Minutes:
The Programme Manager – Targeted Lung
Health Checks introduced the report and began by recapping the
national programme of work that had been completed by the National
Cancer Alliance. She stated that a successful trial of the Targeted
Lung Health Checks had been completed in Manchester, so ten new
trials were being started across the country, based on factors such
as demographics, instances of lung cancer, and survival rates of
lung cancers. She explained that since Thurrock had been chosen for
the trial, Thurrock CCG had identified practices and the criteria
for eligible patients had been decided. She explained that eligible
patients would be those between 55 and 74 years old that were
either current or ex-smokers, and everyone that met this criteria
would be invited to participate in the trial. The Programme Manager
– Targeted Lung Health Checks added that the public health
team had worked hard to ensure practice records were up-to-date
regarding residents smoking status, and the communications team had
also raised public awareness. She clarified that this service was
opt-in and it was up to the patient to decide whether they would
like to take part in the targeted lung health check, but the trial
had been very successful in Manchester. She thanked HealthWatch,
Thurrock CCG and the public health team for their hard work on the
trial, and explained how a number of public awareness events had
been held, such as the ‘Mega Lungs’ which had been
set-up in Asda car park and Blackshots and had gained lots of
interest. She clarified that as the trial was run in partnership
with Luton CCG, there would be two teams, with one based in
Thurrock and the other in Luton, and described how the recruitment
had already started for both of these teams. The Programme Manager
– Targeted Lung Health Checks went on to mention that the
team were currently in negotiations with the CT scanner mobile van,
and they had chosen a supplier that was based in Thurrock as they
would be able to identify suitable sites which had easy access. She
described how the vans were being specially created and would each
have a reception room, four private consultation rooms and would be
connected to a mobile CT scanner, which would be offered to
patients straight after their consultation if needed. She added
that the vans would be placed in areas such as supermarket car
parks, as during the consultation event in March, this is where the
majority of residents had wanted them. She stated that Thurrock CCG
were also working closely with Basildon Hospital for this trial as
patients who were found to have lung issues would be referred there
to see specialists or the primary care team.
The Accountable Officer Thurrock CCG added that there would be a
soft launch at one practice in Thurrock, as although the targeted
lung health checks were being rolled out equally across the
borough, rates of lung cancer differed across Thurrock. Councillor
Ralph began the debate and raised concern that there would be
‘unseen smokers’ across the borough as not everybody
was honest with their doctor regarding their smoking status. He
also asked if the criteria could be changed to include people over
40, as he felt that it could be too late to catch issues by the
time residents reached 55. The Director Public Health responded
that cancer tended to be a disease that affected older people, and
the screening programme had to balance risk with harm. He stated
that there was harm associated with CT scans as it could detect
nodules on the lungs that were not cancerous, which could create
mental distress, particularly if a biopsy of the nodules was
needed. He added that rates of lung cancers increased dramatically
after people reached the age of 55.
The Chair raised concern as residents under the age of 55 may still
be concerned regarding their lung health, and asked if they could
request to access the service. The Accountable Officer Thurrock CCG
replied that any resident with concerns regarding their lung health
could access their GP, and would enter the two-week cancer pathway
if necessary, but would not be eligible for the targeted lung
health check.
Councillor Redsell felt that this was good work being undertaken,
but raised concern that Council employees were still smoking
outside the Council building, and college students were smoking
outside the college. She felt that the prevalence of smoking should
be tackled, starting with outside Council buildings. The Director
Public Health drew the Committee’s attention to page 32 and
the figure quoted that only 9.8% of Thurrock’s population
smoked, as he believed the actual figure was nearer to 20%. He felt
that if Thurrock’s prevalence of smoking was that low, it
would be one of the lowest in the country, which was not true. He
also raised concern that only 52% of the eligible cohort had had
their smoking status recorded, as this could mean almost half of
eligible patients would be excluded from the trial. The Programme
Manager – Targeted Lung Health Checks stated that this data
came from the East of England Cancer Alliance and were the figures
for the eligible age range. The Accountable Officer Thurrock CCG
added that residents could not be forced into being honest
regarding their smoking status, and the communications team were
working to raise awareness that residents should be honest with
their GP.
The Chair raised concern that only 52% of eligible patients had had
their status recorded, and felt that even if people were not honest
with their GP, they would still have a smoking status. She asked if
data was missing from the dataset. The Accountable Officer Thurrock
CCG replied that the smoking status could be left blank by
GP’s, as the question was sometimes not asked. She added that
the trials in Manchester had worked hard to identify patients, and
then persuaded them to come to the trials by sending three
attendance letters. She felt it was a two-prong approach, as it
needed people to be honest with their smoking status, but also
enticed to come to the trials. The Director Public Health added
that people could only be honest with their GP if their GP asked
them the question regarding their smoking status. He felt that 48%
not recorded was high, and asked if patients could be written too
or texted to ask them what their smoking status was, as he felt 95%
status recorded would be a better figure. The Accountable Officer
Thurrock CCG explained that she would go back and clarify the
figures regarding smoker status and prevalence of smoking in
Thurrock.
Councillor Muldowney felt that the work being undertaken was good,
but highlighted Appendix One, as she felt there were problems
around the procurement process. The Programme Manager –
Targeted Lung Health Checks responded that these issues had been
identified a while ago as there was an issue regarding how quickly
the units could be produced. She stated that they had now received
assurances from the company producing the units that this would not
be an issue anymore. She added the Trust were awaiting a Memorandum
of Understanding (MOU) to ensure funding, and then contracts could
be signed.
The Chair questioned the resources based approach, as funding was
based on the prevalence of smoking. The Accountable Officer
Thurrock CCG replied that revenue funding was also received from
the number of scans provided, so if the number of scans increased
then so would funding. The Chair asked if a verbal update on the
programme could be bought back before Committee in January to see
how the programme was developing, and again in March.
RESOLVED:
1. The Health and Wellbeing Overview and Scrutiny Committee noted
the report and championed the rationale for the criteria population
to participate in lung health checks.
Supporting documents: