To ask the Minister of Health to detail any measures his Department is taking to ensure equal access to cancer diagnosis and treatment services for patients in rural areas.

My department is committed to ensuring equitable and timely access to cancer diagnosis and treatment services for all. The majority of cancer patients have access to diagnostics, cancer surgery and Systematic Anti-Cancer treatment (SACT: chemotherapy and immunotherapy) within their home trusts. Patients may need to travel outside their Health & Social Care Trust area of residence to access more specialised treatments such as radiotherapy at the NI Cancer Centre and the North West Cancer Centre, or for advanced surgical or tertiary treatments in specialist centres.

Since the pandemic, many treatment services have increased efforts to assess and review patients via virtual appointments where feasible. Additionally, where clinically appropriate, prescriptions have changed to oral treatments and longer administration intervals to reduce the frequency of hospital visits. Plans are also being developed for patient self-administration of some SACT treatments. Some trusts also offer SACT medicines delivery service, or a medicine vending facility to reduce frequency of hospital visits, or waits at hospital.

As outlined in the ‘Health and Social Care NI: A three-year plan’. I state my commitment to addressing health inequalities. I am seeking to bring care closer to home where feasible. Having easier access to services by locating them in the community will be an important part of achieving greater population health and wellbeing. Out of hospital care is part of the overall long-term direction of health service reform. Where a patient requires on-going treatment and care following a cancer diagnosis, the development of ambulatory care services, or phlebotomy hubs as outlined in the NI Cancer Strategy will help to achieve this, however these developments will be dependent on cancer strategy funding.

There has been a significant increase in referrals for suspect cancers since 2019/20. Workforce capacity issues in several specialisms integral to cancer diagnosis including, endoscopy, radiology and pathology have inevitably impacted diagnostic demand and waits, potentially affecting patient outcomes. To ensure patients have faster access to diagnostics, some services will need to operate from a smaller number of sites. New regional initiatives to improve timely access to diagnostics, such as Elective Day Procedure Centres and Rapid Diagnosis Centres have been developed.

Some patients are eligible for financial support with travel costs and this can often be means tested. Patients who are travelling long distances for appointments will be made aware of travel support available to them (e.g. travel costs if eligible, parking costs, and volunteer driver services).

My department has also funded the Northern Ireland Cancer Registry at Queens University to develop a Routes to Diagnosis project. This project aims to identify the key event in each cancer patient’s pathway that most directly led to their cancer diagnosis, whether through GP red flag referral, screening programmes, emergency departments, or other routes. This research will highlight any demographic inequalities that may need to be addressed. The Northern Ireland Cancer Registry are now working on a report for patients diagnosed 2018 -2021, which will provide analysis on cancer patients’ routes to diagnosis, analysed by rural and urban location.