We’re delighted that Dr Majid Kazmi of Guy’s & St Thomas’ NHS Foundation Trust will be speaking at the HSJ Cancer Forum. We caught up with him for a quick chat…
What has the pandemic taught you about managing cancer care?
The first wave of the pandemic was a challenge as we did not really know what to expect and much of the NHS shut to everything apart from management of the pandemic. We tried to keep going as much as possible with treatments but there was a real reduction in patients being diagnosed with cancer. In subsequent waves we were better able to continue services although staff sickness and isolation became increasingly problematic. The pandemic showed that in the face of necessity, the NHS can adapt rapidly but also showed that we need more resilience in our systems and better separation between elective and emergency care in terms of estate. For cancer patients, delaying treatments or diagnostics are not an option, and not having access to clinical trials can mean the difference between life extension or palliation.
Why is inequality such an important issue in cancer care and treatment?
Inequality in cancer care was already an issue pre-pandemic and unfortunately it has been made worse by CV19. Patients from poorer backgrounds, certain ethnic groups and even certain age and disability groups had less good outcomes. The vaccine hesitancy and impact of CV19 on certain groups exacerbated this further. We know even by region in the country there is significant variation in outcomes between the best performing and worst performing. If we truly believe that high quality healthcare is a fundamental right for all citizens, then we need to understand the reasons for the inequality and come up with robust plans to deal with it. This can only be done in partnership with patients and the various communities and stakeholders.
What innovations are you introducing to help you bounce back post-pandemic?
The main change has been the willingness to adopt technology quickly. It shows what is possible if there is enough of an impetus. In the south east London sector, like others, we made a lot of changes overnight, some we had already been developing and others were just implemented immediately. What we now need to do is to consolidate on what innovations worked well and embrace new innovations. In cancer care, home delivery of oral chemotherapy and the ability to have blood tests locally rather than travel to the hospital were positively received by patients and their carers. That needs to be sustained and further refined to allow local delivery of subcutaneous therapies and even patient self-administration of subcutaneous therapies. Making every contact count involves better triaging of patients into those that need face-to-face consultations and those that can be managed remotely. On the surgical side, improving our peri-operative processes to try and maximise theatre utilisation and reduce length of stay with better pre-habilitation and enhanced recovery. Flexible working for staff allowing certain activities to be done off-site to free up space on-site such as clinic rooms. Shared resources with our network partners enables patients to access the right diagnostic or therapy as quickly as possible.
What progress have you made in relation to the Cancer Workforce Plan?
This remains a real concern and struggle. Pre-pandemic we already faced significant challenges. London itself also faces challenges around cost of living and work-life balance. The pandemic has thrown this into sharp focus, compounded by BREXIT and pension issues. Many senior members of the workforce are reducing hours, it is increasingly difficult to recruit staff from overseas and the pandemic has led to an exodus from London. All NHS organisations need to make the staff offer more attractive, particularly for the lower paid - this not just about pay but really valuing your staff. We need to embrace technology such as AI to reduce burden on human resource and we need to accelerate things we already had in train around using the skills of the extended workforce better such as reporting radiographers, nurse endoscopists, physician associates and prescribing pharmacists.
What do think you will gain from attending the HSJ Cancer Forum in May?
The cancer care system is one big family globally and we all face similar challenges. The great thing about these forums is the ability to share knowledge and ideas. Many problems may have already been addressed somewhere else or even by the non-healthcare sector. We should be outward looking and willing to embrace novel concepts. The status quo is not an option. Attending forums like this also fosters that sense of; you are not alone in this and that together we can make a difference.
To join Dr Kazmi, and many other prominent practitioners in the cancer space, register for your fully-funded place here.