excellence (NICE) which sets out key markers of high quality lung cancer care to inform the work of commissioners, providers and healthcare professionals, and provide clear information to patients about the kind of care and support they should expect to receive
We hope that this guide is a useful addition to the support available to commissioners and will help to ensure that the health reforms deliver better outcomes for lung cancer patients.
Download the guide HERE
The National Institute for Health and Clinical Excellence (NICE) is in the process of developing a number of ‘quality standards’ – concise statements of what defines high-quality, cost-effective patient care in the treatment and prevention of various diseases and conditions. Development of the lung cancer quality standard is underway, and the UKLCC believes it is crucial to get this right in order to ensure that lung cancer patients across the country receive the highest standard of treatment and care.
The UKLCC has therefore published its own quality standard – a set of 20 quality statements setting out what UKLCC professionals believe constitutes best practice. The standard covers the whole patient pathway, from awareness raising and support at diagnosis stage, right through to the quality and accessibility of clinical treatment.
Click here to download a copy of the UKLCC’s lung cancer quality standard
National Lung Cancer Audit 2009: Half of patients do not see a Lung Cancer Nurse
The National Lung Cancer Audit published by the NHS Information Centre on 2nd December 2009 shows that:
- Only half (51%) of lung cancer patients are currently seen by a lung cancer specialist nurse and only one in four have a nurse specialist present at the time of the diagnosis.
- Where patients are seen by a lung cancer nurse, six out of ten (59.4%) receive active treatment / treatment to halt the spread of their disease*
- Conversely, where lung cancer patients do not have access to a lung cancer specialist nurse, only three in ten (30.9%) receive any form of active treatment*
*This relationship has not been measured previously and further work will be required to define its precise significance, but it does suggest, at the very least, a strong association between good specialist nursing and other aspects of high quality care.
Other highlights from the report:
- 94 percent of all lung cancer cases are now recorded in the National Lung Cancer Audit (over double the number first recorded in 2005)
However, despite nearly all hospital trusts in England, Scotland and Wales now participating in the Audit:
- Only around one in ten patients receive surgery (11%) – still the best chance of a cure
- Only about half (54%) of patients receive any form of treatment to halt the spread of their disease
- There remains wide variation in standards across the country
Official Comment from UK Lung Cancer Coalition:
“The National Lung Cancer Audit appears to show that, where specialist nurses are at the heart of the multidisciplinary lung cancer teams, patients are more likely to receive active treatment and this could have a big impact on survival. The UK Lung Cancer Coalition believes that every lung cancer patient should have access to a lung cancer nurse from the moment they are diagnosed.” Dame Gill Oliver, Chair, UK Lung Cancer Coalition.
NB Active treatment – treatment to halt spread of disease i.e. chemotherapy, radiotherapy or surgery
Official Comment from National Lung Cancer Forum for Nurses:
“The National Lung Cancer Audit highlights the pivotal role of lung cancer nurse specialists and yet lung cancer continues to be the poor relation. On average, there is one lung cancer nurse in England for every 132 people diagnosed with lung cancer, compared to 82 people per every breast cancer nurse. Without access to lung cancer nurses, patients will suffer as they will not have access to the in-depth nursing knowledge, care and support that lung cancer specialist nurses can provide.” Liz Darlison, Chair, National Lung Cancer Forum for Nurses.
UKLCC launch Lung Cancer Plan
12-POINT PLAN WILL DOUBLE LUNG CANCER SURVIVAL INSIST EXPERTS
The UK’s leading lung cancer experts have today (5th November) outlined a 12-point plan to help double lung cancer survival and eradicate the huge national inequalities that exist in lung cancer care.
The development of screening, greater funding of research, earlier diagnosis and ensuring all patients, wherever they live, have access to a full range of lung cancer specialists and professionals, are among some of the detailed calls to action announced in the first-ever UK Lung Cancer Plan.1
“UK lung cancer survival is one of the worst in Europe with half of all lung cancer patients dying within six months,” says Dame Gill Oliver, chair of the United Kingdom Lung Cancer Coalition (UKLCC).
A recent analysis showed that UK survival rates lag seriously below the European average, despite the high national expenditure on health services. Only Malta (with a five-year survival rate of 4.6%) has a lower survival rate than Scotland (8.2%) and England (8.4%). In comparison, 16.8% of lung cancer patients in Iceland are still alive five years after diagnosis.2
“Not only are the differentials across Europe alarming but currently, despite service improvements, you are four times more likely to survive lung cancer in some parts of England than others*,” adds Dame Gill. “This is unacceptable.”
The UKLCC’S vision is to double lung cancer survival during the next eight to ten years, with the co-operation of health professionals, local primary care organizations and government. The new 12-point plan highlights the areas where the biggest gains can be made and is the result of months of discussion between the UKLCC’s experts, including doctors, nurses, researchers and patient groups.
“We know if we apply the best standards of care already being demonstrated in some parts of the country, we can double one year and five year lung cancer survival rates by 2010 and 2015,” says Dr Mick Peake, chair of the UKLCC’s clinical sub-group and NHS national clinical lead for lung cancer. “Thousands of lives could be saved as a result.”
Lung cancer is the UK’s biggest cancer killer3; it kills over 33,000 people each year,3 which is more than breast cancer, prostate cancer, bladder cancer and leukaemia combined.4 The disease accounts for one in 20 of all deaths in the UK,5 one in six of all cancer cases and one in four of all cancer deaths.6 It is reported that four people die from lung cancer in the UK every hour.3 Despite, being labeled a ‘smoker’s disease’, thousands of people with lung cancer have never smoked.
– ends –
Note to editors:
*The NHS Performance Indicators (2002) for lung cancer survival shows wide variations in lung cancer survival in England. Currently, as a result of socioeconomics and health provision inequalities, you are four times more likely to survive from lung cancer in Chelsea, Stockport and Solihull than you are in Northumberland, Rotherham or Sunderland (for example). 7
The UK Lung Cancer Coalition (UKLCC) is a powerful new coalition of the UK’s leading lung cancer experts, senior NHS and Department of Health professionals, charities and healthcare companies. It is the UK’s only multi-interest group in lung cancer and it is the first time that all the major charities with an interest in the disease have joined forces to fight lung cancer. The UKLCC is supported by gifts in kind from charities and software manufacturers and by direct grants from AstraZeneca, GE Healthcare, Lilly UK, Pierre Fabre, Roche Products Ltd, Sanofi-aventis who are bound by a funding and governance policy. www.uklcc.org.uk
- Lung Cancer Plan: improving lung cancer survival in the UK. UK Lung Cancer Coalition; November 2007
- Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, Kunkler I, and the EUROCARE-4 working group. Recent cancer survival in Europe: a 2002-02 period analysis of EUROCARE-4 data. Lancet Oncology. Published online August 21, 2007
- Figures from Cancer Research UK, available at: http://info.cancerresearchuk.org/cancerstats/types/lung/mortality/
- Figures from Cancer Research UK, available at: http://info.cancerresearchuk.org/cancerstats/mortality/cancerdeaths/?a=5441
- Cancer Atlas of UK and Ireland, 2005. Chapter 13, p139
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Lynsey Conway on 07778 304233