Opportunities for Improvement
Recommendation
Screening and other forms of early detection can improve outcomes by identifying lung cancer at an early stage. The pilot study
on lung cancer screening in Manchester was expanded to ten sites in England in March 2019. Northern Ireland, Scotland and
Wales may benefit from conducting similar studies.Rationale
Indicator 6: An evidence based approach to lung cancer screening / early detection can improve treatment outcomes by
identifying lung cancer early. Workshop participants noted that early detection and timely diagnosis is the biggest challenge
in each of the devolved nations of the UK. The screening pilot study in North Manchester was shown to quadruple the early
detection of lung cancer and has now been expanded to ten sites in England. Northern Ireland, Scotland and Wales might benefit
from participating in a similar study. Wales is currently exploring the approach they should take. However, there is concern that
healthcare systems may not be able to adequately cope with an increased demand from the increase in the number of patients
diagnosed through a screening programme.Recommendation
Data collected via the National Lung Cancer Audit has led to improvements in the quality of care delivered to lung cancer
patients. Expanding it to cover the entire UK could help to improve the current understanding of how the needs in each nation
may differ.Rationale
Indicator 16: The National Lung Cancer Audit was developed to respond to findings in the late 1990s that outcomes for lung
cancer patients in the UK lagged behind outcomes seen in other western countries and also varied within the UK. The National
Lung Cancer Audit covers England, Wales, Guernsey and Jersey. Following a change in legislation and adaptation of IT systems,
Northern Ireland is hoping to be included in the near future.Recommendation
Ensure that the psychological burden faced by lung cancer patients is addressed with pathways to access psychological support
services.
Rationale
Indicator 14: The UK neither includes psychological assessment, mentions the psychological burden of lung cancer nor provides a
referral pathway for psychological support services in their lung cancer guidelines. Providing a pathway in the guidelines provides
clear and practical steps to ensure that patients can receive the support that they need. Each of the devolved nations of the UK
note that this area needs to be improved. In Northern Ireland, some nurses only provide psychological support at the time of
diagnosis. In Wales, as in England, a specialist nurse provides an overarching holistic approach but not every patient receives this.Recommendation
Cancer registries lack clinical data. In the UK, a clinical cancer registry could provide helpful data.
Rationale
Indicator 16: The UK’s cancer registry and vital registration data collection systems have been evaluated as being of high quality.
Clinicians have suggested that a stronger clinical component to the cancer registry could help to improve the overall care that
lung cancer patients receive. However, it was noted that in practical terms the National Lung Cancer Audit has fulfilled this need
for clinicians (at least in the nations that use it— see opportunity 2, above).Opportunity 1
Opportunity 2
Opportunity 3
Opportunity 4