doc and patient
While the chance of survival for people with cancer is increasing overall, the disease remains the most common cause of death in the UK, leading to 29% of all deaths in 20131, and the numbers of diagnoses continue to rise year on year. Cancer is a key priority for the UK public and for the government. This is putting a financial burden on the NHS, whose healthcare budgets are already being squeezed by a combination of the aging population and the UK government's austerity measures. Given increased rates of early diagnosis alongside improved duration of patient outcomes cancer is now often being viewed as a long term condition rather than an acute event with poor prognoses. This is also putting pressure on service provision that can only grow given further innovations in treatment and care. 

Cancer in the UK 

The risk of cancer increases as people age, and so the numbers will increase as people live longer – over a third2 of all cancers are diagnosed in people of 75 years old or more, and for people born after 1960, one in two2 will be diagnosed with a form of cancer during their lifetime 

The aim of innovation is to improve cancer prevention, diagnosis, treatment and care. However, developing innovative diagnostics and drugs requires significant investment and the implementation of personalized medicine regimens is complex, involving planning, training, and administration. This combined with the rising rates of cancer and people's increased lifespan is leading to both financial and logistical burdens for the NHS, in a time where budgets are under pressure. 

Finding a solution 

Improving access to innovative drugs has the potential to have a major impact on survival and outcomes for patients and whilst there are currently a number of available access routes at this time, biopharma must work with the UK government to create a more sustainable and equitable way of ensuring medicines access. 

The industry can also support the NHS by providing pathway mapping and service redesign initiatives. These projects, sitting under the auspices of joint working, can really assist NHS healthcare professionals and payers navigate service and pathway efficiencies including wholesale service redesign. The most effective projects utilize project management and six-sigma methodology to really understand the problem before proposing pathway change and other solutions, the types of support that can be offered ranges from stakeholder workshops, data analytics, nurse programmes and patient support initiatives. Given the perceived lack of utilization of current NHS capacity management tools, simulation modeling is a growing area of interest for biopharma and the health service. 

Pathway mapping and service redesign in practice 

An example of a successful pathway redesign program took place in an NHS clinic providing patients with lung cancer follow up appointments. The clinic faced capacity issues and escalating waiting times, and staff were unsatisfied and overworked. A redesign of the pathway was required to develop a stronger sense of organizational control and increase efficiency for patients. 

The redesign project mapped the current pathway to provide a baseline of clinic activity. Engagement with stakeholders via semi-structured interviews examined ideas for service improvement, barriers to service delivery, and alternate follow up options for oncology patients. Patient involvement was vital to the project’s success, indicating that 60% of patients would be happy to receive consultations over the telephone. Evidence was reviewed around clinic capacity, patient flow, and stratification, allowing for a new pathway to be fully mapped out and developed. Two nurse-led clinics and a telephone follow up clinic were established following the redesign, resulting in a reduction in routine follow up clinic visits. Staff morale also improved as a result. 

The role of biopharma in improving innovation uptake 

The biopharma industry can further support their market access activities through creating tailored local joint working programs with the NHS. By working in partnership with the NHS these programs can support decision makers in creating capacity within their services to fully exploit the effectiveness of new and novel therapeutic interventions in redesigned care pathways. By meeting specific local needs and facilitating pathway efficiencies it can be possible to accelerate access to innovative drugs and as such further improve outcomes for patients. 

Read the full case study HERE.


  1. Office for National Statistics. 2014 . Infographic on ONS death registration statistics with data on mortality rates and causes of deaths. [Online] <> [Accessed 11 May 2015] 
  2. Cancer research. 2015. All cancers combined; key statistics. [Online] <> [Accessed 11 May 2015]