Oncology clinics are under pressure to meet growing patient demand. The UK population is continuing to grow, and people are living longer fuelled by developments in modern medicine. Alongside population growth and ageing, higher rates of awareness, screening and diagnosis are strong drivers of increasing cancer cases.2
The pandemic has brought forward unprecedented challenges, disrupting cancer screening, diagnosis and management. As cancer services recover, existing capacity pressures will come under additional stress from a backlog of patients resuming screening and requiring treatment, likely for more advanced disease. With an urgent need for more oncology resource, Astellas is partnering with the NHS to deliver solutions.
The impact of COVID-19 on prostate cancer care is high
Prostate cancer is the most commonly diagnosed cancer in the UK. More than 47,500 men are normally diagnosed with prostate cancer every year,3 equating to around 4,000 diagnoses for every month of lockdown. Approximately 400,000 UK men are living with and after prostate cancer,3 potentially relying on vital services.
Prostate cancer typically affects males over the age of 50 years, and risk increases with age. The risk of prostate cancer occurring is even higher for black men.3 In addition to this, COVID-19 appears to disproportionally impact the same demographics as prostate cancer.4 Men and the elderly are more likely than women and younger people to be hospitalised from and die of the virus,4 and black ethnic groups are more vulnerable to COVID-19 than others.4 With the impact of COVID-19 high in the prostate cancer population, and the services that many men depend on stretched, the pandemic is directly threatening patients’ health in multiple ways. As we look ahead, the resumption of usual care will require innovative use of the existing NHS workforce.4
Empowering non-medical practitioners (NMPs) to relieve overstretched oncology services and enhance patient experiences
Pioneering workforce utilisation models could be more widely adopted to expand capacity in oncology clinics. One option is enhancing the role of NMPs, healthcare professionals without a medical degree – like nurses or pharmacists – who undertake specialist training to allow them to undertake their own patient clinics. By undertaking clinics for the more stable cancer patient, NMP’s can relieve the time burden on oncologists and increase capacity.
NMP delivered clinics have been shown to have many benefits including:
- Expected capacity alleviation through NMP clinics will allow the medical or surgical specialist consultant to manage more complex patients, potentially leading to better patient care.
- It is expected that increased patient access to a health professional in a timely manner and continuity of care with an NMP will lead to increased patient satisfaction
Supporting the implementation of NMP-led clinics
While the benefits of NMP-led clinics are clear, barriers exist to setting them up. The cost of training can be as much as £10,000,5 making NHS funding difficult to attain and the paperwork difficult to navigate. The education is also not readily available.
To overcome these challenges, Astellas facilitated 12 workshops throughout the UK between October 2018 and September 2020. These sessions highlighted the return on investment NMPs provide the NHS and provided nurses and pharmacists with advice on how to write and submit a successful business case to attain funding. Workshop delegates have now implemented over 15 new NMP-led clinics throughout the UK. In the same timeframe, Astellas enabled three preceptorships, sharing best practice in partnership with a centre of excellence with nurses and allied health professionals to assist in the establishment of NMP-led clinics.
The potential of NMP-led clinics in prostate cancer and beyond
Non-medical prescribing can provide high-quality cancer care balanced with sustainable use of the NHS workforce. The benefits of this approach have become pronounced during the pandemic and could help alleviate the particularly high burden on resource within prostate cancer clinics. Longer-term, the model warrants consideration for unlocking NHS capacity and supporting oncology services more generally.
For more information about how Astellas is supporting the capacity alleviation within oncology clinics, please contact: [email protected]
 Office for National Statistics. Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2019. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2019estimates Last accessed: February 2021
 EFPIA. Comparator report on cancer in Europe 2019 – disease burden, costs and access to medicines. Available at: https://www.efpia.eu/media/580501/comparator-report-on-cancer.pdf Last accessed: February 2021
 Prostate Cancer UK. About prostate cancer. Available at: https://prostatecanceruk.org/prostate-information/about-prostate-cancer Last accessed: February 2021
 Parliament UK. Written evidence submitted by Astellas Pharma Ltd (DEL0200). May 2020. Available at: https://committees.parliament.uk/writtenevidence/4504/pdf/ Last accessed: February 2021
 Graham-Clarke, Emma et al. Facilitators and barriers to non-medical prescribing - A systematic review and thematic synthesis. PloS one vol. 13,4. 30 Apr. 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927440/ Last accessed: February 2021