Capacity-sparing innovations in blood cancer could unlock NHS potential

Lord Darzi’s review of the NHS will inform the government’s 10-year plan for the health service, for which I believe cancer should be a key focus. Darzi’s review sets out the scale of the challenge facing cancer care.¹ Thankfully there are implementable solutions to these challenges.

The role of medicines in freeing up cancer service capacity and, in turn, improving patient choice, is one of those solutions, however, it has not yet been fully realised. In blood cancer, actions could be taken to ensure services are working efficiently and in the best interests of patients and this should be embedded in forthcoming government policy.

Unfortunately, blood cancer patients face challenges in accessing new treatments, and receiving the best care possible.²

In 2023, AbbVie commissioned and funded IQVIA* to undertake primary research of healthcare professionals and NHS managers in England to understand how capacity issues affect the ability to plan for, and adopt, new treatments. Forty-two healthcare professionals and managers from 17 integrated care systems responded to the survey.³

Key survey findings:

• 95 per cent highlight that capacity challenges affect cancer services’ ability to adopt new treatments and innovation.³
• 62 per cent reported that oncology infusion units operate at a high-capacity limit daily (90-100 per cent).³
  
• 60 per cent said that staffing is a key factor impacting infusion unit scheduling in England.³
  

Resolving capacity challenges in infusion units requires giving patients greater choice in their treatment and care decisions

Unlike solid tumours, blood cancers are often not treatable with surgery or radiotherapy, so continual improvement to patient outcomes is often reliant on the development of new therapies.⁴ Infusion-based therapy is one of the more common methods of treatment.⁵

Our research found that generally, non-infusion treatments can be broadly regarded as beneficial to services, capacity, and patient choice.³ Respondents noted that, compared to infusion treatments, non-infusion treatments:

• Reduce inpatient ‘time on unit’, improve patient flow, and produce less clinical waste.³
  
• Improve capacity in some infusion units.³
  
• Improve patient choice of treatment options.³

Non-infusion treatments aren’t always the most appropriate option for patients. But, crucially, where appropriate, they offer infusion services the ability to alleviate capacity challenges to plan for and adopt other innovations in blood cancer.

The Darzi review¹ highlighted that the best change empowers patients to take as much control of their care as possible. In blood cancer, services require the additional capacity to allow for more innovations to be made available, and in turn, for patients to have greater choice.

The government’s forthcoming NHS 10-year plan provides an opportunity to embed commitments to improve patient-centred care. Affording greater choice in decisions about treatment and care could enhance quality of life and also help to address capacity challenges in blood cancer.

As outlined in our new UK Blood Cancer Action Plan, it is vital that we, as a blood cancer community, define the minimum standard of care that supports clinical excellence and equity of access to approved treatments. This must ensure that patient choice is central to treatment decisions. – Rubina Ahmed, director of research, policy and services, Blood Cancer UK⁶

As a first step, cancer alliances and providers should implement regular demand and capacity assessment of systemic anti-cancer therapy services, such as infusion units, as committed in NHS England’s 2024/25 operational guidance.⁷ This will establish the scale of demand locally.

Then, within the NHS 10-year plan, we need clearly to outline the positive role that medicines, including non-infusion treatments, can have in reducing pressures on infusion services.

I feel optimistic about the future of cancer services, particularly because, whilst we know there are challenges, we have the solutions available to overcome them. The Darzi review recognised the power of technology to unlock productivity.¹ It will take political leadership to ensure those solutions are delivered for patients and the wider NHS in blood cancer services.

*IQVIA is a global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries.

 

 References

¹Independent Investigation of the National Health Service in England (2024)

²Blood Cancer UK (2024) Taking blood cancer out of the shadows: A plan to increase survival in the UK

³IQVIA data. Survey Results Report

⁴All-Party Parliamentary Group on Blood Cancer (2018) The hidden cancer: the need to improve blood cancer care

⁵Blood Cancer UK. Blood cancer treatment types

⁶Personal Communication from Blood Cancer UK

⁷NHS England (2024) 2024/25 priorities and operational planning guidance