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Take a look at a selection of our recent media coverage:

Global cancer burden ’rapidly growing’ says WHO as England launches national gene testing

5th February 2024

Both the global cancer burden and inequity in cancer and palliative care services are growing across the world, according to new figures released by the World Health Organization (WHO).

Published to coincide with World Cancer Day (4 February 2024), the survey undertaken by the WHO’s cancer agency, the International Agency for Research on Cancer (IARC), shows a growing need for more cancer-related health services worldwide.

Over 35 million new cancer cases are predicted in 2050, a 77% increase from the estimated 20 million cases in 2022, the IARC said.

This ’rapidly growing global cancer burden’ reflects population ageing and growth, as well as changes to people’s exposure to risk factors such as tobacco, alcohol, obesity and air pollution, it added.

Cancer prevalence

The figures show that 10 types of cancer collectively comprise around two-thirds of new cases and deaths globally. Lung cancer is the most commonly occurring cancer worldwide, followed by female breast cancer and colorectal cancer.

In 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths, with lung cancer accounting for 2.5 million or 12.4% of the total new cases.

Female breast cancer ranked second with 11.6% of new cases, followed by colorectal cancer, which accounted for 9.6% of new cases. Prostate cancer and stomach cancers were the next two most common, respectively.

Lung cancer was also the leading cause of cancer death, accounting for nearly a fifth of the total cancer deaths, followed by colorectal cancer 9.3% of deaths and liver cancer 7.8% of deaths.

Differences were seen between sexes, with breast cancer being the most commonly diagnosed cancer and leading cause of cancer death amongst women, whereas it was lung cancer for men.

Prostate and colorectal cancers were found to be the second and third most commonly occurring cancers for men, with liver and colorectal cancers second and third most common causes of cancer death.

For women, lung and colorectal cancer were second and third for both the number of new cases and of deaths.

Lung cancer’s re-emergence as the most common cancer is likely related to persistent tobacco use in Asia, the IARC said.

Cancer and palliative care services

The figures also show that a majority of countries do not adequately finance priority cancer and palliative care services.

Only 39% of participating countries covered the basics of cancer management as part of their funded core health services for all citizens, and only 28% of participating countries additionally covered care for people who require palliative care.

In areas where patients are underserved in relation to cancer treatments, rates of cancer are higher, highlighting a growing inequity in cancer services worldwide.

Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, stated that the UK Government needs to prioritise cancer care in light of the increasing number of global cases.

She said: ‘These new estimates show the increased burden that cancer will have in the years to come. UK Governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has, in part, widened health inequalities. We know around 40% of cancer cases could be prevented.’

She added: ‘Now is the time to turn the tide by implementing policies that enable people to live healthier lives by reducing their exposure to risk factors and prioritising a national cancer plan which includes better screening and early detection.’

Gene testing programme for England

The WHO figures come as NHS England announces the launch of a national gene testing programme to identify cancer risk for people with the BRCA gene.

The BRCA refers to two genes, BRCA1 and BRCA2, which repair DNA damage and help to protect against cancer. If one of the genes is faulty, this can increase a person’s chance of getting cancer significantly.

People with Jewish ancestry are around six times more likely to carry such genetic faults than the rest of the population and are therefore at increased risk of developing some cancers.

Through genetic testing, the NHS plans to identify people carrying faults in the BRCA gene to ensure those affected have access to early surveillance and prevention services.

People with at least one Jewish grandparent can register for a saliva test kit, and following the success of the pilot programme, it is expected that the national roll-out will see around 30,000 people tested over the next two years.

Commenting on the programme, Peter Johnson, national clinical director for cancer at NHS England, said: ‘BRCA testing for the people most at risk has the potential to save lives by allowing them to take steps to reduce the chance of cancers developing or making sure that any cancer can be detected as early as possible, with those at increased risk able to take advantage of surveillance and prevention programmes with their health teams.’

A version of this article was originally published by our sister publication Nursing in Practice.

Flexible working for retired consultants made possible with new NHS Emeritus pilot scheme

16th January 2024

A new platform allowing recently retired consultants who still hold a license to return to the NHS in a more flexible capacity has been launched by NHS England as part of a range of measures to bring down the elective care backlog.

The NHS Emeritus pilot scheme will run for a year across England and it is expected Emeritus consultants will be able to start carrying out appointments from February 2023.

This will follow a full registration process, which includes pre-employment checks and face-to-face interviews with NHS Professionals.

Once registered, a cloud-based platform will link Emeritus consultants with secondary care providers who upload the activity they would like supported. This could range from outpatient appointments, specialist advice requests and education and training support.

The Emeritus consultants can then express their interest in undertaking the specific work listed, and providers will choose the consultant whose skillset and availability best matches the appointments they need covered.

Appointments would be scheduled and arranged with patients in the normal way and carried out in-person or remotely, if clinically appropriate.

This means Emeritus consultants could be based anywhere in England and support hospitals in areas with workforces shortages in a particular specialty or a higher demand for services, or more remote areas where travel is difficult for patients.

The platform aims to provide trusts with an alternative to using agency staff, while allowing experienced specialists who are nearing retirement but want to keep working in the NHS longer, or recently-retired consultants who want to re-join, with an easy route back in with more flexibility.

Stella Vig, NHS national clinical director for elective care, said: ‘The NHS prides itself on its hard-working and committed staff, and it is often the most experienced and knowledgeable clinicians who are lost to the NHS once they retire, even though they still have a lot more they can give to benefit patients.

‘Many have said they want to be able to keep giving back to the health service once they have retired, but in a more flexible way – through the NHS Emeritus initiative, we can provide an opportunity for consultants to continue to work in the NHS in a way that fits in with their life and schedule, and ensures the NHS can still benefit from their skills and knowledge, whether that be through providing training and education, or continuing to see patients and help add much-needed capacity as we work toward our aims of bringing down the longest waits for elective care.’

Consultant urologist Simon Williams is currently employed by University Hospitals of Derby and Burton, and going through the final stages of the registration process for the Emeritus scheme ahead of retiring soon.

He said: ‘Having spent 32 years working in the NHS I have built up a wealth of experience and skills. NHS Emeritus is a great way to continue to share that and still see patients, but in a more flexible way.

‘The programme will enable me to help trusts across the country using remote consultations, not just those in my local area, which could really help free up capacity for their consultants to see more patients in-person and help bring down some of the longer waits for routine appointments.’

Dr Sarah Clarke, president of the Royal College of Physicians, said: ‘At a time when the NHS is facing unprecedented demands, paving a way for our recently retired experienced doctors to be able to contribute their skills again as emeritus consultants is a very welcome step forward.

‘As outlined in RCP’s Later Careers Guidance, we know that more than a third of physicians who are not yet retired say they want to retire early, but almost 60% of physicians would delay retirement if they could work flexibly or reduce their hours, highlighting that integrated flexible working would greatly improve retention.

‘We will closely follow the Emeritus pilot and very much hope that it offers a flexible opportunity for experienced physicians to once again provide vital care for their patients while importantly reducing waiting lists.’

If the pilot is successful, the scheme has the potential to be expended to cover other work areas, the NHS said.

Ms Vig added: ‘It’s a simple concept, but one that we hope will benefit everyone taking part – and we envisage that this is just the beginning, with the potential to broaden NHS Emeritus out to a wider cohort and to include different types of work in the future, which could benefit thousands of patients across the country.’

The new tool is one initiative being rolled out to help deliver the NHS Elective Recovery Plan and to cut the longest waits for routine care.

Recent research has suggested that the NHS must treat 10% more non-urgent hospital cases a month to reverse the increasing waiting list for elective care.

NHS England issues post-strike priorities as reality of reducing elective backlog becomes clearer

NHS trusts and integrated care boards must work to reduce elective long-waits and meet cancer 62-day backlog targets following this month’s strike action, NHS England has said.

In a letter addressed to chief executives and directors, NHS England outlined its expectations following the disruption caused by the junior doctors’ strike held in January.

It said that trusts will likely face a combination of pressures including seasonal Covid and flu presentations, cold weather-related presentations, staff sickness and the need to reschedule patients’ cancelled appointments.

NHS England urged trusts to ‘continue to prioritise the safety of patients’, including urgent planned surgery and other treatment for time-sensitive conditions, particularly fast progressing cancers.

It said the priorities from January to March remain for:

  • All systems to deliver at least 76% four-hour performance and Category 2 ambulance response times as committed to in quarter four in the November planning round, supported by continued delivery of actions identified as part of the Urgent and Emergency Care Recovery Plan
  • All systems and providers to deliver their cancer 62-day backlog reduction targets as well as achievement of the 75% faster diagnosis standard by March 2024
  • All systems to continue to reduce elective long-waits in line with the ambitions in the Elective Recovery Plan and activity levels agreed in the most recent planning exercise.

The latest round of junior doctor strikes lasted for 144 hours from 7am on 3 January to 7am on 9 January as part of their ongoing salary dispute.

NHS data showed that more than 113,700 inpatient and outpatient appointments due to be held during the strike had to be rescheduled.

Since strikes began, the cumulative total of acute inpatient and outpatient appointments rescheduled is now 1,333,221, according to NHS England.

Reducing backlog and building resilience

As these latest NHS priorities were shared, a new study suggested that the NHS must treat 10% more non-urgent hospital cases a month to reverse the increasing waiting list for elective care.

Even if system capacity were to increase by 30% – as NHS England’s target sets out – it would still take ‘several years’ to clear the backlog, researchers from Universities of Edinburgh and Strathclyde said.

Published in The Lancet, the research paper estimated there were 10.2 million fewer referrals made to elective care between the beginning of the Covid-19 pandemic and October 2022.

It also highlighted that the NHS waiting list for elective treatment increased between January 2012 and 2020 suggesting ‘a gradual service decline’ even before the pandemic.

The researchers concluded that even if the 30% increase in capacity is achieved during the next three years, ‘several years (beyond the end of 2025) will be needed for the backlog to clear.’

They added: ’Our study emphasises the need to improve healthcare system resilience to ensure that the effects of any future emergencies on the provision of routine care are minimised.’

The most recent NHS England data revealed that the Covid-19 backlog has fallen for two months in a row, dropping by 95,000 individual pathways from 7.7 million in October to 7.6 million in November.

NHS England said this was due to NHS staff delivering more than 1.63 million treatments in November – the highest monthly activity on record and around 150,000 more than the same month before the pandemic.

Earlier norovirus outbreak adding to winter pressures on hospitals, NHS England warns

1st December 2023

The number of patients in hospital with norovirus is triple that of this time last year and is adding to mounting winter pressures, NHS England figures show.

Surveillance data also shows so far in the 2023/24 season, the cumulative number of norovirus cases is 9% higher than the five-year average.

The increased rate is mostly accounted for by unusually high activity earlier in the season, according to a report from the UK Health Security Agency with data up to 19 November.

The data shows that cases had been increasing over the previous two weeks, but remain within the range of what might be seen for the time of year.

Overall, an average of 351 people were in hospital with diarrhoea and vomiting symptoms every day last week compared to 126 in the same week last year, NHS England said.

There were also 13 children with the virus in hospital each day, compared to an average of just three for the same period in 2022.

Laboratory reports for rotavirus are also showing an increase with cumulative figures for the 2023/24 season 25% higher than the average for the past five years.

The figures suggest that winter pressures may be mounting on the NHS with adult bed occupancy already running at more than 95% and 1,200 more patients admitted than the end of November last year.

And problems with discharging patients from hospital into social and community care settings are continuing to have a ‘considerable impact’ with more than 12,600 adult beds a day occupied by people ready for discharge – one in seven of the total, the NHS said.

NHS England national medical director, Professor Sir Stephen Powis, said: ‘We all know somebody who has had some kind of nasty winter virus in the last few weeks and today’s data shows this is starting to trickle through to hospital admissions, with a much higher volume of norovirus cases compared to last year, and the continued impact of infections like flu and respiratory syncytial virus in children on hospital capacity – all likely to be exacerbated by this week’s cold weather.‘

He added that staff were working hard to prepare for winter and there had been a significant reduction in ambulance handover delays. He also urged people to get their Covid and flu vaccines if they were eligible.

However, he concluded: ‘The demand on hospitals and staff is high, with more than 1,200 extra patients in hospital compared to last year, and we know that is likely to grow considerably before Christmas.’

A version of this story was originally published by our sister publication Pulse.

New inpatient tool for spotting deterioration in children launched by NHS England

3rd November 2023

A single, national standardised early warning system for paediatric teams in hospital settings is being rolled out by the NHS in England as a way of ensuring deterioration in a child’s condition is detected and escalated quickly.

Available from today (3 November), the new inpatient Paediatric Early Warning System (PEWS) chart allows paediatricians to measure things like blood pressure, heart rate, oxygen levels and levels of consciousness. The system tracks any changes and has different scores representing the level of concern.

If a parent or carer raises a concern that their child is getting ill or sicker than the score shows, this will immediately escalate the child’s care regardless of other clinical observations.

Unlike the similar universal system currently in place for adults, there are four separate charts for different age ranges, including 0-11 months, one to four years, five to 12 years, and those aged 13 and over.

The ultimate aim of the PEWS is to improve working methods and safety to support better health outcomes.

It is part of the System-wide Paediatric Observations Tracking (SPOT) programme, led by NHS England in collaboration and endorsement from the Royal College of Paediatrics and Child Health (RCPCH) and the Royal College of Nursing (RCN).

The partnership has been developing PEWS for three years, with pilots running across 15 sites demonstrating clear benefits for both patients and staff.

Updates to the system – such as those based on any guidance from Martha’s Rule, which gives families and patients the right to a second medical assessment – will continue to be implemented as required.

Professor Sir Stephen Powis, NHS national medical director, said: ‘We know that nobody can spot the signs of a child getting sicker better than their parents, which is why we have ensured that the concerns of families and carers are right at the heart of this new system with immediate escalation in a child’s care if they raise concerns and plans to incorporate the right to a second opinion as the system develops further.’

The NHS will develop and circulate a leaflet and video content for parents to explain how to communicate concerns to healthcare staff and encourage them to escalate if needed.

Dr Mike Mckean, vice president for policy, at the RCPCH, said: ‘The National PEWS chart is an extremely important new tool that will support all paediatricians and wider child health teams to spot deterioration in children in hospital. Alongside training and resources, it will help teams across the country improve patient safety, efficacy and quality of care.

‘The SPOT programme builds on systems already in place in many trusts and has the many advantages of becoming a national system. I’d strongly encourage all paediatricians to look at the chart and consider what they need to do to smoothly transition towards integration and embedding the National PEWS into their trusts.’

Standardised tools and e-learning for using national PEWS charts in a range of health settings are in development.

In 2023/24 trusts are expected to appoint an education/implementation lead who will begin to support their trust to roll out the national PEWS.

Plans are in place to expand the system to emergency departments as well as mental health, ambulance and community services in due course. It is also hoped that the national PEWS chart will become the standard of care in England, meaning all medical and nursing students will receive instruction on its use during their training.

Patients given choice to travel for elective care in England to reduce waiting times

1st November 2023

Around 400,000 patients who have been waiting the longest for elective treatment will be offered the opportunity to travel to a different hospital to be treated sooner, NHS England has said.

Any patient who has been waiting longer than 40 weeks for treatment and who does not have an appointment within the next eight weeks will be contacted by their hospital.

It comes after analysis by the Health Foundation indicated that the waiting list for elective NHS care will peak at eight million next summer if current trends continue, regardless of whether NHS strike action continues.

Patients contacted by their hospital will be asked to specify how far they are willing to travel, with the NHS then identifying alternative hospitals with capacity.

NHS England said in some cases the request will be uploaded to the NHS’s Digital Mutual Aid System – its hospital matching platform – to see if NHS or independent sector providers elsewhere in the country can provide their care.

Patients will remain on the waiting list for their home hospital until there is confirmation that their full care pathway has been moved to another provider. If no alternative is found within eight weeks they will retain their position on their current waiting list.

The NHS estimated that approximately 400,000 patients – or 5% of the overall waiting list – meet the criteria and will be contacted by their hospital.

This system is made possible, the NHS said, thanks to ‘the hard work of NHS staff‘ as well as innovations such as ‘surgical hubs, community diagnostic centres, and the use of robots and AI to speed up surgery and other treatments‘.

NHS chief executive Amanda Pritchard said: ‘Despite pressure and the huge disruption caused by strikes, NHS staff have made great progress in reducing the longest waits for patients. This new step to offer NHS patients who have been waiting the longest the opportunity to consider travelling for treatment is just another example of how we are introducing new approaches to reduce how long patients wait, while improving the choice and control they have over their own care.

‘Giving this extra option to these patients also demonstrates the clear benefits of a single national health service, with staff able to share capacity right across the country.

‘So, whether a patient’s care moves to the next town or somewhere further away, it is absolutely right that we make the most of available capacity across the country to continue to reduce the backlogs that have inevitably built up due to the pandemic and provide the best possible service for patients.’

Louise Ansari, chief executive of Healthwatch England, welcomed the news but said: ‘We’re now calling on NHS England and integrated care boards to work together to ensure everyone choosing to travel for faster treatment is given support, including with the costs of transport and accommodation – as described in the Elective Recovery Plan. Otherwise, this option risks deepening health inequalities by only providing solutions to people who can afford to contribute towards the additional costs of travel.‘

A version of this story was originally published by our sister publication Healthcare Leader.

Heart failure to be covered by virtual wards, NHS England says

26th October 2023

Virtual wards should be expanded to include heart failure patients to help reduce recovery times and ease pressure on hospital beds during the winter season, new NHS clinical guidance has outlined.

NHS England has now pushed for integrated care boards to work with cardiac clinical networks to better understand their heart failure population needs and workforce competencies.

The expansion is set to build on the use of and learning from virtual wards for acute respiratory infection and frailty.

It comes after the NHS met its target last month to deliver 10,000 virtual ward beds, through which more than 240,000 patients treated successfully since April 2022.

There are currently a dozen heart failure virtual wards up and running, NHS England said. This includes Liverpool University Hospitals NHS Foundation Trust and Mersey Care NHS Foundation Trust, which together have supported more than 500 people on virtual wards for heart failure.

According to the guidance, as a minimum requirement the new virtual wards should ensure people with heart failure have access to rapid specialist advice and guidance, including via video or telephone, where necessary.

ICBs must also make sure these digital wards feature a daily virtual review with the heart failure team or a multidisciplinary team, with robust processes for escalating concerns.

NHS England also advised an ICB’s approach support ‘seamless patient care’, which may include:

  • Access to multimorbidity specialist input
  • A single point of access
  • Ambulatory care
  • Same day emergency care
  • Rapid response teams
  • Urgent community response
  • Virtual ward plans communicated across the local system.

NHS England’s national clinical director for heart disease Professor Sir Stephen Powis said: ‘More than 240,000 patients have already benefitted from virtual wards, and now we are growing this service to patients with heart failure.

‘This is a positive development in how the NHS can treat patients, and testament to the hard work of our staff after hitting our target of 10,000 virtual ward beds last month.

‘The expansion has been implemented at a key time just before winter, when there will be a lot more pressure on our hospitals and will free up beds for those who need them the most.’

Around 200,000 people a year are diagnosed with heart failure and often require significant NHS support, including long or frequent hospital stays. Some 5% of all emergency hospital admissions in the UK are attributed to the condition.

A version of this story was originally published by our sister publication Healthcare Leader.

The ‘damning reality of emergency care’ in England outlined by MPs in new report

The quality of patients’ access to urgent and emergency care in England ‘depends too much’ on where they live, the House of Commons Public Accounts Committee (PAC) has said in a scathing new report into urgent and emergency care access.

Entitled ‘Access to urgent and emergency care‘, the report said staff ‘have been let down by a system which has seen performance fall far below the standard the NHS says patients should expect to receive’.

It highlights that NHS’s own target for A&E waits had not been met since 2015, and its target for ambulance handovers had been missed each year since it began reporting against this metric in 2017. Regional variation was found to be particularly prevalent, it said.

Proportions of the most serious A&E patients waiting less than four hours in March 2023 ranged from 53.3% in the Midlands to 62.1% in the South East.

Ambulance services covering large rural areas, like the South West and East of England, are especially challenged, with Category 1 response times in 2021/22 varying from 6 minutes and 51 seconds in London to 10 minutes and 20 seconds in the South West.

The PAC said that evidence suggested the Department of Health and Social Care had ‘not sufficiently held NHS England to account’ for meeting targets and improving urgent and emergency care.

What’s more, differences in the capability of individual trusts, including around management, clinical leadership, and technology, were also highlighted. The PAC said these must be addressed to reduce variations in patients’ access to and experience of services.

Commenting on the report, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: ’This is another report that lays out the damning reality of emergency care. Our members and their patients are being let down.’

And he described the Committee’s finding that performance varies from region to region as ‘disheartening but not surprising’.

He added: ’We must be able to better understand what is happening at a local level. At the moment we do not know how well or how poorly individual hospitals are doing because the official data is published by each trust, which may encompass several sites. 

’RCEM is campaigning for NHS England to publish transparent performance figures for individual A&Es, so increased resources and support can be provided to the sites that are struggling the most. Improving equality of care and resulting in significant benefit to patients and staff.’

Delayed discharge and winter pressures

The PAC report also highlighted that not enough is being done to tackle delayed discharges, which has a serious knock-on impact throughout the whole urgent and emergency care system, with beds unable to be released for new patients and thus exacerbating A&E waiting time issues.

The number of patients staying in hospital when they no longer need to stood at an average of 13,623 in Q4 of 2022/23, up from 12,118 in the same period one year before.

To this end, Dr Boyle said: ’We are on the cusp of what looks likely to be another devastating winter. Having adequate capacity for our patients is vital. This will reduce dangerous levels of bed occupancy and improve flow through our hospitals and go some way to easing the pressure on the system. 

“We know that since the pledge [to] increase bed numbers by 5,000 was made in January, we have not made nearly enough progress on this fundamental solution. The priority must now be on significantly increasing bed numbers before the cold weather, and the inevitable winter pressures hit.’

Workforce retention plans

The PAC also called into question the ‘assumptions underpinning’ NHS England’s plan to retain 130,000 staff over the next 15 years, as set out in its recent workforce plan, particularly given the staff turnover rate in the health service was 9% in 2022/23.

And despite having ‘more money and staff than ever before’, the NHS has made ‘poor use of it’ to improve urgent access for patients with urgent and emergency services ‘deteriorating’ in spite of greater spend, it concluded.

It also flagged a 23% fall in NHS productivity following the Covid-19 pandemic, even though it had been improving pre-pandemic.

It has now called on NHS England to set out its understanding of the causes for the fall in productivity and how it will address them.

Similarly, it urged NHS England to establish the causes for variation in performance, and how it might bring the ‘worst-performing organisations’ closer in line to the standards achieved by the best.

‘NHS under increasing pressure‘

Committee chair and Labour MP Dame Meg Hillier said: ‘Excluding demand-led spending such as welfare payments, health takes up approximately 40% of day-to-day budgeted spending by Whitehall departments. It is vital this is delivering benefits for patients. The Government and health system need to be alert to the serious doubts our report lays out around the workforce crisis, both the approach to tackling it now and the additional costs funding it in the future.’

Responding to the inquiry report, NHS England’s national clinical director for urgent and emergency care, Professor Julian Redhead, said: ‘While this report includes data which is more than two years old and coincided with a once in a generation pandemic, it is right to note the NHS has been under increasing pressure with staff experiencing record A&E attendances, hospitals fuller than at any point in their history and with thousands of beds taken up each day, in part, due to pressures in social care.

‘It is testament to the hard work of staff and results of our NHS winter plan – rolling out 800 new ambulances, 10,000 virtual ward beds and work towards 5,000 extra core beds – that waiting times for ambulances, 999 calls and in A&E have improved across the country during this financial year.

‘This progress has come as the NHS has committed to delivering £12bn of annualised savings by 2024/25 – all while dealing with more than a 100,000 staff posts being vacant.’

A version of this story was originally published by our sister publication Healthcare Leader.

Bispecific antibody glofitamab available on the NHS ‘within weeks‘ for advanced lymphoma

19th October 2023

The NHS will fast-track the bispecific antibody glofitamab (brand name Columvi) for treating relapsed or refractory (R/R) diffuse large B‑cell lymphoma (DLBCL) in adults after two or more systemic treatments following its recommendation by the National Institute for Health and Care Excellence (NICE).

Set to be made available in England ‘within weeks‘, glofitamab is the first off-the-shelf CD20xCD3 T-cell engaging bispecific antibody. Administered as an intravenous infusion, it works by encouraging healthy immune cells in the body to destroy the cancer cells.

While current DLBCL treatments such as CAR T therapies are provided in specialist centres across England, glofitamab can be offered at more cancer treatment sites across the country, improving timely access. It is thought that more than 700 people in England could benefit from the treatment.

NHS England’s Cancer Drug’s Fund Lead, Professor Peter Clark, said: ’The approval of this drug is great news for people living with an advanced and aggressive form of blood cancer, who are set to benefit from this new treatment.

’Not only does it provide a potentially life-saving option for patients who may have not responded to CAR T therapy, it is also an alternative for some CAR T eligible patients who choose instead to have glofitamab closer to home.

’This is the latest in a long list of cutting-edge drugs available on the NHS to help people with cancer live a longer and better-quality life.’

Helen Knight, director of medicines evaluation at NICE, added: ‘We are committed to getting the best care to patients fast while ensuring good value for the taxpayer.

‘Advanced B-cell lymphoma is an aggressive form of blood cancer and can progress quickly. The sooner people can access the best treatment for them, the better chance they have of living for longer and improving their quality of life.

‘This is why it is such good news that our independent committee has found that glofitamab is clinically and cost effective for treating people with this advanced form of cancer, and we welcome the news that NHS England will make this available to patients quickly.‘

Positive glofitamab trial results

The NICE recommendation coincides with glofitamab receiving its license by the Medicines and Healthcare products Regulatory Agency and is based on the positive results obtained from the Phase 1/2 NP30179 study.

Of the 154 participants who received treatment, 39% (95% confidence interval [CI], 32 to 48) had a complete response at a median follow-up of 12.6 months.

The majority (78%) of complete responses were ongoing at 12 months. The 12-month progression-free survival was 37% (95% CI, 28 to 46).

The most common adverse event was cytokine release syndrome (CRS) (63%). Adverse events of grade 3 or higher occurred in 62% of the patients, with grade 3 or higher CRS in 4% and grade 3 or higher neurologic events in 3%. Discontinuation of glofitamab due to adverse events occurred in 9% of the patients.

Referring to the rollout of bispecific antibodies as a breakthrough for patients with lymphoma, Dr Wendy Osborne, an NHS consultant haematologist specialising in lymphoma at the Freeman Hospital in Newcastle, said: ‘Bispecific antibodies use the patient’s own white blood cells to attack and kill the lymphoma, a form of blood cancer. The antibody has two arms: one arm attaches to the cancer cell and the other to the patient’s own white blood cell, a T-cell.

‘By bringing these cells together, the patient’s own immune system is activated and kills the cancer cell and so chemotherapy is not required. Patients don’t have the side effects of chemotherapy and often feel well on this outpatient-based treatment.‘

Glofitamab gained conditional marketing authorisation in the EU in July 2023.

Earlier in 2023, glofitamab was found to induce a fast and durable complete response rate in patients with refractory mantle cell lymphoma.

NHS England bosses join calls for Government to resume strike talks as winter pressures loom

5th October 2023

‘Serious discussions’ must resume between the Government and doctors to end strike action ahead of winter, NHS England bosses said today.

At this afternoon’s board meeting, NHS England chair Richard Meddings stressed that winter pressures ‘impossible to manage’ if also impacted by strike action.

And chief executive Amanda Pritchard noted talks between the Government and doctors needed to urgently resume.

Following months of strike action, consultants and junior doctors have jointly been striking for three full days this week, with ‘Christmas Day’-level cover.

Mr Meddings told the board that it is ‘simply not sustainable to continue to operate with this amount of disruption’.

He said: ‘There’s simply not enough staff on “Christmas Day cover” days to complete the usual tasks while also dealing with business-as-usual levels of demand.

‘It would be impossible to manage this coming into the winter period. But we will continue of course to do all we can to keep caring for patients, putting them first but we urgently need to see a clear path to resolution and for all parties to work together to do the right thing by patients and to find an agreement to this dispute.’

Ms Pritchard said that the focus of NHS England’s discussions with both unions and Government regarding the strike action continues to be patient safety.

She added: ‘We all want to see serious discussions resume between unions and Government and with winter approaching that cannot happen soon enough.’

The Department of Health and Social Care declined to comment and instead pointed towards a previous statement.

This saw health secretary Steve Barclay urging unions ‘to end their relentless strike action’ and argued that doctors ‘have received a fair and reasonable pay rise – as recommended by the independent pay review body, which we’ve accepted in full’. 

The BMA has repeatedly asked the Government to return to the negotiating table, with consultants saying this week that they are willing to involve reconciliation service ACAS and revive strike action discussions.

Yesterday NHS England told the British Medical Association (BMA) in a formal warning letter that ‘cumulative’ impact of doctor strikes are now causing ‘significant disruption and risk to patients’.

However the BMA argued that patient safety is being put at risk due to strike planning failures by NHS England.

BMA council chair Professor Phil Banfield said that the union has always been open to discussing ways to maintain patient safety.

BMA Cymru Wales has announced it will ballot junior doctors in Wales for strike action for six weeks from the 6 November. If successful, it will lead to a 72-hour full walk-out by participating junior doctors in Wales.

This comes following ’the Welsh Government’s failure to make any effort to restore junior doctors’ pay, which has left BMA Cymru Wales with no choice but to enter a trade dispute and ballot for strike action’, it said.

A version of this story was originally published by our sister publication Pulse.

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