4. What measures will the Welsh Government introduce to improve lung cancer outcomes in the next 12 months? OAQ52808

Health boards and trusts are working to improve lung cancer outcomes in a number of ways, including the development of a value-based pathway of care. This will make the best use of the resources that are available, tackle variation in care, and deliver the outcomes that matter to people.

Thank you very much for the reply, Minister. Lung cancer is the third most common cancer in Wales, but it is responsible for the majority of cancer-related deaths. Like all cancers, it can be effectively treated or survival can be improved if diagnosed early. However, only 16 per cent of patients in Wales are diagnosed at stage 1. NHS England recently rolled out a one-stop shop designed to catch cancer early and speed up diagnosis. The centres act as a point of referral for people with vague, non-specific symptoms that their GP or healthcare professional suspects may be cancer. These centres have proved effective at identifying potential lung cancer patients before symptoms appear and before the cancer has advanced or set in the body. Will the Minister agree to consider introducing such a one-stop shop here, so that Wales will no longer have the poorest survival rates of all United Kingdom nations?

We have a number of things that we focus on on cancer outcomes, including implementing a lung cancer pathway through the lens of value-based healthcare. One-year survival from lung cancer has improved 5.8 percentage points, and five-year survival by 4 percentage points, between 2005 and 2009 and between 2010 and 2014. The cancer patient experience survey showed that 93 per cent of lung cancer patients reported a positive experience of their care—a significant improvement when compared against the previous survey.

We do have a national leadership group of expert clinicians, the Wales thoracic oncology group, that works within the cancer network to co-ordinate activity in Wales. The group has overseen a national lung cancer initiative over the past three years that included a symptom awareness campaign, a programme to get people ready for surgery, and to improve access to that surgery. We've also improved access to stereotactic ablative radiotherapy by funding new equipment at the Velindre Cancer Centre so that patients can access the advanced radiotherapy technique in Wales. In addition, the new treatment fund has led to faster access to a number of new drugs, including several for lung cancer. So, the Member can be assured that it is a matter we are keeping under close regard. 

Leader of the house, the reason Wales has some of the worst lung cancer survival rates in Europe is due, in the main, to delays in diagnosis. Unacceptably long waits for diagnostic tests and routine downgrading of general practitioner referrals contribute to late diagnosis of lung cancer. So, leader of the house, what is your Government doing to cut diagnostic waiting times and ensure that GP referrals are not downgraded?

We have some really interesting things happening in in this field, actually. The Welsh Government, like the rest of the UK, follows the expert advice of the UK National Screening Committee. The UKNSC does not currently recommend routine asymptomatic screening for lung cancer, but we are due to review the policy after the results of the NELSON randomised lung cancer screening trial are published. If that recommendation is for screening for lung cancer, the Wales screening committee will consider how this can be appropriately implemented in Wales, with a view to speeding up the screening. The National Institute for Health and Care Excellence recommends the primary investigation for suspected lung cancer is an urgent chest x-ray for people aged 40 and over with defined unexplained symptoms, and GPs are aware of this.