Cancer survival rates

Improvements in cancer survival rates over the past 40 years in the UK are charted by Macmillan Cancer Support in a study undertaken by the London School of Hygiene and Tropical Medicine. Huge improvements for some cancers are contrasted with an absence of change for others, particularly lung, brain and pancreatic cancers. NHS Information Centre has published data on bowel cancer care that highlights the continuing problem with late diagnosis. A policy briefing from Breast Cancer Care takes a look at inequalities in care, especially amongst older women.

Just checking

The idea of a postcode lottery often claims attention: a recent article in BMC Public Health considers how far this term can be applied to the outworkings of the Health Check as delivered in North West London. The study looked at how NHS Health Checks worked in 8 PCTs in the area, finding considerable variation, with substantial differences in funding levels and in how the programme was interpreted and implemented. Another study, this time from Stoke on Trent, looks at options for cost effective delivery of the Health Checks programme, comparing drop in clinics with booked appointments and considering the merits of targeting particular age groups.

To strategically go

Strategic commissioning is being embraced by local authorities as the way forward for public service delivery, according to a report from local government think tank Localis (in partnership with Essex County Council and Mears). Commission Impossible draws on findings from a survey of council leaders and chief executives which shows that the practice of commissioning services from outside providers is widespread and "set to accelerate significantly." While various healthcare press reports focus on the make-up of newly formed clinical commissioning groups (CCGs), a paper from the NHS Confederation and Royal College of General Practitioners addresses the oft-raised question of conflicts of interest and offers some timely guidance. In an article for Pulse, the chair of the Tower Hamlets CCG summarises this group's approach to integrated commissioning, joining the dots between primary and secondary care and local authority provision. This month's expert on call from the NHS Institute features Mark Jennings, Senior Advisor to the Development for Commissioners Programme, focusing on integration and commissioning.

Known unknowns

There's no question that good quality evidence is needed for public health policy development and decision making. But some topics are better served than others. A study by a team from McMaster University in Ontario attempts to map usage, quantity and quality of review level evidence coverage in a range of public health topics. The researchers, who examined the contents of the Canadian health-evidence.ca site, found that social determinants of health and healthy communities were amongst those most lacking in review evidence.