Opportunities for Improvement
Recommendation
Spain needs an updated National Cancer Control Plan.
Rationale
Indicator 1: Spain’s National Cancer Control plan was published in 2010 and needs to be updated. There is a decentralised
approach to the delivery of cancer care in Spain and the regions are responsible for the care that cancer patients receive.
However, having a unified national approach via a national cancer control plan will help ensure equitable access and that
economically deprived areas are not disadvantaged. Workshop participants noted that the National Cancer Strategy is currently
being updated. The new strategy will be implemented at three different levels: national, regional and hospital. Participants
suggested that implementing quality standards or an accreditation system could help to address the local and regional variations
in Spain.Recommendation
Participation in lung cancer screening trials and studies may enable Spain to determine whether screening is appropriate for its
population.
Rationale
Indicator 6: There is no evidence to show that Spain has participated in a lung cancer screening study or clinical trial. Workshop
participants felt strongly that screening should be part of the National Cancer Strategy.
Recommendation
Involvement of patient organisations in national assessments of disease and policy development can help to build consensus.
Rationale
Indicator 7: A specific lung cancer patient organisation exists in Spain. However, there is no clear evidence that patients were
represented in clinical guideline development. Involving patients in the development of clinical guidelines can 1) help to identify
issues that may be overlooked by health professionals, 2) influence the development of recommendations from a patient and
carer perspective, and 3) emphasise the importance of including shared decision making. Workshop participants noted some
concern as to whether lung cancer patient organisations were ‘ready ’ to participate in the development of clinical guidelines.
Perhaps reassuring organisations that they would be participating in order to ensure their experiences are represented (rather
than being expected to contribute opinions on scientific issues) could help to allay their concerns.Recommendation
Referral for diagnostic assessment for patients suspected of having lung cancer should be prioritised within a specified time
period as there is currently no mention of a rapid referral for diagnostic testing.
Rationale
Indicators 8 & 9: Providing a timeframe within which patients suspected of having lung cancer should receive testing is an
important milestone for delivery of care, as well as having a timeframe for confirmed lung cancer patients to receive secondary or
tertiary care. Spain does not provide such timeframes, nor does it have dedicated fast-track referral processes in its lung cancer
guidelines. Workshop participants noted the importance of building strong relationships between primary care and hospital-
based specialists. Understanding the reasons for delay in diagnostic assessment is needed in order to implement appropriate
measures for improvement.Opportunity 1
Opportunity 2
Opportunity 3
Opportunity 4