John Baron MP criticises ‘process targets’ in NHS cancer debate

MP seeks clarification from Minister over funding release

Yesterday afternoon, John Baron MP led a Westminster Hall debate into NHS cancer targets. As Chairman of the All-Party Parliamentary Group on Cancer (APPGC), John has worked to persuade the NHS to focus more on outcomes, such as one-year survival rates in order to encourage earlier diagnosis, and less on process targets such as the 28-day and 62-day wait targets.

In Westminster Hall, John said,

“Despite both Front Benches having highlighted improving survival rates when in Government, and supported process targets as a means of driving change, it remains an ‘inconvenient truth’ that cancer survival rates in England continue to lag well behind international average survival rates – what is more, there is very limited evidence that we are catching up.”

“In recent decades, the NHS has been beset by numerous ‘process targets’, which instead of measuring the success of treatment, measure instead the performance against process benchmarks. These have their role to play, but all too often are a blunt tool offering information without context and which, in my view, can hinder rather than help access to good treatment – especially when financial flows are linked to these process targets.”

“The APPGC’s most recent report highlighted an example when process targets can act against patients. In 2016, NHS England announced £200 million of Transformation Funding, intended to help the newly-formed Cancer Alliances to achieve the standards set out in the 5-year Cancer Strategy to 2020, and bids were invited. However, after the bidding process closed, a requirement for good performance against the 62-day wait target was retrospectively introduced – resulting in multiple Alliances, whose performances were deemed not good enough, not receiving their expected funding allocation.”

“In the longer-term, the NHS needs to rebalance its focus altogether away from process targets in favour of those outcome measures, such as one-year cancer survival rates, which best help patients. Moreover, if outcome measures are good, it follows that processes will also be good – patients will be seen and diagnosed in a timely fashion, appropriate to their illness – whilst also having the benefit of allowing the NHS to design services and pathways flexibly and without the ‘straitjacket’ imposed by blunt process targets.”

In his speech, the Cancer Minister, Steve Brine MP, when responding to John’s points said that performance against the 62-day wait process target is not a pre-requisite for funding release.

Afterwards, John said,

“It was a good debate, and I am grateful to all those who made a contribution. Having served nine years as Chairman of the APPGC, these matters are close to my heart, and I hope the NHS will move away from process targets in favour of a focus on outcomes – as others also pointed out in the debate, surviving cancer is what really matters to patients and their families.”

“I was surprised to hear from the Minister that performance against the 62-day wait is not a prerequisite for funding release, as this does not appear to be NHS England’s approach in practice. I am writing to the Minister to seek clarification on this important point, as many Cancer Alliances are not receiving their full allocation of Transformation Funding because of their performance against this standard.”