The Committee received a presentation from Femi Odewale, Managing Director, NEL Cancer Alliance and Angela Wong, Chief Medical Officer, NEL Cancer Alliance on an Integrated Care Board Deep Dive into Cancer.

On a broad impact, Families across London are being significantly affected by cancer. An overall profile indicates a very high number of cancer diagnoses in London, with figures mentioned in the millions. Last year’s data cited approximately 7,735 patients (with an unclear reference that might suggest higher aggregate numbers) indicating the large volume of cases in North East London.

On patient characteristics, it was stated that despite the high volume of diagnosed cases, only a small proportion are classified under the most advanced or critical categories.

It was stated that performance over the period has shown sustained strength when measured against FPS (First Patient Seen) standards. On key time benchmarks, the discussion referenced target metrics such as 6-2 days and 31 days, which play a crucial role in assessing timely diagnosis and treatment.

On the overall service delivery, officers informed Members that the team is on course for delivering service improvements in line with the established standards and targets.

Members noted the following on early diagnosis approach:

It was stated that the strategy centres on three key pillars: screening, awareness, and prevention.

• Screening Programs:
  • Breast Screening:
    Women aged 35 to 64 are primarily targeted; additional age groups (15 to 17 for certain screenings) are also mentioned.
  • Lung Cancer Screening:
    A new initiative targeting asymptomatic patients, acknowledging that a small percentage of those screened may actually have the condition.
  • Bowel Cancer Screening:
    Efforts to boost screening uptake are underway, leveraging the fact that the service is free for the eligible population.

The performance data indicated a mixed performance across different age cohorts (for example, improvements for the 24-25 age group as compared to previous years) with some variations observed in breast screening uptake.

The following vision and future work were outlined

• Long-Term Goals:
  The overarching vision is to enhance cancer outcomes in North East London by reducing variations in care and driving sustainable change through testing, innovation, and a personalised care strategy.
• Program Expansions:
  Future work includes extending early diagnosis programs and refining the diagnostic and treatment continuum as part of a broader strategic push toward innovative and consistent care delivery.

1. Lung Cancer Screening Programme

• New Initiative:
  A newly introduced lung cancer screening programme targets patients using both age (specifically between 50–54 and 74) and smoking history as criteria.
• Yield & Diagnostic Rate:
  The programme has a detection yield of approximately 1–3%.
• Performance Achievement:
  The programme has achieved a 77% survival (or early diagnosis) rate in the screening stage compared to an overall lung cancer stage detection rate of around 36%. Nationally, the target is diagnosing 75% of patients, and this initiative has exceeded that benchmark.

2. Awareness Campaigns and Outreach Strategies

• Increasing Awareness:
  Efforts are underway to boost cancer awareness using non-traditional means. Initiatives include innovative campaigns such as targeted social media outreach (e.g., through platforms akin to Facebook) to increase recognition of cancer symptoms and encourage early health-seeking behaviour.
• Targeted Approaches:
  Campaigns are designed to reach specific groups, with strategies like pressuring women to seek early diagnostic tests and targeting 50% of men as part of a broader awareness drive.
• Sustainable Materials:
  The development of enduring awareness materials, including advertisements and educational content, aligns with the overall vision of reducing inequality and improving outcomes by enhancing early detection.

3. Integration of AI and Technological Innovations

• AI in Imaging:
  The programme has introduced artificial intelligence to alleviate backlog in chest X-ray readings. AI now processes and reports findings within 3 minutes overnight—addressing 70% of the X-ray backlog.
• Clinical Prioritisation:
  A system has been established that prioritises urgent cases (designated P1A, requiring reporting within 24 hours), with other cases having a maximum window of 72 hours. This structured approach supports early diagnosis and faster treatment initiation.
• Digital Resources:
  Alongside these technological improvements, a suite of 19 animated videos has been developed to further support education and awareness within the screening and diagnostic processes.

·         AI Performance and Areas for Improvement:
Clinicians expressed concerns that in some instances the results achieved by AI have not met expectations. There is ongoing work to further explore best practices and refine these areas to ensure confident and reliable use of data technology.

·         Focused Application in Diagnostics:
The discussion highlighted the effective use of AI in chest X-rays, where automated processes reduce human error and enhance diagnostic speed. However, there’s a need for a cautious approach, ensuring that legal and clinical standards are met, especially in making decisions that affect patient outcomes.

·         Communication Challenges with Diagnostics:
A major issue raised was how diagnostic results are communicated. Specifically, while rapid AI analysis (e.g., within 3 seconds) is promising, the subsequent process—having results returned to general practitioners (GPs) for follow-up—may not offer the expected improvements in patient care. This raises the question of how to better integrate AI outputs into the clinical communication pathway, particularly for critical cases like cancer.

·         Digital Integration and National Programs:
There’s an ongoing effort to digitize records and integrate communication channels. Examples include the NHS app, which is under development to allow patients access to letters and results. Wider national and international initiatives are being monitored to learn from best practices and ensure these projects support integrated care.

·         Data Granularity and Local Reporting:
The discussion also covered the need for more granular data analysis (e.g., by borough such as West Essex) to tailor services and address local clinical demands. Future actions may involve setting up a breakdown for expedited resolution and targeted communication improvements.

·         Next Steps:
Despite some progress in core areas, further work remains to improve performance, communication, and integration across the system.

Following the presentation, Members asked and received responses to questions raised about Cancer Alliance and Deep Dive into Cancer.

The Committee noted the presentation with thanks and acknowledgement that additional update sessions may be needed at future meetings.