Who we are

In the UK, All.Can is a partnership between leading health charities and biopharmaceutical companies with a shared ambition for cancer patients to receive world-class, patient-centred care that is sustainable for the NHS to deliver.

All.Can UK is a multi-stakeholder initiative involving patient group and industry experts. All.Can UK is funded by Bristol Myers Squibb (primary sponsor) and MSD (supporting sponsor). All.Can UK is chaired by The Patients Association, a leading national charity which is dedicated to supporting the rights and interests of all patients and their families. The initiative brings together a collaborative Working Group of health charities.

What we do

The initiative brings together a collaborative Working Group of health charities to identify the current inefficiencies in cancer care and develop evidence-based, best practice solutions that put the patient first. Together, we collectively advocate for their implementation by Government and NHS system leaders:

  • Put patients at the heart of cancer policy – and make sure that efforts to drive efficiency are always focused on what matters to patients and their families.
  • Invest in data and systems – to help improve efficiency across all aspects of cancer care.
  • Create accountability – by using data to drive changes in relevant national and regional policies and legislative/non-legislative frameworks.
  • Focus political will – to drive the implementation of efficient practices into cancer planning, policies and practice across the UK, and with the engagement of all relevant stakeholders.
  • Ensure the sustainability of cancer care – define solutions for sustainable cancer care and improve patient outcomes in the future.

Why we do it

Every two minutes someone in the UK is diagnosed with cancer.1 Now, half of the UK population born after 1960 can expect to receive a cancer diagnosis in their lifetime,1 and the survival rate of people with cancer in the UK has doubled over the last 40 years2 – the highest it has ever been.3. This is leading to cancer services facing record-breaking levels of demand4 as cancer is increasingly seen a long term condition.

A cancer diagnosis is not only life changing for a patient, it is hugely costly to both the NHS and wider economy. At this time of increasing incidence and survival, it is imperative that the NHS is able to deliver more with less whilst always providing the very best possible care for patients.

Furthermore, the NHS has historically needed to balance increasing demand with funding pressures, which has resulted in finances focussing on covering day-to-day operating costs rather than transforming services for the benefit of patients.5

It was therefore highly welcome that the NHS Long Term Plan 3, published in 2019, signalled the health service’s long-term commitment to improving cancer care for patients. Key milestones relating to early diagnosis, screening and personalised care3 will all help to improve care pathways and the provision of services, but it is important to ensure that these changes are made in the areas that matter most to patients to ensure that they feel supported throughout their treatment and beyond.

How we do it

In order to support the NHS in improving patient care, All.Can looks to provide proactive and implementable solutions for UK policymakers and NHS leaders to improve NHS efficiency, share learnings from best practice in cancer care and develop a world class cancer service in the UK.

All.Can patient survey

All.Can International conducted a patient survey in more than ten countries, which asked almost 4,000 cancer patients1 and carers where they identified inefficiencies in their care. We define waste and inefficiency as any aspect of cancer care that is not focused on what matters to patients. The UK was a pilot site for the international survey, the findings of which were presented at the Britain Against Cancer conference, in the UK Parliament, in December 2018.

The UK survey results highlighted that there are opportunities to improve efficiency across the entire care pathway: from screening and diagnosis, through to the treatment and care that patients receive, and follow-up:

  • 2 in 5 responders said they were diagnosed with something different – either initially or on multiple occasions.7
  • 1 in 5 people with cancer had to wait for more than six months to be diagnosed with cancer.8
  • 20% of respondents said that they did not need some sort of psychological support during/after their cancer care. Of those who did, half said that it wasn’t available.8
  • Approximately 40% were not given any information about patient groups, charities, or other organisations who could support them.8

Our current focus

In light of the UK findings of the All.Can survey, the Working Group collaboratively agreed the initiative’s four priorities: 9

  • To improve patient experience, the NHS should value the psychological and emotional wellbeing of patients equally to their physical health.
  • To improve cancer outcomes, the NHS should incentivise best practice in early diagnosis and its dissemination.
  • To improve public awareness, the NHS should ensure the provision of accessible information throughout the care pathway by collaborating with PAGs more actively.
  • To ensure there is capacity and skillset within the workforce to meet demand now and in the future, the NHS should work with Health Education England to implement the Cancer Workforce Plan and the NHS People Plan.

Placing the psychological wellbeing of people with cancer on equal footing to physical health

Following the UK results of the All.Can survey, the Working Group decided it would focus on the value of psychological and emotional wellbeing for people with cancer:

  • The link between mental health and cancer is well understood, with around one in four cancer patients requiring expert psychological assessment and intervention as a result of their diagnosis.8
  • The NHS has taken steps to expand the availability of mental health services in recent years;3 however, there remains unmet need.9
  • The number of cancer survivors in the UK is projected to increase by approximately one million per decade from 2010 to 2040; resulting in four million people living with cancer in 2030.10 As a result, there potentially could be a growing burden placed on the health service to provide support to patients.

In order to gain a deeper understanding of inefficiencies in cancer care, All.Can UK have developed a report, All.Can UK: Placing the psychological wellbeing of people with cancer on equal footing to physical health. To inform this report, All.Can UK undertook the following activity:

  • Extensive literature review
  • Oral Evidence Sessions with patient groups
  • Interviewed academic experts in the field of mental health and cancer care
  • Engagement with Working Group members

The evidence uncovered barriers that patients face in accessing mental health support and examples of best practice across the NHS and voluntary sector in providing it. Key themes include:

  • A lack of awareness within the NHS oncology workforce about patients’ psychological wellbeing
  • Variation in access to mental health screening for people with cancer
  • A ‘one size-fits-all’ approach to care

The report makes the case for the NHS and the wider oncology community to come together and address the unmet need in service provision for mental health care during the cancer pathway. In 2021 and beyond, All.Can UK is focusing on activity to realise the recommendations through a campaign called Cancer: Out of Sight Not Out of Mind.

You can download the report here.

If you would like more information on the report, please email the All.Can Secretariat at All.Can@hanovercomms.com

References

  1. Cancer Research UK, Cancer Statistics for the UK. Available here: https://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk#heading-Zero [accessed: November 2020]
  2. Cancer Research UK, Cancer survival statistics. Available here: https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival [accessed: November 2020]
  3. NHS England (2019), NHS Long Term Plan. Available here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf [accessed: November 2020]
  4. NHS England and NHS Improvement Board (2019), Operational performance report. Available here: https://www.england.nhs.uk/wp-content/uploads/2019/09/BM1920-operational-performance-report.pdf [accessed: November 2020]
  5. NHS Confederation (2018), System Under Strain: Why demand pressures are more than a winter phenomenon. Available here: https://www.nhsconfed.org/-/media/Confederation/Files/Publications/System-under-strain-report-WEB.pdf. [accessed: November 2020]
  6. All.Can, All.Can patient survey. Available here: https://www.all-can.org/what-we-do/research/patient-survey/ [accessed: November 2020]
  7. Quality Health (2018), All.Can Patient Experience Survey. Final table of detailed results – UK.
  8. Macmillan Cancer Support (2015), Psychological support: sharing good practice. Briefing. Available here: https://www.macmillan.org.uk/documents/aboutus/health_professionals/macvoice/psychological-support-sharing-good-practice.pdf [accessed: November 2020]
  9. NHS Providers (2019), Mental Health Services: addressing the care deficit. Available here: https://nhsproviders.org/media/606029/mental-health-services-addressing-the-care-deficit.pdf [accessed: November 2020]
  10. Macmillan Cancer Support (2019), Statistics fact sheet. Available here: https://www.macmillan.org.uk/_images/cancer-statistics-factsheet_tcm9-260514.pdf [accessed: November 2020]
  11. Westminster Health Forum (2019), Westminster Health Forum policy conference: Cancer care in England – access to treatment, improving diagnosis and implementing the NHS Long Term Plan. Agenda.
  12. Macmillan Cancer Support, Right there with you. Available here: https://www.macmillan.org.uk/about-us/what-we-do/right-there-with-you [accessed: November 2020]
  13. All.Can UK: Placing the psychological wellbeing of people with cancer on equal footing to physical health. 2020.
  14. All.Can UK Infographic: Placing the psychological wellbeing of people with cancer on equal footing to physical health. 2020.
  15. All.Can UK Pledge card: Placing the psychological wellbeing of people with cancer on equal footing to physical health. 2020

Contact

All. Can UK Secretariat, Hanover Communications

All.Can@hanovercomms.com

A range of health charities from across the cancer community have inputted into the development of this programme and work together to deliver it. A full list of our current members can be found below:

 

Chair

The Patients Association

Steering Committee

Melanoma UK

Brain Tumour Research

Bristol Myers Squibb

Funding Partner

MSD

Funding Partner

Working Group

Bowel Cancer UK

Brain Tumour Research

British Liver Trust

Cancer52

Fight Bladder Cancer

Kidney Cancer UK

Look Good Feel Better

Melanoma UK

Pancreatic Cancer UK

Shine Cancer Support

The Patients Association

The Urology Foundation

All.Can UK hosts Annual General Meeting

In November 2020, All.Can UK hosted its second Annual General Meeting (AGM). The meeting was an opportunity to reflect on the initiative’s activity over the past year which included finalising the psychological wellbeing report and associated materials.

During the meeting, the Working Group discussed and agreed the 2021 programme of work which will focus on the dissemination of the psychological wellbeing report through the Cancer: Out of Sight Not Out of Mind campaign.

The AGM also saw the election of the All.Can UK’s Steering Committee. Nominations ran for the Steering Committee in November, with two members being elected to sit alongside the Chair and All.Can UK’s two Funding Partners (Bristol Myers Squibb and MSD):

  • Melanoma UK
  • Brain Tumour Research

We welcome the new Steering Committee and look forward to their contribution to shaping All.Can UK throughout 2021. We also would like to thank Bowel Cancer UK for their contribution in 2020.

All.Can UK hosts inaugural Annual General Meeting

In November 2019, All.Can UK hosted its first AGM, which focused on putting in place the appropriate Governance structures for the initiative and aligning on the initiative’s strategy and priorities for 2020.

The meeting was an opportunity to reflect on the initiative’s activity over the course of 2019, which included a webinar, a Working Group meeting in May (at which Macmillan Cancer Support presented on their cancer navigator pilot), the initial development of a report on psychological wellbeing in cancer, and attendance at the annual Westminster Health Forum seminar on cancer.

Similarly, the Working Group discussed and agreed the 2020 programme of work. In line with All.Can UK’s priorities, activity in 2020 centred on psychological wellbeing in cancer and the finalisation of the report, including an external launch.

Notably, the AGM saw the election of All.Can UK’s Steering Committee, who provide the executive function of the group. The Steering Committee oversees the strategic direction of All.Can UK and ensures it is achieving its stated aims. Nominations ran for the Steering Committee in November, with two members being elected to sit alongside the Chair and All.Can UK’s two Funding Partners (Bristol Myers Squibb and MSD):

  • Melanoma UK
  • Bowel Cancer UK

We welcome the new Steering Committee member and look forward to their contribution to shaping All.Can UK throughout 2020.

 All.Can UK support Westminster Health Forum event on cancer care

In September 2019, Rachel Power, Chair of All.Can UK and Chief Executive of the Patients Association, spoke on behalf of All.Can at the Westminster Health Forum’s 2019 seminar ‘Cancer care in England – access to treatment, improving diagnosis and implementing the NHS Long Term Plan’.11

During her speech and subsequent panel appearance, Rachel stressed that the patient voice should be central to service design; indeed, every single decision about a person’s care should be delivered in a way that meets their personal needs. For this reason, improvements to the diagnosis pathway must be led by engagement with patients and an understanding their experiences.

Quality Health also featured and discussed results of All.Can’s patient survey alongside the National Cancer Patient Experience Survey. Importantly, All.Can’s patient survey covered the entire patient pathway, from diagnosis through to the support received by patients during their treatment and beyond. Strikingly, 2 in 5 respondents said their cancer was misdiagnosed either initially or multiple times and 1 in 5 people with cancer had to wait for more than six months to be diagnosed with cancer.8

This was a significant opportunity for All.Can UK to raise awareness of the survey’s findings and generate consensus about the need to refocus efforts relating to service design so that they can be improved in the best interests of patients.

 

All.Can UK hosts annual Working Group meeting with Macmillan Cancer Support

In May 2019, a record number of patient groups came together at our annual Working Group meeting to hear from Macmillan Cancer Support and Quality Health on the results of All.Can’s global patient survey.

The meeting was highly informative and productive and benefitted from a wide representation of the cancer community. Macmillan Cancer Support provided attendees with information about their ‘Right there with you 12’programme and the cancer navigation pilot. This presentation was highly timely given the results from All.Can’s recent patient survey and the UK initiative’s focus on psychological wellbeing and the need to ensure patients are supported throughout their care and treatment journey.

Attendees also heard from Quality Health about the interim results from the international All.Can patient survey.

All.Can UK: Placing the psychological wellbeing of people with cancer on equal footing to physical health

Disclaimer:

All.Can UK is a multi-stakeholder initiative involving patient group and industry experts. All.Can UK is funded by Bristol Myers Squibb (primary sponsor) and MSD (supporting sponsor). All.Can UK is chaired by The Patients Association, a leading national charity which is dedicated to supporting the rights and interests of all patients and their families. The initiative brings together a collaborative Working Group of health charities.

Job bag number: ONCUK2001211-01 GB-NON-03353
Date of prep: November 2020