Scrap Follow-up Checks for Cancer Survivors?

Daily Telegraph Thursday 26th December 2013

By Laura Donnelly, Health Correspondent

Routine follow-up appointments for cancer survivors should be scrapped before the NHS is overwhelmed by demand, a leading charity has said.

Macmillan Cancer Support said the system of six monthly check-ups for those recovering from the disease was no good for patients and could bankrupt the health service unless it was radically overhauled.

The charity said the time that hospitals spend on routine follow-up appointments has increased almost ten-fold since the Seventies, because of increasing cancer incidence and higher survival rates.

Advances in cancer treatment mean that the number of survivors is forecast to double to four million within 15 years, and Cieran Devane, the charity’s chief executive, said this meant that hospitals would otherwise be “overwhelmed” by demand.

He said that the current system, which means most survivors see their specialist every six months for five years, does not properly target help towards those who need it or give patients enough advice about the symptoms which mean they should seek urgent help. The charity is calling for an overhaul of the blanket system and says that, instead, all patients should be given far more help when their treatment finishes with more information passes to family doctors so that side-effects and any subsequent disease can be detected.

Mr Devane said: “Put simply, the current follow-up appointments system is past its sell-by date and is no longer fit for purpose. The health and social-care services across the UK must radically transform how they deal with patients’ aftercare, especially as the number of people getting and surviving cancer is soaring.

Doctors need to be able to identify which patients need regular face-to-face appointments and specialist support and which don’t. They also need to support cancer patients to develop the skills to manage their own condition.

The pressure on hospitals will only get worse. Cancer specialists will be overloaded if we continue with the current system, which is wasteful for the NHS and does not give survivors the support they actually need.”

Death rates from cancer in Britain have fallen by more than a fifth since 1990.

The charity said that about one in five cancer survivors is likely to benefit from regular follow-up appointments but that all needed to be given far more information about symptoms that could mean the return of the disease, or other conditions associated with cancer, which were unlikely to be detected in routine check-ups.

Studies have found that women who survive breast cancer have twice the risk of suffering from heart problems, while prostate cancer survivors have twice the risk of osteoporosis.

Mr Devane said that a new system of care should also ensure that patients had a number to call so that they could quickly access help instead of waiting for routine check-ups.

Schemes using this model are already in place for breast cancer in Northern Ireland, bowel cancer in Sheffield and head and neck cancer in West Yorkshire.