Mesothelioma Framework galvanises cancer networks but resources are a barrier

A new action plan to improve health services for people in England with the asbestos-related cancer mesothelioma is being adopted by most cancer networks, but time and resources are proving a major barrier to effective implementation, according to a new survey released today by the British Lung Foundation almost a year after the Mesothelioma Framework was introduced. The charity is also launching a new patient guide advising people affected by mesothelioma how the Framework affects their care.

The majority of cancer networks (82%) responded to the survey, which was carried out in December 2007. All those who responded had identified lead clinicians for mesothelioma and most had identified a lead nurse. Nine out of ten said they ensure all mesothelioma patients are discussed by a lung cancer Multi Disciplinary Team and have their cases reviewed by a clinical nurse specialist acting as their key worker.

Worryingly however, three quarters of networks said they had identified barriers to implementing the Framework’s recommendations, namely time and resources. This was a barrier to the development of Specialist MDTs in some areas. The same proportion said that the lead clinician had not set aside time to carry out the agreed responsibilities associated with the position and nearly half said the lead nurse had not found the time for such duties. Nine of the cancer networks who said they had identified barriers provide services in mesothelioma ‘hotspots’.

10 networks provided suggestions for overcoming barriers to implementing the Framework, these included:virtual conference facilities; a common audit; funding for MDT coordinator, lead nurse and lead clinician to carry out these duties; national guidance for PCTs; recommendations for lead nurse case-load.

“A year on from the publication of the Mesothelioma Framework it is encouraging that the majority of cancer networks in England have taken on board the Framework’s key recommendations. But considering that the UK is facing an epidemic of mesothelioma in 2011 – 2015 it is vital that the barriers to progress identified in the survey are urgently addressed, and that the suggestions for overcoming them are taken forward,” says Dame Helena Shovelton, Chief Executive of the British Lung Foundation.

Mick Peake, National Clinical Lead for Lung Cancer, says: “The fact that nearly all the cancer networks in England are taking steps to adopt the Mesothelioma Framework’s recommendations is a great achievement. It shows the networks understand the severity of the disease and recognize the importance of early diagnosis, as well as the measures that need to be in place for patients to receive the best treatment and care. What is of concern, however, is that a number of networks are slow to introduce specialist Multi Disciplinary Teams. Progress on this must be speeded up if people with mesothelioma are to receive the care they need.”

Key Findings

• Most respondents (86%) said the Mesothelioma Framework had had an impact on their services.
• All had identified a lead clinician for mesothelioma and most (89%) had identified a lead nurse.
• Most (93%) said all mesothelioma patients had been discussed by a lung cancer Multi Disciplinary Team.
• Half (50%) said they had identified a specialist Multi Disciplinary Team for their mesothelioma patients.
• Most (89%) said that every mesothelioma patient is reviewed by a clinical nurse specialist acting as their key worker during the course of their illness.
• Three quarters (75%) said they had identified barriers to implementing the Framework’s recommendations
• 21 (75%) said the lead clinician had not set aside time to carry out position responsibilities and 13 (47%) said the lead nurse had set aside time for position responsibilities.
• 21 (75%) said they had identified barriers to implementing the Framework’s recommendations, namely administration problems and a lack of time, funding and resources. Of these, 9 networks provide services in areas with high incidence of mesothelioma.

Mesothelioma is a chest cancer that develops between 15 and 60 years after exposure to asbestos. Only six per cent of the UK population know what the disease is, yet this deadly cancer kills one person every five hours in the UK. The rising number of deaths from the condition is linked to the use of asbestos in the building industry up until the mid 1980s.

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