The government has launched a ‘national war on cancer’ with the aim of improving prevention, diagnosis and treatments over the next decade, including the development of new vaccines and therapies for the condition.
However, the move by the health secretary Sajid Javid has come as research has highlighted the ongoing return-to-work challenges people of working age can face from a cancer diagnosis, treatment and recovery, not least significant failings by occupational health and HR departments.
In a speech today to mark World Cancer Day, Javid is set to launch a call for evidence, to run over the next eight weeks and underpin a new “10-Year Cancer Plan” for England. This, Javid will argue, is intended to build on the NHS Long Term Plan and will include ambitions to:
- Increase the number of people diagnosed at an early stage, where treatment can prove much more effective
- Boost the cancer workforce
- Tackle disparities and inequalities, including in cancer diagnosis times and ensuring recovery from the pandemic is delivered in a fair way
- Intensify research on mRNA vaccines and therapeutics for cancer
- Intensify research on new early diagnostic tools to catch cancer at an earlier stage
- Improve prevention of cancer through tackling known risk factors such as smoking
Javid is expected to say: “This plan will show how we are learning the lessons from the pandemic, and apply them to improving cancer services over the next decade.
“It will take a far-reaching look at how we want cancer care to be in 2032 – ten years from now. Looking at all stages, from prevention, to diagnosis, to treatment and vaccines.
Cancer and return to work
“We want to hear views from far and wide to help us shape this work. Please join us in this effort, so fewer people face the heartache of losing a loved one to this wretched disease.”
However, it also remains clear the pandemic has had a massive impact on cancer care, especially in terms of the waits backlog for elective care and the impact of people either putting off or not coming forward about cancer symptoms.
There were nearly 50,000 fewer cancer diagnoses across the UK during the pandemic, including 34,000 in England between March 2020 and November 2021, NHS England has estimated.
This latest initiative comes on top of calls by MPs for NHS England to come up with a plan by April to tackle the NHS waits backlog.
Lack of return-to-work conversations
The impact of cancer care, treatment and return to work on those of working age has been highlighted by Stephen Bevan of the Institute for Employment Studies (IES) and Barbara Wilson of Working With Cancer, who are both living with cancer.
This has concluded the mental health impact of treatment is often greater than the physical for those of working age. Most feel guilty about taking time off work for treatment and worry they will be a burden to their colleagues.
There is also often a large fall in full-time working for those returning to work, although the majority remain the main income-earner in their household.
Other findings from the research include that just half (57%) of cancer patients returning to work know they are legally disabled under the Equality Act 2010.
Crucially, more than half said their medical teams or occupational health professionals did not discuss their return to work, and only 22% of HR departments told patients about their right to ask for reasonable adjustments and a phased return to work.
Although cancer survival rates are increasing, it is disappointing that so many people living with cancer face barriers to getting back to work after often distressing treatment.” – Stephen Bevan, IES
A third of respondents did not make a phased return to work and a quarter had to take annual leave to receive vital cancer treatment.
While most respondents said they had received positive support from their colleagues and line managers, a significant minority experienced bullying, being shunned at work and redundancy.
Those living with advanced or metastatic cancer reported receiving lower levels of support and access to workplace adjustments, suggesting that many employers find it more difficult to know how to support patients with complex cancers and those with a terminal diagnosis.
Bevan, head of HR research development at the IES, said: “Although cancer survival rates are increasing, which is good news, it is disappointing that so many people living with cancer face barriers to getting back to work after often distressing treatment. It is especially concerning that so few GPs and specialist cancer nurses are having conversations with patients about work.”
Wilson, chief executive of Working with Cancer, added: “We are worried that so many people living with cancer – and their employers – remain unaware that the Equality Act entitles cancer patients to workplace adjustments which can help them return to work and to adjust to a life with or after cancer.
“Our own work with people living with cancer shows that access to information about managing work and cancer, coaching support and flexible working can make an enormous difference to people’s lives,” she said.