ObjectivesThis study sought to explore the differential patient satisfaction reported by patients with cancer who are from ethnic minority backgrounds, examining patient-reported experience of interacting with medical and nursing staff.SettingAs a secondary analysis, we collated data collected over two consecutive annual rounds of the National Cancer Patient Experience Survey (NCPES) from September 2012 to November 2013.ParticipantsThere were 138 878 responses from 155 hospital trusts across the National Health Service in England, representing a response rate of 63.9% based on the total identified cohort of patients receiving cancer care over those 2 years.OutcomesWe used the results of the annual survey, which sought to assess overall patient satisfaction along with patient experience of interacting with clinical nurse specialists, hospital doctors and ward nurses.ResultsEthnic minority patients reported lower satisfaction and less positive experiences of care overall. While some of this difference appeared related to demographic and socioeconomic variation, ethnic minority patients remained less positive than those in the White British group, after statistical adjustment. Ethnic minority patients also reported lower confidence in, and less understanding of, healthcare professionals, including clinical nurse specialists, doctors and ward nurses.ConclusionsGiven the diversity of the British population, as well as the clustering of ethnic minority patients in certain urban areas, a better understanding of the expectations and additional needs of ethnic minority patients is required to improve their experience of and satisfaction with cancer care.

This study aimed to determine whether the management and survival of patients with lung cancer varied among 26 health authorities in South East England. The Thames Cancer Registry identified patients diagnosed with lung cancer (ICD-10 codes C33 -C34) between 1995 and 1999. After excluding death certificate only patients, 32 818 (81%) patients were analysed. The proportions of patients receiving active treatment varied among health authorities between 5 and 17% for non-investigative surgery, 4 and 17% for any chemotherapy, 8 and 30% for any radiotherapy and 15 and 42% for any active treatment. One-year patient survival ranged from 11 to 34%. There was evidence of health authority level variation even after adjusting for case mix. Patients whose first hospital attendance was at a radiotherapy centre were more likely to receive active treatment (OR 1.72, 95% CI 1.21 -2.46), chemotherapy (1.38, 1.06 -1.79) or radiotherapy (1.86, 1.28 -2.71). There was some evidence that patients whose first hospital attendance was at a radiotherapy centre survived longer. This study shows there is geographical inequality in the treatment given to lung cancer patients and patient survival in South East England. There was some evidence to suggest that these inequalities might be explained by variations in access to oncology services. Future studies should investigate the pathways and barriers to specialist care in this condition.

Socio-economic deprivation was associated with lower rates of treatment and this partly explained variations in survival. Subjects who were referred to specialists were more likely to receive active treatment and treatment patterns varied between first trust attended.

The allocation of funding for new anticancer treatments within the UK has not kept pace with demand. Clinicians find themselves restricted in the use of licensed drugs which they feel are in the best interests of individual patients. Against this, health authorities have a duty to ensure that scarce resources are used equitably to meet the needs of the local population as a whole. Differential levels of funding for new treatments across the country have led to concerns about rationing by postcode. This paper outlines an approach to the prioritization of new treatment for advanced cancer developed jointly by clinicians and health authorities in South London. The approach involves evidence reviews and consensus meetings. Existing and new treatments are rated on a four-point ‘relative effectiveness scale’, which takes account of the impact of the treatment on quality of life and on survival. The strength of evidence supporting each effectiveness rating is also classified. Health Authorities have used these ratings to determine overall funding levels, while leaving decisions on individual patients to the relevant Trusts. © 2000 Cancer Research Campaign