Health Technology and its role in helping to relieve ongoing pressures in cancer services

Publish date: Apr 18, 2024

Author: Alice Dainty, Senior Manager, Medical Affairs, BD

Hospitals in England are struggling to meet key targets to tackle the backlog in cancer care and routine treatments¹ and, according to senior doctors, the NHS is struggling to provide safe and effective care for all cancer patients². A record 7.3 million individuals are currently on NHS-wide hospital waiting lists, which is roughly three million more than before the COVID-19 pandemic¹. Meanwhile, half of all cancer units have reported frequent delays for chemotherapy².

As part of the Elective Recovery Plan, NHS England aimed to return the number of people waiting more than 62 days for treatment, following an urgent referral, back to pre-pandemic levels by March 2023³. 74% of patients were seen within 62 days pre-pandemic in February 2020⁴. In October 2023, this figure was at 63.1% and therefore not only has the target still not been met, but it is a long way off the new updated NHSE target of 85%⁵. The impact of these delays can have a detrimental effect on patients.

The current NHS challenges

It is vital to ensure that every patient gets the right medication at the right time. However, this can be a challenge for many organisations. With workforce shortages, tightening budgets and rising patient numbers, healthcare services are under increasing pressure, and cancer care is one area that is under considerable strain.

When services are under strain, errors are more likely to occur. It has been estimated that 237 million medication errors occur each year in England in the NHS⁶. Cancer medication prescribing, preparation and administration is a complex, high-risk process, and the consequences of an error can be severe. For patients, this could mean toxicity or a sub-optimal response to treatment. For staff involved in the error, not only is there a potential for loss of confidence and impact on mental health, but there may also be a reluctance to continue working in such a high-risk environment. Error reduction is paramount in ensuring patient safety, whilst also helping increase efficiency, reduce waste, and improve the working environment for staff.

Workforce shortages are also having a detrimental impact on cancer services. A 2022 British Oncology Pharmacy Association (BOPA) survey evaluation found that high vacancy rates in both aseptic and clinical services mean that services are working at, or above, capacity⁸. BOPA stated that given the small numbers of staff entering aseptic services, the filling of a vacancy at one hospital is likely to result in a new vacancy at a neighbouring hospitalv⁷. 91% of the survey respondents reported that delays in their pharmacy service resulted in subsequent delays to patient treatment⁷. For any patient with cancer, time is valuable, and particularly for those undergoing palliative treatment, any time spent at the hospital is time away from friends and family in what could be the last few months of their life. A delay in treatment delivery can impact disproportionately on a patient’s quality of life.

An additional strain on cancer services is workflow inefficiencies, such as those brought on by paper-based documentation and manual processes. These result in excessive time being spent on operational or administrative duties in comparison to valuable, clinical work, making it more difficult to meet the demands from increasing patient numbers and tackling the patient backlog.

The drive for innovation and automation

In October 2020, Lord Carter of Coles published the Transforming NHS Pharmacy Aseptic Services in England report, which highlighted how the transformation of pharmacy aseptic services and the use of automation could improve patient safety and increase productivity within pharmacy aseptic services⁸. These services are responsible for the chemotherapy that treats cancer patients, amongst other important and innovative medicines.

Two of the key highlights within the case for change were as follows:

• Investment in becoming an early adopter of innovation and supporting the development of the next generation of improvement technologies to future proof services.
• A need for standardisation – of products, protocols, processes and training.

Overall, the aseptic services report emphasized the potential for digital transformation to have a positive impact on safety, efficiency and patient care within pharmacy aseptic services.

NHS England also highlighted the importance of meeting the changing healthcare needs of the population in a cost-effective way by taking full advantage of digital and technological innovations, as stated in the NHS Workforce Plan¹¹.

The role of MedTech in improving cancer services

Significant benefits can be gained from the introduction of a technology solution such as BD Cato^™ to support the transformation of a hospital pharmacy’s aseptic service.

BD Cato^™ is an integrated software solution from prescription through preparation and to administration. It is intended for use in chemotherapy, parenteral nutrition, antibiotics and pain medication. It supports the preparation and dispensing of correct doses by providing step-by-step workflow guidance, gravimetric control, barcode scanning and image capture. By providing a hard stop when there is a deviation, it allows correction of an error at the point it occurs, resulting in reduced remakes¹⁰. BD Cato^™ improves efficiency compared to a manual, paper-based workflow by streamlining process steps, automating calculations, reducing manual documentation, and eliminating non-value-adding processes. Additionally, electronic documentation and lot traceability support a paper-less workflow.

Data from a 2021 study showed how the addition of the BD Cato^™ prescribing, compounding and administration software solutions to an oncology medication chain within a hospital increased detection and decreased the risk of error at each stage of their process¹⁰. They demonstrated an overall reduction in compounding time by 35%, and were able to double the output of compounded doses without increasing headcount in the unit¹⁰. Additionally, with BD Cato^™ ReadyMed – a barcode medication administration solution – nurses were able to reduce the time for medication administration verification from approximately 6 minutes per item to 41 seconds per item. This equated to an overall reduction of nursing time for the unit, saving 3 hours and 24 minutes per day¹⁰.

James Martin, Lead Pharmacist – Oncology and QA Services, The London Clinic, said that “Integration of BD Cato^™ with our e-prescribing system has been a game changer, removing the need for manual in-process checks, streamlining the workflow, and the use of barcodes to identify and check components has significantly reduced our preparation time.”*

The opportunity for collaboration

On a local, regional and national level, the pandemic increased collaborations between the NHS and the medtech sector. We have seen that this collaboration can make a difference. By transforming aseptic services, we have the chance to deliver better quality of treatments, drive efficiency improvements, and help future proof the service.

BD is committed to collaborating with the NHS, stakeholders and beyond, to help to address the cancer backlog, and are dedicated to supporting hospitals to provide safe and efficient care for all cancer patients.