Lung tests have ‘flipped’ results for cancer treatment

Patients on Teesside have been invited for tests in a lung health check programme to pick up warning signs. This has reversed trends for people receiving “curative” treatment to overcome cancer rather than palliative treatment to improve quality of life and manage symptoms.

Samuel Peate, chief operating officer for the South Tees Hospitals NHS Foundation Trust, said: “If you look at the impact of that programme, we’ve effectively moved from the patients going through the lung pathway where 80% of patients would have ended up with a palliative diagnosis and 20% or thereabouts with a curative intervention and treatment.

“The targeted lung health check programme has effectively flipped that the other way around. We’ve clearly identifying patients with cancer much sooner, but that’s leading positively to around 80% patients having treatment for a curative outcome, and 20% or thereabouts with a palliative outcome.”

A board meeting of the University Hospitals Tees group, which covers the North and South Tees trusts, was told how these results were masked by standards which NHS trusts follow, one of which is to start people’s cancer treatment within 62 days of referring them. Mr Peate said the targeted lung check programme was good for patients but did not necessarily play out in the published statistics, which show 67% of cases meeting the 62-day standard for North Tees, 61% for South Tees, in March.

He said: “From a 62-day standard perspective, the palliative pathway’s much shorter with much less interventions, therefore it’s easier to be compliant. The curative pathway has much more intervention, diagnostics and then through to treatment.

“That ultimately means the pathways are longer, it’s more difficult to be compliant with the 62-day standard. That being said, the team are doing a huge amount of work to see through innovation, working innovatively and differently to ensure patients are treated from a curative perspective within 62 days.”

He added: “It’s clear we’re seeing quite a big increase in demand, particularly in neurological cancer over the course of the last year, 18 months or so. Some of that is playing out in the timeline to treatment.

“We can absolutely see for neurological treatment that we are diagnosing patients more quickly because of the interventions we’ve put in place. Time to biopsy earlier this year might have been up to 40 days, that is now showing at 20 days.”

Group chief executive Stacey Hunter said the success showed the detail behind fundamental standards which hospitals worked towards. She said: “Our 62-day cancer standard position, we’ve got an ambitious plan this year to improve it at South Tees by just over 10%.

“One of the nuances that sits under that is the work the team at South Tees have been doing on targeted lung checks, and the impact that’s had for people who live in the Tees Valley. Whilst we might not be at the standard, and we will be relentless at trying to get back there, it’s massively positive.”

Group managing director Neil Atkinson gave a performance report which highlighted “alerts” needing attention. For the North Tees trust, these included rates of stillbirths and breast-feeding and readmission, and sickness absence.

One of the alerts was the standard for admitting, transferring or discharging patients within four hours of arrival, but the trust was still at 89%, consistently above national standards. Mr Atkinson said: “That was below what we had planned for.

“That performance is still way above what most other trusts are able to deliver, and would put the trust in one of top two or three performing trusts in the country. It is still performing very well.”

In South Tees, there were six alerts including E. coli infections, breast-feeding, cancelled operations not booked in 28 days, faster cancer diagnosis, sickness absence and training. But he said there had also been improvements in both trusts, showing “we’ve moved on from winter pressures”.

Ms Hunter said: “We are seeing sustained progress for patients at South Tees that have been really difficult to secure.

“North Tees and Hartlepool have a strong and excellent track record for all things urgent and emergency care. The reason we set ourselves a massively ambitious target there is because we want to keep pushing ourselves.

“We want to keep being ambitious. The work that team do is still exceptional.”