National Assembly for Wales
Health and social Services Committee
Review of Cancer Services for the People of Wales
| Name of respondent: Lorraine Nicholls (Specialist Network Manager) on behalf of David McNaughton (Team Leader for Pfizer Oncology) |
| Are you responding on behalf of an organisation?Yes |
| If so please give the name Pfizer Oncology |
| Address:Pfizer Ltd Walton Oaks Dorking Road Tadworth Surrey KT20 7NS |
| Telephone number: 01737 330904 (c/o Jo Krag) or Mobile 07798 926801 |
| Would you be willing to give oral evidence to the Committee? No |
| 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 use of information technology has the potential to help deliver significant improvements by:
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| 2 | How effectively is research and good practice being integrated with service delivery? What can be done and by whom to improve this? |
| Response | Pharmaceutical companies can help by sharing knowledge on their oncology pipeline to the NHS. There should be better dialogue / collaboration between Pfizer clinical research and the Welsh R&D group. To effectively integrate research into service delivery, improved evidence based medicine training when trial results are available to disseminate and discuss evidence at MDT type meetings. Also identify research areas important within Wales based on epidemiology and consultants experience. |
| 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 | The commissioning service is too complex with no accountability for cancer services. This involvement could be defined better with greater responsibility through consistent and transparent approach. From a cancer network perspective, there could be devolvement of budgets but statutory requirements would have to change in the future. There is a requirement for more clarity with regards to NICE / AWMSG process (see ABPI / WIG cancer response). |
| 4 | What evidence is there of the value of screening and immunisation? |
| Response | More extensive screening for biomarkers would allow better identification of suitable patients for targeted therapies. Better use of available drugs and identification of trial patients. There is evidence to suggest that early intervention is critical, perhaps focus attention on groups who don’t present early. |
| 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 | The main barriers are the continuous and rapidly changing landscape within the NHS, negative perception of the industry ad delays in trial coordination leading to low recruitment and less experience of new therapies. The barriers could be overcome by a number
of initiatives;
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| 6 | How can the NHS and the voluntary sector work together more effectively to deliver services? |
| Response | There should be a single source of funding for more joint accountability and responsibility by getting patient representatives fully involved in this process. Also patient education / information are essential as we have recently seen through the Cancer Information Maze publication. |
| 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 | As NHS discuss and implement a patient led NHS, should it be patient choice? This requires good IT links to essential services, and the ability to audit at local level. Perhaps services redesign to take account of relative, patient and carer. |
| 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 | There are a number of potential ways to reduce the inappropriate prescribing of treatments by;
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| 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 | Pfizer Oncology believes this is an ethical / moral dilemma for any HCP / authority. Patients should be allowed to pay for treatment to relieve pressure for the NHS current financial environment. However, patients should not be forced to pay for part or all treatment if all their financial ability does not allow them to do so. If the payment is to relieve the current NHS situation, should the DoH be re-evaluating the PbR and tariffs within future cancer and relates treatments. |
| 8(iii) | Do doctors, pharmacists and other health professionals have adequate access to independent advice and guidance on the prescribing of drugs? |
| Response | No, for truly independent advice and guidance. There are such groups as Welsh MRec (not high profile enough), NeLH, EBM, SMC, NICE and LNDG. The question to ask is independent of what? NHS, manufacturers, DoH or HTAs? |
| 9 | Are services centred on the patient, with service users consulted? If not what are the reasons for this and how can patient involvement be improved? |
| Response | Patients are sometimes consulted on services but never on budgets which may be the constraining factor for cancer care. Patient involvement could be improved by the development of jointly written and signed treatment management plans by patient and MDT. Inviting patient experience to be inputted on services and potential changes may assist the future patient led NHS. |
