6. What action is the Welsh Government taking to improve services for people affected by neuroendocrine tumours? OAQ(5)0043(HWS) 

The Welsh Government is committed to improving the provision of the neuroendocrine tumour services in Wales. The Welsh Health Specialised Services Committee has carried out a thorough review of south Wales services and is now working to implement improvements.

Cabinet Secretary, I’ve been contacted by constituents who are concerned about delays in neuroendocrine tumour referrals. What assurances can you give that such referrals take place within the timeframes and guidelines recommended by the Welsh Health Specialised Services Committee?

Thank you for the question. In north Wales, people access a specialist service in Liverpool and there isn’t a particular issue about access. The challenge here in south Wales is how—. There is the ability, for people who wish to, to access services in England while we’re working on a model here. It is a specialist service and it’s a relatively rare indication. The challenge has been working through the previous recommendations. We had a stakeholder meeting in September—literally three weeks ago. That’s been carried forward and I expect that the Welsh Health Specialised Services Committee’s management board will then make a choice about the future delivery of the service model.

I recognise that the pace has not be as quick as both people in the service and patients would want it to be, but there is a recognition that a choice needs to be made and then people need to get on with delivering that model for the future. At this point in time, I think people are travelling further than they perhaps could do or should do. Having a properly specialist service organised in this manner should actually mean that we can improve outcomes for people as well as access.

Cabinet Secretary, there have been various tensions in the system, obviously, depending on where you live in Wales, as to exactly when you might be seen. There are some examples of excellent practice and then in other areas, there are delays in actually progressing through to the treatment path and cancer services. We have put forward, on several occasions—and it has been proven in practice in other parts of the United Kingdom—that if a senior oncologist was put in post to have a national overview to drive improvements in cancer services, this could act as a beneficial improvement in waiting times and in the general delivery of cancer services across Wales.

What would your view be of putting an individual in place with the necessary clinical background to help assist you in your role, and your officials, in driving forward improvement on cancer waiting times, so that the postcode lottery is, as best as it can be, taken out of the system?

On the particular part of neuroendocrine tumours, we do have a path forward where there is clinical leadership and a recognition of what we need to do. We’re awaiting the outcome from the Welsh Health Specialised Services Committee. I think you’re asking a much broader question about cancer services in general. Of course, I indicated yesterday—I’m not sure if you were back at the time—that the cancer delivery plan is being refreshed. It’ll be launched before the end of the calendar year and that does provide both service leadership and clinical leadership. And importantly, the third sector is involved in that too.

The challenge is whether we have a national clinical lead indicated, and whether that will really drive improvement. But I think that, given the work that has been done on that refresh and given the—. In the clinical community in Wales in cancer services, there’s actually a real unity of purpose that I think the delivery plan process has helped us to deliver. So, I don’t think it’s about a national clinical lead for this area or having a particular oncologist appointed. It’s really about saying: when we get that plan, how do we deliver it at pace and at consistency, and what reforms do we need to make about the way we deliver those services, both in primary care, with primary care oncology support, as well as what we need to do in secondary care and over the whole pathway? So, there’s lots for us to go at and I’m optimistic that we can do that over the course of this term and have not just better access, but better outcomes for people here in Wales as well.