Business | NAFW
| Name of respondent:Mansel Aylward, Jonathon Gray and David Seal |
| Are you responding on behalf of an organisation?YES |
| If so please give the name Wales Centre for Health |
| Address:14 Cathedral Road, Cardiff, CF11 9LJ |
| Telephone number:(029) 2022 7744 |
| Would you be willing to give oral evidence to the Committee?YES |
| 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:The
following is a response on behalf of the Wales Centre for Health. |
| I am content for my evidence to be publishedN/A |
| I am not content for my evidence to be published N/A |
Business | NAFW
| 1 |
How can information technology be used more effectively to track and facilitate the patient’s journey? |
| Response |
We need a common data set for all cancer patients and families across Wales. Too often episodes of care are recorded in separate databases. This should include cancer genetic information. |
| 2 |
How effectively is research and good practice being integrated with service delivery? What can be done and by whom to improve this? |
| Response |
Moderately well. There is a clear need to increase the recognition of Cancer Genetics (provided through all Wales Medical Genetics Service) as a conduit for research in the critical area of genetics to the patient/family. |
| 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 |
Currently too complex. We should use the networks to commission on a regional level. An agreed national framework is nevertheless needed to guide and inform the commissioning process. |
| 4 |
What evidence is there of the value of screening and immunisation? |
| Response |
Screening is critical. Cancer genetics can identify many at risk - and we can build on the successful breast cancer screening collaboration to effectively detect other cancers in at-risk people. |
| 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 |
Fragmented commissioning - resolve by using the networks. Joined-up approaches are essential and should be informed by Community Health Profiles. There is a pressing
need to establish a national framework for commissioning with a strong evidence-base. Constraints in service capacity impacts on variation in practice and treatment. Increase in the use of chemotherapy does result in lack of appropriate facilities to prepare
and administer sytotoxic drugs. Shortages in relevant health care professionals and specialists pharmacist add to the problem. |
| 6 |
How can the NHS and the voluntary sector work together more effectively to deliver services? |
| Response |
Critically important to involve voluntary sector to engage effectively with the public and inform public opinion. (cf: response to 8(i) below) |
| 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 |
We have piloted, but would ask for more work on addressing family history of cancer in terminally ill so that screening can be put in place for surviving family. |
| 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 |
A firm stance should be taken to reduce such prescribing. More effort should be put in to engaging and communicating with the public on these issues with a more structured and robust strategy and policy to more effectively to harness the power of the media,
community leaders, voluntary groups, and stakeholders. |
| 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 |
A cautious approach is needed; but this general policy is probably unwise and could be inequitable in the provision of NHS services which are not directly involved with the administration, monitoring and follow up of such cases. Each case should be considered
on its individual merits. In the final analysis the clinicians caring for the individual patient in such circumstances should have a pivotal role in deciding the merits of the case. |
| 8(iii) |
Do doctors, pharmacists and other health professionals have adequate access to independent advice and guidance on the prescribing of drugs? |
| Response |
No: therapeutic and technology appraisal processed and issue of clear, unambiguous and authoritative guidance must play a critical role to balance the plethora of information provided by a commercially driven pharmaceutical industry. Current mechanisms for issuing
independent and authoritative guidance in this area needs to be strengthened. |
| 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 |
There have been good attempts through the networks a more coordinated approach with charities in developing agendas for services is essential. |
