What drives care gaps?
Care gaps are extremely complex. There are, of course, issues in access to and affordability of care and treatment, but health outcomes are only partly related to health services. Wider system-related factors, including the social determinants of health (such as economic stability, education level, sociodemographic and environmental factors), can lead to markedly different outcomes. Clinicians may have different levels and types of training, workload and unconscious bias, leading to care gaps. At the institutional level, differences in person-centred approaches, supportive technology and infrastructure may mean that different hospitals or regions within a country provide inconsistent standards of care.
How do we fix care gaps?
As there is no ‘one-size-fits-all’ approach to treating cancer, there is no single solution to fixing gaps in care. Practical, adaptable tools and approaches are required, supported by consensus-driven, person-centred best practice. We need realistic analysis of the needs of people with cancer, and we need to involve them and those working in cancer care to co-develop solutions for both the long and the short term. People experiencing gaps in care must be brought into every piece of research and every decision made – especially people from marginalised communities, who feel the impact of gaps particularly acutely. Some gaps may be more straightforward to close, but most will require system-level changes and significant political motivation and advocacy. As Bob Hudson, David Hunter and Stephen Peckham aptly put it:
‘Policies do not succeed or fail on their own merits; rather their progress is dependent upon the process of implementation.’
The pandemic has created new gaps in cancer care and widened pre-existing ones – and both are likely to grow as we emerge from it. Yet I firmly believe that post-COVID-19 recovery also presents a unique opportunity for change. This year’s World Cancer Day comes with a new and powerful message for equity and positive change; I hope that we can listen to this message and drive important improvements for all people with cancer.
The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.
