Beating cancer by improving the public’s health: the road ahead in England

Cancer, Covid-19
Doctor looking at the results of a scan

Every year, around 367,000 people are diagnosed with cancer in the UK.

Around 4 in 10 of those cancers are caused by things we know contribute to someone’s risk of getting cancer – like smoking, being overweight or obese or drinking alcohol. Meaning that if we could prevent every cancer linked to these modifiable risk factors, we could potentially prevent 165,000 cancers happening each year.

That’s why improving the nation’s health is vital, because as well as helping people live happier, healthier lives – it will also help us beat cancer.

That’s where Public Health England (PHE) comes in. The organisation plays a key role in protecting and improving the health of England’s 56 million people, as well as managing vital data that can help us tackle health inequalities and improve cancer services.

But in August, Health Secretary Matt Hancock announced it would be disbanded.

The UK Government is currently consulting with experts on how this could work, but time is short – with PHE planned to disband by March 2021. And despite the looming deadline, t’s still unclear how the vital work PHE does to help prevent cancer, support cancer screening programmes, and collect and analyse cancer data will continue beyond this point.

There’s a lot at stake. Here’s what must be protected.

Prioritising cancer prevention

PHE plays a key role in preventing diseases like cancer – from developing the next plan to meet the Government’s smokefree 2030 ambition to gathering evidence to form policies to tackle obesity, as well supporting efforts to reduce alcohol-related harm.

Councils across the country do much of the work on the ground – running stop smoking, weight management and alcohol treatment services – with PHE providing expertise and support to local government to do this. It’s really important that support continues, so that the work of councils can have the greatest impact in improving people’s health.

We know this work has impact. Smoking rates have reduced from 40% of adults in the UK in the 1970s to just 14.1% by 2019, and a key driver of this reduction has been public education campaigns informing us of the dangers of smoking. PHE has been responsible for these awareness-raising campaigns in recent years, and not just for smoking. They’ve also produced innovative work to help people make healthier food choices.

Investing in these high-impact public education campaigns in future will be crucial and Government needs to make sure this continues.

Supporting cancer screening

Working with the NHS, PHE helps to design, implement and review the 3 cancer screening programmes – for bowel, breast and cervical cancer – as well as developing accessible information for clinicians and the public to support informed uptake and reduce inequalities.

Regardless of who’s responsible for this work in future, it’s key that the expertise PHE has isn’t lost, but instead is used to continue to improve cancer screening. This includes PHE’s role in training the organisations that deliver screening services, developing invitations and information materials and providing unbiased, comprehensive assessments of how well screening programmes are doing – so everyone can access world class cancer screening.

This expertise doesn’t just benefit England. Right now, the UK’s National Screening Committee, which advises ministers in all 4 UK nations on screening, sits within PHE. And it’s crucial this expertise is not lost.

Protecting data to improve care and drive research

As well as expertise in cancer prevention and screening, PHE is at the heart of making sure that we have the right information to tackle inequalities in cancer care, improve cancer services for everyone and help drive forward life-saving research.

That’s because they’re responsible collecting, analysing and looking after data on over 14 million cancers through the national cancer registry – providing vital insight that can help drive improvements in cancer care.

We work with PHE to develop these insights to improve care, alongside many other partners across the cancer community. Regardless of where these responsibilities sit in the future, efforts to work with others and to give partners safe and secure access to cancer data for research and analysis should be protected.

This data collection doesn’t just apply to cancer. PHE also collects data to help improve the public’s health more broadly, helping the NHS and councils plan health improvement services – data that should continue to be updated and published under new public health arrangements.

Finally, and perhaps most importantly, PHE works hard to make sure that people with cancer and the public understand and trust how cancer data is used. It’s vital this role is maintained.

Seizing the opportunity to improve health and prevent cancer

The decision to restructure how we deliver public health in England is an opportunity to not only prioritise, but strengthen, how we work towards make the country healthier.

This would not only benefit people with cancer, but the health and wealth of the whole country. A healthier population would ease pressure on the NHS and make us more able to cope with situations like COVID-19.

The Government missed an opportunity to do this in the recent spending review, with funding for public health frozen. This follows years of significant underinvestment in public health, and given the impact of COVID will make it much harder for Government to meet their ambitions to tackle inequalities across the UK.

That’s why it’s so important to get new health improvement structures right. These efforts are crucial to a future where fewer people develop or die of cancer. The UK Government must seize this opportunity.

Matt Sample is a policy advisor at Cancer Research UK 

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