In September Lord Darzi published a review of the NHS in England. Amy, our Senior Policy Officer shares her thoughts on the review, the response from the government and what it means for people affected by myeloma and their clinical teams.

What is the Darzi review?

In July this year, the new Secretary of State for Health and Social Care Wes Streeting MP commissioned Lord Darzi to investigate the performance of the NHS across England, and his findings were recently published in a report. Lord Darzi’s investigation looked at access to NHS services, quality of care and the overall performance of the health system.

The findings were stark, particularly around cancer care, and show that the NHS is in a critical condition and reform is needed.

Following the publication, the Prime Minister pledged to carry out the “biggest reimagining of the NHS since its founding”, and this will include developing a new 10-year plan for the NHS.

Myeloma UK welcomed the announcement of the new long-term plan for the NHS. We will be working to ensure that the review goes further and faster so that everyone with myeloma can have the best possible life now and look forward to a more positive future.

The nine-week investigation led by Darzi’s team gathered evidence from an Expert Reference Group of over 75 of the most important organisations contributing to the health service, as well as charities like National Voices, who Myeloma UK are members of, professional bodies and other organisations who share a passion for the NHS and its future. This collaborative approach is welcomed and has set a baseline for the NHS from which to transform. Lord Darzi has identified the major themes for the forthcoming 10-year health plan, which include:

  • Empowering patients to take control of their care
  • Expanding GP and community care services
  • Reducing waiting times
  • Harnessing technology and digital transformation

What does the Darzi review mean for myeloma patients?

In relation to cancer services, while there were no direct references of blood cancer, the report highlighted some key findings:

  • Waiting time targets are being missed for cancer services
  • Cancer care still lags behind other countries
  • No progress has been made in early diagnosis of cancers

Worryingly, the report showed that far too many lives are lost to avoidable causes, including cancers, that are either preventable or treatable, and “there is significant scope to improve performance of the NHS and to save lives.”

The report also highlighted that “important progress has been made in reducing the number of cancers diagnosed as result of an emergency presentation, with the proportion falling from nearly 25 per cent in 2006 to below 20 per cent in 2018 and 2019.” While it is good to see this number reducing we know that almost a third of people with myeloma are diagnosed through an emergency route. Presenting as an emergency means a higher likelihood of two or more serious complications caused by myeloma. It is also worrying that people from the most deprived areas continue to be the most likely to present as an emergency.

We’re calling for the Department of Health and Social Care (DHSC) to reduce the number of people diagnosed with myeloma through an emergency route by making sure that myeloma and other blood cancers are included in the metrics for routes to diagnosis including emergency presentations.

The report stated that while “early diagnosis is an important priority since it is associated with higher survival rates, no progress whatsoever was made in diagnosing cancer at stage I and II between 2013 and 2021.”  We hope that the government will relook at new ways to improve early diagnosis. 1 in 2 people with myeloma wait over five months to get the right diagnosis.  This finding confirms our concern that people are still facing delays in diagnosis, which we know has a direct impact on peoples’ quality of life.

We’re calling on the DHSC to work with the NHS in England and organisations like Myeloma UK to develop new measures to improve early diagnosis for myeloma patients.

Increased waiting times for treatment were also highlighted in the report, using research from Cancer Research UK who found that “the 62-day target for referral to first treatment for cancer has not been met since December 2015.” It is not yet known how many myeloma or blood cancer patients have been affected by this target not being met since 2015, but it is important that both diagnosis and treatment is timely to ensure the best possible outcomes for people.

We are calling on the DHSC to invest in workforce and equipment to meet the growing demand for cancer care and support a reform of diagnostic and treatment services in England.

How has the government responded to the Darzi report?

The Prime Minister, Sir Keir Starmer, responded to the report by promising “the biggest reimagining of the NHS” since it was formed, with a new 10-year health plan to be published in the next few months. He proposes three key areas of reform: transition to a digital NHS, moving care from hospitals into the community, and focusing efforts on prevention.

What does Myeloma UK think?

The Darzi review was shocking and at times distressing to read. However, we welcome the commitment from the government to act on the findings.

We welcome a long-term plan, much of which is line with Myeloma UK’s strategy. However, we know all too well that every day counts when you are living with myeloma, so we will be writing to the government in the next few weeks to outline some quick things that could be implemented to help improve things right now. For instance, we’ll be sharing our rapid review of the non-specific symptom pathways in England. You can read more about that here >

Prevention is one of the key areas of focus for the government so we’ll also be sharing the work that we are carrying out looking into why MGUS and smouldering myeloma progress into active myeloma.

We’re also continuing to work with the devolved governments and making sure that each government prioritises myeloma.

By working together with the governments across the UK we can increase the pace of change for people affected by myeloma.

Together, we are the cure.