In the following exclusive, Mark Stephenson, CEO of Reframe Cancer, explores why navigating the cancer journey is just as important as treatment itself. With the UK facing some of the worst cancer mortality rates in the developed world, thousands of patients are still diagnosed too late, despite 40% of cancers being preventable. He examines the critical role advisers and employers can play in supporting patients, from early detection and prevention to tailored guidance throughout treatment and recovery.
Before we look at the importance of cancer navigation, we must first put the UK in context. As a country, we have one of the worst mortality rates in the world for cancer, identified by both Lord Darzi’s Report and the National Cancer Plan. We are therefore in a unique position that shows it’s not the treatment but the navigation of the cancer journey that is seeing people being picked up too late, at stages three and four, versus stage one and two, where the outcome can be very different. It also doesn’t need to be this way, as 40 % of cancers are preventable.
Sir Charlie Mayfield’s Keep Britain Working report has also outlined the economic impact of people not working in the UK due to ill health, which is now £212 billion. What many people probably aren’t aware of is that £12 billion of that is cancer-related. On average, people are missing 75 days off work when they’re on their cancer journey. That’s an average; however, for some people, it can be a lot more.
Cancer prehabilitation
It is also important to be aware that cancer care extends beyond the urgency of initiating treatment. It involves comprehensive management of the entire pathway, including diagnosis, prehabilitation, treatment, survivorship, rehabilitation and supportive care. A full prehabilitation and rehabilitation programme is increasingly critical to the process. Cancer prehabilitation represents significant clinical value to the NHS. Digital prehabilitation is evidence-based to improve cancer outcomes. Delivering cancer prehabilitation to all patients is now a key aim for the NHS as part of the National Cancer Plan. The plan is committed to delivering digital-first universal prehabilitation by 2028, which will set the new standard for cancer prehabilitation and rehabilitation across the UK. So being physically fit, eating right and being mentally prepared is going to affect your treatment and recovery as well. This shows how many different elements you must have lined up to support the whole cancer journey, so people recover as best they can.
Navigation
No two people go through the same cancer journey. No two treatment plans are going to be the same. There are so many different types of treatment that can happen, and there are over 200 different cancers. That’s why having a support programme that’s dedicated to that individual is so important. You must add to this the complexity of NHS trusts; some will have a lot of cancer nurse specialists who are able to do some of this. Others will have next to none of this support; it is a real postcode lottery based on where you live. Additionally, approximately 80% of people will rely just on the NHS when it comes to treatment, but approximately 15% will use a combination of NHS and private healthcare. This can create a lot of crossover and potential confusion, which in turn can create stress and anxiety at a time when someone is preparing for treatment. Having someone who can navigate you through that, prepare you for each bit, and help explain what the options are is invaluable. Often, patients are given options around treatment, but the patient is not an expert and will often not understand what those options mean. We will never tell people what they need to do, but our clinical nurse specialists explain those options clearly to them to help people make decisions as they go through their journey that are best suited for them.
Most patients also really want to continue working in some way. I think the workplace often makes the mistake of assuming that people who have cancer can’t and won’t be able to work, but most people do want to continue. They’ve got a right to work as well and are protected by law. So again, it’s about helping the patient and the employer both understand what they can do and enabling and advocating for patients to work as well.
We also measure everything that we do. So we’re measuring reductions in stress, anxiety and fatigue, for example. We are measuring the quality of life for people. All these aspects become really important. So in time, we’ll be able to give people a clear return on investment as well. The most important aspect, however, is that we are helping people get through their cancer journey.
Looking ahead to the rest of the year, I think unfortunately, costs are going to continue increase, even with all the targets and ambitions in the National Cancer Plan. Nothing is going to immediately pick up. But I think the biggest challenge is that a lot of employers are going to speak to advisors and ask what we need to do? What do I need to have in place to be able to cope with all these changes that are happening around us? We must help advisors understand what the simplest, clinically robust solutions are that employers should have in place. Similarly, Critical Illness is an amazing insurance product, but my challenge to insurers would be to explain it better, link through how good a product it is, explain the stats, explain the details behind them, and I think you’ll be able to help your end customers so much better by having that knowledge and understanding. Unfortunately, cancer isn’t an easy area to understand, but I think just understanding that if prevention is discussed more, there is more education around screening, if each employer had a cancer plan in place, and the navigation support was there, you can make a real difference.
Reframe Cancer provide CQC regulated cancer navigation and support for employers and insurers.
Mark will also feature on the upcoming New Insurance and Protection special episode of the IFA Talk podcast, releasing on the 23rd March, further exploring how advisers can better support clients through cancer, and asking the critical question: are they doing enough?
