More than 60 cancer patients a year die much sooner than those in other parts of the country, according to a report discussed by health chiefs today (Tuesday 18 July).
It said that cancer was also more common among poorer people and that they were more likely to die sooner.
In part this was because they were less likely to have gone for screening and they tended to wait too long before seeing a doctor about their symptoms.
A report to the Brighton and Hove Clinical Commissioning Group (CCG) said: “The mortality gap between the poorest groups and the most affluent appears to be widening.”
It said that about 1,150 people received a cancer diagnosis each year – mostly for breast, lung, colorectal or prostate cancer.
The report also said that 68.9 per cent of adults with any type of cancer in Brighton and Hove were still alive one year after diagnosis.
This compared with 74.5 per cent in the best-performing area of the country. The difference accounts for 64 premature deaths a year.
The outlook for patients wasn’t helped by the delays in seeing a specialist at the Royal Sussex County Hospital after being referred by a GP (general practitioner).
All patients should be seen within 62 days – known as the 62-day “referral to treatment” standard. But Brighton and Sussex University Hospitals (BSUH), which runs the Royal Sussex, has struggled to meet the target for some patients.
One of the departments worst affected – digestive diseases – had performed particularly poorly during and after a race row between doctors in the department.
The report to the CCG governing body today said: “Brighton and Sussex University Hospitals (BSUH) continues to be challenged in meeting the 62-day urgent GP referral to treatment standard in 2016-17 and has seen a decline recently in other cancer standards.
“This has in part been due to increase in activity and pressures within the system in diagnostics and bed pressures.
“There has been a focus locally and nationally on achieving the 62-day standard and work in sustaining cancer performance.
“The independent Cancer Taskforce heard throughout their engagement on the national cancer strategy how distressing poor experiences can be and heard concerns from patients particularly about poor communication – how healthcare professionals spoke with them, the information and support they were given to help manage their health and consequences of cancer in their wider lives, and the way they were able to access information.
“Communication was highlighted as a major influence on patient experience and the taskforce believes that we should be making better use of the digital revolution where patients can have online access to their test results and other communications throughout their treatment and care.
“The national report identifies areas which Brighton and Hove can make improvements on.
“In Brighton and Hove 77 per cent said that they found it easy to contact their clinical nurse specialist (CNS), compared to 87 per cent nationally, and 36 per cent said that they were given understandable information about whether radiotherapy was working, compared to 60 per cent nationally.
“The NHS has dramatically improved patient outcomes over the past 15 years. Cancer survival is at its highest ever, outcomes are better, waits are shorter, patient satisfaction much higher across the country which is due to the commitment of staff and funding.
“It also recognises quality of care can be variable, preventable illness is widespread, health inequalities deep-rooted.
“It also highlights the challenges in cancer as patient needs change. There are new treatment options and increasing pressure on services.
“Cancer is the main cause of death for all ages and for those under 75 years in the city.
“Despite improvements in cancer treatments and mortality in recent decades, outcomes in the UK are poor compared to the best in Europe.
“The survival rate among the under 75s in the city is lower than the national rate.
“At a national level, the mortality rate from cancer has been steadily decreasing, but this is not the case in Brighton and Hove, where the decline has been very small.”
The report – setting out a cancer strategy for Brighton and Hove – said that the evidence for change showed, for example, that about 42 per cent of cases of cancer in the UK were preventable through the adoption of healthier lifestyle choices.
The lifestyle factors included smoking, poor diet, drinking alcohol and a lack of physical activity. Smoking was the single biggest cause of cancer, accounting for 19 per cent of all cases.
And in Brighton and Hove, the report said, “the prevalence of smoking in adults is 21 per cent, higher than the national figure of 17 per cent”.
It said: “On average there are 370 smoking-related deaths per year in Brighton and Hove, which again is higher than the national average.
“However, the city did have a significantly higher rate of successful quitters in NHS Stop Smoking Services than the England average in 2015-16.
“Brighton and Hove has more young people smoking than any other local authority in the south east.
“According to the national What about Youth survey smoking prevalence is 14.9 per cent (which is) 5.9 per cent higher than the average for the south east (9 per cent) and 6.7 per cent higher than the national average (8.2 per cent).
“42 per cent of adults in Brighton and Hove drink more than the UK recommended weekly amount of alcohol. This compares to the average for England of 26 per cent.
“Rates of alcohol-related A&E attendance and hospital admissions have increased in recent years, and in Brighton and Hove’s ‘Big Alcohol Debate’, 36 per cent of respondents were worried about the effect alcohol has on people in the city.
“Although the local figure for obese children is below the national average, 13.3 per cent in year 6, compared to 19 per cent for England, by adulthood over half (52.4 per cent) of the adult population in Brighton and Hove are classified as overweight or obese.
“Although this figure is also less than that for England, at 64.6 per cent, excess weight could be lost by adopting a healthier diet, increasing physical activity and drinking less alcohol.”
Air pollution was another factor. The report said: “It is estimated that within Brighton and Hove 200 deaths are brought forward each year by airborne pollution.”
And sun safety was also highlighted, with the report saying: “Brighton and Hove has a higher rate of malignant melanomas than England – 27.4 cases per 100,000 people compared to 23.3 for England.
“Brighton and Hove CCG have identified the following priority areas for action
- Preventing people dying prematurely by improving early identification of symptoms in primary care
- Enhancing quality of life for people by improving outcomes and delivery of the national cancer survivorship programme
- To ensure treatment is commenced without delay by delivering the 62 day referral to treatment national standard
“Brighton and Hove CCG will ensure that there is equitable access for services with particular focus on vulnerable groups.”
The clinical chair of the CCG, David Supple, and the director of public health, Peter Wilkinson, said: “The NHS and the local authority face several pressures over the next few years with increased demand on services and limited resource.
“Demand for cancer services is rising three times faster than other conditions for the NHS and services are struggling to meet operational standards under the current pressures.
“The strategy is a powerful indication of our shared commitment to preventing cancer and to ensuring that people affected by cancer are able to access the right intervention, in the right place, at the right time and with the right outcome.”
Jason Barrow, who presented the cancer strategy to a meeting of the CCG governing board, said that waiting times were now improving in Brighton and Hove.
Dr Barrow, a GP at the Park Crescent Health Centre, in Brighton, also praised the work of the Macmillan Horizon Cancer Centre.
The centre is a partnership between Macmillan Cancer Support, the Sussex Cancer Fund and Brighton and Sussex University Hospitals NHS Trust which opened las year next to the Royal Sussex County Hospital.