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CANCER IN SCOTLAND SUSTAINING CHANGE
FOREWORD
BY THE MINISTER FOR HEALTH AND COMMUNITY CARE
The last 3 years has witnessed a period of unprecedented change and significant improvement in cancer services in Scotland. Immediately after its publication in 2001
Cancer in Scotland rapidly and effectively started a process of regional planning and investment backed up by sustainable changes in the delivery of cancer care across the country. The process has been challenging, sometimes frustrating but mostly rewarding - for patients and frontline staff.
Evidence of the obvious changes and improvements and their impact on behaviours and attitudes, is readily available from the 6-monthly progress reports published on the
Cancer in Scotland dedicated website,
www.cancerinscotland.scot.nhs.uk .
But what of the next 3 years and beyond?
From the outset it was recognised and emphasised that
Cancer in Scotland was not a quick fix but a long haul that might take 10 years and more to deliver the aim of making Scotland's cancer services amongst the best in the world. A superb and most encouraging start has been made, backed up by 25 million recurring investment, ring fenced until at least 2005-06.
For cancer, the emphasis will continue to be on improving quality of services for patients. That is a direction of travel that is agreed by clinicians and patients everywhere. Clinicians want to deliver the best care possible and patients want to know that they have access to effective treatment meeting their needs.
A key component of the quality improvement agenda is information - to support clinicians and to support patients. Robust data is a vital tool for cancer networks if they are to continue to assess the effectiveness and quality of the services they provide. A sound start has been made in developing prospective clinical audit in cancer services, but the nationwide picture remains patchy and for some cancers the systems are still lacking. Current models of prospective clinical audit are resource intensive - for clinicians and data collectors/managers. This information should be available as a by-product of routine clinical care. Existing electronic information systems across the patient pathway are not connected, for example between primary and secondary care and secondary care with tertiary care.
The National Cancer IM&T Plan published in 2002 presents a vision of a joined-up future. Joined up IM&T systems, with CHI as the unique patient identifier, connecting through Electronic Clinical Communications Implementation (ECCI) and Scottish Care Information (SCI) gateway, can provide a generic Scotland-wide resource that has the potential to improve speed and quality of clinical information and support clinical audit.
Putting patients at the centre of all we do is at the heart of quality improvement and frameworks that best support patients and carers as partners in developing services will be a key theme for the next phase of the cancer strategy. That is partly about building on the patient involvement we are already seeing in the cancer networks for the planning and development of services. It is also about ensuring that patients' views and experiences inform cancer care in a far more systematic way so that services are designed round the needs of patients and better outcomes for patients are secured.
All three regional cancer networks and the Scottish Cancer Group recognise and strongly support the three broad and interlinking strands for sustained effort over the next 3 years - quality improvements, patient involvement and information and knowledge management.
This work will not be easy but the cancer networks have shown that they thrive on challenge and grasp opportunities.
If the last 3 years are a sample of what can be achieved with the tremendous drive, enthusiasm and commitment that are so clearly demonstrable, I have confidence that the next 3 years will transform the delivery of cancer care in Scotland.
Malcolm Chisholm, MSP
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