National Assembly for Wales

Health and Social Services Committee

Review of Cancer Services for the People of Wales

Name of respondent:

Dr A T Axford

Are you responding on behalf of an organisation?

Ceredigion and Mid Wales NHS Trust

If so please give the name

Address:

Caradog Rd
Aberystwyth
SY23 1ER

Telephone number:

01970 635748

Would you be willing to give oral evidence to the Committee?

If required

If the evidence you give below is your personal view, rather then that of an organisation, please state whether or not you are willing for your evidence to be published by putting a X in the appropriate box below:

I am content for my evidence to be published X

I am not content for my evidence to be published

1	How can information technology be used more effectively to track and facilitate the patient’s journey?
Response	Improved and increased use of tele-health - E referral televised MDT meetings, availability of PACS imaging of telepath systems.
2	How effectively is research and good practice being integrated with service delivery? What can be done and by whom to improve this?
Response	The Welsh Cancer Trials Network has done much to change the culture of R&D in Wales and needs to be built on with more financial support.
3	What are your views on the complexity of commissioning services? Is the process hampered by the involvement of the local health boards, cancer networks and Health Commission Wales? How could it simplified?
Response	Significantly hampered by LHB’s - would favour regional commissioning by cancer networks.
4	What evidence is there of the value of screening and immunisation?
Response	Screening for cervical and breast cancer has a reasonable evidence base, but screening for prostate and colo-rectal CA remains uncertain.
5	What are the barriers to the NHS in Wales keeping abreast of, and responding to, developing technologies and therapies? How might these barriers be overcome?
Response	Lack of investment in new technologies - e.g. chart is not available in some networks.
6	How can the NHS and the voluntary sector work together more effectively to deliver services?
Response	Hospital at Home is a good example of the need for more linkage between NHS & voluntary sector - voluntary bodies should be allowed better engagement.
7	How can the collection and use of data on where the terminally ill spend their last weeks or months be improved better to inform service provision for those people?
Response	It should be possible to enhance CANISC to capture this data.
8	There are a number of issues around prescribing and the cost of drugs:
8(i)	What should be done and by whom to reduce continued prescribing of inappropriate drugs?
Response	Within each network there should be a patient pathway with explicit guidance on chemotherapy regimes. Regular audit by cancer network required.
8(ii)	Should people who are prepared to pay privately for drugs not available to them on the NHS, be able to do so without having to become private patients and having to pay for all their treatment?
Response	This sets a dangerous prededent and puts clinicians in an invidious position.
8(iii)	Do doctors, pharmacists and other health professionals have adequate access to independent advice and guidance on the prescribing of drugs?
Response	Yes
9	Are services centred on the patient, with service users consulted? If not what are the reasons for this and how patient involvement be improved?
Response	To some extent yes, but room for increased patient and carer involvement.