Wednesday, 29 June 2011

Loneliness of a not very long distance runner

Too late. My ‘secret’ is out. Rather than take out a super-injunction, I have decided to come clean. I have registered to run in the 2012 Virgin London Marathon. There, I have written it down and pressed ‘publish’. I am a man of my word, and there is no going back now!

I have confided in a few close friends and family. The general reaction has been to raise the question ‘why would you want to do that?’. After thanking them for their encouragement, I proceeded to explain that this is something I have always wanted to do.

One of my first tasks as Chief Executive was to stand on the finishing straight of this year’s event. As I watched the sense of achievement of the faces of so many runners, whether they were sprinting or hobbling, I was genuinely inspired and, much to my surprise, that inspiration has stayed with me. My Dad and brother have both run the marathon previously - so it must be at least genetically possible.

The other big reason is, of course, TeamPB. I am so proud that The Prostate Cancer Charity and Breast Cancer Care have come together to be the official charity partners of the marathon in 2012. In the Olympic year too. It is blooming marvellous and I am looking forward to being part of TeamPB (and not just because it is an excuse to wear luminous pink in public), and running with what will hopefully be our biggest ever team. I know I am biased, but it is great to be involved in a partnership between two great charities that has the potential to last long after the marathon.

So, the training has started. It is very small steps on a long journey. I have a programme that I am following (most of the time). I have avoided the first major risk of injury when I had to climb into the back of the wardrobe to find my running gear. I am sure my colleagues will rally round and support my efforts people on the weeks when I think this is the stupidest idea since the invention of the one legged bar stool. I will keep you posted on progress, as well as my blisters, and remember you are being given plenty of warning – I will be asking for lots of sponsorship!

Wednesday, 15 June 2011

A time for change?

So, as the results of the NHS Listening Exercise have come to pass and the Government seeks to make what certainly appear to be major concessions on some of their flagship reforms – I find myself reflecting on what these changes actually mean.

As someone who worked in the NHS for many years, I am pleased to see that GPs will not stand alone in commissioning services, but will be supported by other healthcare professionals including hospital doctors and nurses, as well as involving patients. GPs need the space and time to be good doctors and this means they cannot and should not be the sole source of commissioning expertise across the whole system. I am also pleased to see that cancer networks will continue to have an active role as experts guiding local cancer care. Choice can be an important aspect of this, particularly in prostate cancer diagnosis and treatment. A genuine compact between a man and his GP or clinician is essential if he is to choose and receive the right care for him. However, we need a system that provides an equal choice to all, in all parts of the country. The idea of introducing choice into the NHS is certainly not new. It was a key driver in the battle to reduce waiting times ten years ago. That experience showed that choice only works when patients have access to high quality information to support them making decisions through every step of their journey through the system.

Research is one area where swift developments need to be made to ensure new treatments reach those they can help. I am pleased to see it will be a core aspect of the NHS, but hope it does not get bogged down in a focus on short term solutions to short term problems.. I was on BBC Radio Four’s Woman’s Hour on Monday talking about a prospective new urine test for prostate cancer – there is a real opportunity to explore its potential for men. Innovations that may improve a man’s experience and treatment of prostate cancer could be missed if the NHS obsesses on how to assemble its component parts for too long.

Whatever the system that is adopted, a key to success is going to be leadership and that will need to come from across all of the NHS. I have been lucky enough to work with some of the highest quality leaders who were primarily doctors, nurses and other healthcare professionals. These are the individuals who have inspired their clinical colleagues to change the way that they work in order to improve services to patients. I also know that NHS managers will be critical to making the reforms working – they are an easy target for politicians and media but without them change in the NHS will not happen. I was as proud of my work as a manager in the NHS as I was pumping people’s chests as an A&E nurse, and on the good days I knew that in my role as a manger I had made as significant a difference to the lives of patients even if they were not directly in front of me.

Although political scrutiny and debate is necessary to keep the wheels of this change moving in the right direction, we can only hope that politicians channel it effectively to keep this on track. The last few months have made the NHS an even hotter political potato and I am sure there will be a temptation to keep the debate going as it is a pretty effective weapon with which to score political points. However, if the NHS is paralysed for much longer by the debate about reforms there is a very real chance that it will will not save the additional lives it committed to less than six months ago.

Tuesday, 7 June 2011

New research developments

Important new research was recently published about the drug abiraterone. This showed that it can extend the life of men living with advanced disease that is no longer responding to existing treatments, such as chemotherapy. Abiraterone is one of the most significant moves forward for some time in the treatment of men with this type of prostate cancer and the average life extension of four months will make a huge difference to many men and their loved ones.

Yet, although this drug is being fast-tracked by NICE, it may still not be available for some time to many men. We want to see this drug reach those men it could benefit as swiftly as possible. They have very limited treatment options – and simply cannot afford to wait. We are calling on NICE and the Scottish Medicines Consortium (SMC) to urgently ensure that they are able to appraise this new drug as soon as possible, to ensure that guidance on its use in the NHS is available across the UK as quickly as possible so that there isn’t a long gap following licensing.

We have already seen this problem happen. Another drug, cabazitaxel, which can also extend the life of men with advanced disease no longer responding to other treatments, was licensed sooner than was expected and neither NICE nor the SMC have yet completed an appraisal of its clinical and cost effectiveness. This means there is currently a critical gap where cabazitaxel can be prescribed but no guidance exists from NICE or the SMC about who is entitled to receive the drug through the NHS. During this time some local healthcare providers may decide that it is not cost effective to pay for it and men living in that area, who could benefit from this chemotherapy, may not be able to access it – or even be told it exists.

We have already been contacted by men who believe they may be eligible for the to be given the treatment but have not been made aware of it by their GP and the Charity is worried that this could lead to a postcode lottery in terms of access to this drug.

The arrival of these two drugs into the UK should be good news for men with prostate cancer. However the current system runs the real risk of making this a ‘bad news story’. Whilst it is right in a national health service that there should be a clear analysis of the benefits of drugs and we need NICE and the SMC to stick to their word and fast-track the appraisal of this drug. Once abiraterone is licensed, men with prostate cancer will need clear information about whether it is appropriate for them. Furthermore, until guidance is issued by NICE and the SMC, those men for whom any licensed treatment is appropriate need clear information about how they can apply to their local healthcare provider to receive it.