PARLIAMENTARY WRITTEN QUESTION
Prostate Cancer (4 November 2014)

The Government’s Mandate to NHS England sets out an ambition to make England one of the most successful countries in Europe at preventing premature deaths from all cancers, including prostate cancer. Cancer indicators in the NHS Outcomes Framework and the Public Health Outcomes Framework will help NHS England to assess progress in improving cancer survival and mortality for men with prostate cancer.

The National Institute for Health and Care Excellence (NICE) Referral Guidelines for Suspected Cancer (2005) are available to help general practitioners (GPs) assess when it is appropriate to refer patients for suspected cancer, including prostate cancer. NICE is in the process of updating the guidelines to ensure that these reflect latest evidence and can continue to support GPs to identify patients with suspected cancer symptoms and urgently refer them as appropriate. NICE’s anticipated publication date for the revised guidelines is May 2015.

At a local level, it is for individual clinical commissioning groups to promote and enhance the diagnostic capability to deliver better outcomes. Surgery, radiotherapy and chemotherapy treatments that may be used for prostate cancer are commissioned at the moment by NHS England. NHS England’s prostate cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective prostate cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards.

The NICE published an updated clinical guideline on the diagnosis and treatment of prostate cancer in January 2014. NICE has recommended docetaxel, abiraterone and enzalutamide as treatment options for some types of prostate cancer, subject to certain clinical criteria and is currently appraising a number of other prostate cancer drugs. Patients have the right to drugs and treatments that have been recommended by NICE technology appraisal guidance for use in the National Health Service, where their doctor believes they are clinically appropriate. A number of drugs to treat prostate cancer are available through the Cancer Drugs Fund.

To help reduce regional variations, the Care Quality Commission (CQC) is increasingly incorporating information from accreditation and peer review programmes into its assessments of NHS trusts' services for the treatment of prostate cancer. This includes the national cancer peer review programme, which encompasses prostate cancer. The cancer patient survey also asks specific questions on having a specialist nurse. The CQC intends to use data from the national clinical audit which is being developed for prostate cancer. In addition, national statistics on waiting times experienced by patients with suspected and diagnosed cancers continue to be collected, monitored and published in order to improve equity of access to cancer services and to contribute to an improvement in survival rates.

This Government is also investing in innovative radiotherapy treatments to improve outcomes for those with cancer. NHS England has also committed to make up to £6 million available over the next three years to support six trials by Cancer Research UK into the use of Stereotactic Ablative Body Radiotherapy (SABR). This will allow patients to receive SABR treatment now, where clinicians think they could benefit. At the same time doctors can fully assess the effectiveness of these treatments so that in future, if it proves to be effective, they will be available for all relevant patients on the NHS. Two of these six trials will be on prostate cancer.

We have also invested £23 million across 50 United Kingdom centres aimed at increasing the capacity of radiotherapy centres in England to deliver Intensity Modulated Radiotherapy (IMRT). We committed to achieving the ambition of 24% of all radiotherapy to be delivered through more accurate IMRT, and we are now seeing 35% of all radical radiotherapy treatments delivered using this method compared to 5% in 2010.

The National Prostate Cancer Audit (NCPA) First Year Annual Report was published on the 10 November. The report covers the work undertaken since April 2013. It includes a preliminary analysis of the NPCA’s organisational audit, an analysis of existing data sets including patients with prostate cancer in England, and the design of the NPCA’s prospective audit dataset. The findings from the audit will contribute to changes in clinical practice ensuring that patients receive the best care possible and experience an improved quality of life. The audit is funded by the Department and has been commissioned by the Healthcare Quality Improvement Partnership.