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Tuesday, 4 December, 2001, 04:50 GMT
Cancer patients 'failed by NHS'
Operating theatre
Many emergency operations are carried out by non-specialists
Emergency treatment for cancer patients is poor because of a shortage of specialist doctors, says an independent advisory group.

It examined the circumstances surrounding the deaths shortly after surgery of a large number of patients.

And its conclusion was that some patients are being let down by the NHS.

The government has been saying that everything's getting better in cancer care - well, we don't think it is

Ron Hoile, NCEPOD
The report comes only hours after ministers claimed that "significant progress" was being made towards cancer targets.

The National Confidential Enquiry on Perioperative Deaths (NCEPOD) was set up to see if the medical records of those who died following surgery could reveal wider problems in the health service.

Inaccurate pathology

This is its 13th report, and it highlights a number of issues across the NHS which may have an impact on the quality of patient care.

For cancer, these include:

  • Pathology departments failing to assess accurately the spread of the disease in patients - making it much harder for surgeons and other doctors to successfully treat it.
  • Patients undergoing complex operations with the aim of relieving terminal cancer symptoms - despite there being very little evidence of surgery benefits.
  • Too many operations carried out simply to find out what is wrong with the patient, caused by a shortage of scanning equipment or staff.

Of most concern to the report's authors is patients who need emergency cancer surgery - the group's own figures show that they fare less well than those who have planned operations.

scrubbing up
Palliative operations: Questioned
Ron Hoile, NCEPOD's principal clinical coordinator, told BBC News Online that he believed that staff shortages were partly to blame.

"If you come in as an emergency, you may not be operated on by a specialist surgeon, or have your case discussed by a multi-disciplinary team," he said.

"It isn't good when the surgeon is a general surgeon."

Poor care

He added: "The government has been saying that everything's getting better in cancer care - well, we don't think it is.

"There isn't a single mention of emergency care for cancer patients in the NHS cancer plan."

The report also highlights a shortage of specialist cancer nursing care - and chaos in hospital record systems which leaves doctors treating patients without their notes to hand.

Some of the deaths were, it added, directly attributable to poor care on the wards.

The NCEPOD report refers to patients who died... before the publication of the Cancer Plan

Professor Mike Richards, National Cancer Director
However, Professor Mike Richards, the government's "cancer czar", said the issues raised in the report were dealt with in the cancer plan.

He said: "The NCEPOD report refers to patients who died between April 1999 and March 2000 before the publication of the Cancer Plan (September 2000) and before the new investment in critical care.

"As such it provides a valuable baseline against which we can measure the improvements we have made so far in cancer care."

On Monday, Health Secretary Alan Milburn launched a document charting progress against targets in the plan.

It included an extra 50,000 women now being invited for breast screening, and all but a few percent of suspected cancer patients reaching a consultant within a fortnight.

The BBC's Karen Allen
"Shortage of diagnostic equipment like scanners (means) too many patients undergo surgery to discover what is wrong with them"
See also:

02 Feb 00 | Health
Many cot deaths 'avoidable'
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