Written evidence submitted by MSD  (CBD0068)


Key observations[i]


MSD’s Experiences & Insights

From MSD’s experience working with the health system, numerous membership organisations, as well as other industry partners and charities during the pandemic, we have gathered the below insights and undertaken activities which may shed light on some of the key challenges that will need overcoming in order to address the backlog, as well as identified future opportunities for collaboration.



Key factors

In order to tackle the backlog and strengthen provision, Government and NHS should consider focussing on:

  1. Supporting patient access to services, enabling early diagnosis, treatment, and routine immunisationsIt is critical that people feel clear on how and when to access health and routine immunisation services. Public awareness campaigns have an important role to play in this and should continue to be well resourced and collaboration with industry across the pathway seen as an enabler. 


  1. Supporting the NHS workforce – It will be important to identify how to relieve the immediate pressure on frontline staff via better deployment of the multidisciplinary team.


In cancer, MSD is particularly focussed on supporting the Clinical Nurse Specialist workforce,[xxii] who have demonstrated their vital value in maintaining cancer services during the pandemic. A profession already under pressure,[xxiii] it is important that the 32% increase in nursing applications is converted into a sustained and resilient nursing workforce in cancer services.[xxiv]


  1. Reducing health Inequalities, informed by taking a data and insights led approachEquity must be a key component in any service re-design to tackle the patient backlog.


As we move towards a more integrated health system, it will be important that we actively seek to reduce health inequalities. MSD welcomes the ICSs’ mandate to address health inequalities and combined with NICE’s strategic commitment to prioritise tacking health inequalities,[xxv] this presents an important opportunity for collaborate across the entire health community to address common goals. This is especially important in cancer where so much of the country’s cancer burden has social deprivation drivers.[xxvi] This shared focus allows for the system and research community to come together to drive innovation and delivery that meets these inequalities. 


It is vital that data is integrated for better quality insights, clinical decision making and patient outcomes. The COVID vaccine programme introduced new levels of data sharing across services and timeliness of access enabling swift, effective interventions to improve uptake of the COVID vaccine. This needs to be gold standard for all routine immunisations to allow for rapid engagement to prevent outbreaks and vaccine-preventable disease. 


In cancer, MSD has developed CanSEE, a lung cancer data visualisation tool to support healthcare professions in better understanding and sharing their local lung cancer picture with the ability to compare with other systems in England.[xxvii]


The NHS must embrace data, expertise and learnings with the design and roll-out of Integrated Care Systems.  With regard to the more joined up clinical and management of care decisions, a key role for Cancer Alliances and charities in the regions going forward will be important.


Wherever possible the system should learn from the devolved nations and compare and contrast approaches to integration and how effective these have been in delivering for patients.







[i] One year on: How has COVID-19 affected cancer services? - Cancer Research UK - Cancer news

cruk_covid_and_cancer_key_stats_june_2021.pdf (cancerresearchuk.org)

Emergency presentations of cancer: data up to December 2020 - GOV.UK (www.gov.uk)

Survey and Reports (gp-patient.co.uk)

[ii] NHS England Statistics » Consultant-led Referral to Treatment Waiting Times (england.nhs.uk) May 2021

[iii] NHs GP patient survey Over 80% of patients had 'good' GP experience during pandemic - Pulse Today July 2021

[iv] BASHH COVID-19 Clinical Thermometer Survey - Third Round Results Snapshot Sept 20.pdf

[v] UK Lung Cancer Coalition, COVID-19 Matters, October 2020, page 10, https://www.uklcc.org.uk/wp-content/uploads/2020/10/UKLCC-COVID-19-Matters-Report-Oct-2020.pdf

[vi] MSD, Do It For Yourself, Lung Cancer Campaign Early Evaluation Report, March 2021, (not available online) attached with submission to inquiry

[vii] Taskforce for Lung Health, Policy briefing: CT-first pathways for diagnosing lung disease, https://cdn.shopify.com/s/files/1/0221/4446/files/final_Taskforce_position_paper_on_CT-first_approaches_-_May_2021.pdf?v=1623918146&_ga=2.235671681.1635230961.1629785799-457699992.1627995778

[viii] BTOG Lung Screening, June 2021, https://www.btog.org/events/lung-cancer-screening-essential-update/ (accessed 3/8/2021)

[ix] Virtual consultations in the lung cancer pathway -  What works for patients and healthcare professionals? https://www.msdconnect.co.uk/static/mciuk/pdf/Virtual_consultations_in_the_lung_cancer_pathway.pdf (accessed 3/8/2021)

[x] Health Service Journal, Recovering cancer services from covid will take all of us, David Long, 1 October 2021, https://www.hsj.co.uk/service-design/recovering-cancer-services-from-covid-will-take-all-of-us/7028515.article


[xii] https://www.bmj.com/content/369/bmj.m2392

[xiii] Health and Social Care Inquiry on delivering core NHS and care services during the pandemic and beyond. Joint submission by the British Association for Sexual Health and HIV (BASHH) and the British HIV Association (BHIVA) Available at:

https://www.bashh.org/news/news/bashh-and-bhiva-respond-jointly-to-health-and-social-care-inquiry-on-covid-19/ Last Accessed: June 2020

[xiv] Sultan B et al. High prevalence of HIV among people who experience homelessness in London: results of an innovative peer-centred outreach bloodborne virus testing service initiated, at the start of the COVID-19 pandemic. Conference abstract O010. BHIVA BASHH 2021

[xv] Lowbury, R. July 2021 ‘Evolving HIV Care in London’ SECOND DRAFT, Fast Track Cities

[xvi]HIV Commission ‘How England Will End New Cases Of HIV’ Available at:  https://www.hivcommission.org.uk/wp-content/uploads/2020/11/HIV-Commission-Full-Report_online_final_pages-2.pdf 

[xvii] Shah A et al. Impact of the COVID-19 pandemic measures on HIV consultations in England. BHIVA BASHH 2021 

[xviii] Sultan B et al. High prevalence of HIV among people who experience homelessness in London: results of an innovative peer-centred outreach bloodborne virus testing service initiated, at the start of the COVID-19 pandemic. Presentation at BHIVA BASHH 2021 (video) 5th Joint Conference of BHIVA with BASHH (2021) - Oral Research Presentations Session 2 on Vimeo 

[xix] IAS, 2021 General COVID-19 and HIV questions Available at: COVID-19 and HIV (iasociety.org)

[xx] NAT ‘HIV and Integrated Care: can STPs deliver?’ Available at: https://www.nat.org.uk/sites/default/files/publications/NAT_HIV_and_Integrated_Care.pdf Last Accessed: January 2020

[xxi] Public Health England, ‘HIV in the United Kingdom: Towards Zero HIV transmissions by 2030  2019 report’ Available at:  https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/858559/HIV_in_the_UK_2019_towards_zero_HIV_transmissions_by_2030.pdf Last Accessed: January 2020

[xxii] Public Policy Projects, Interim update: Workforce & Talent Development, page 20-21, https://publicpolicyprojects.com/publications/workforce-and-talent-development/

[xxiii] Lung Cancer Nursing UK, Caring for the future, February 2020, https://www.lcnuk.org/system/files/LCNUK_Workforce_Survey_Findings_Report_2019.pdf

[xxiv] Nursing Times, Nursing courses see 32% rise in applications during Covid-19, 18 February 2021, https://www.nursingtimes.net/news/education/nursing-courses-see-32-rise-in-applications-during-covid-19-18-02-2021/

[xxv] NICE strategy, 2021 to 2026, April 2021, page 16, https://static.nice.org.uk/NICE%20strategy%202021%20to%202026%20-%20Dynamic,%20Collaborative,%20Excellent.pdf

[xxvi] Cancer in the UK 2020: Socio-economic deprivation, September 2020, https://www.cancerresearchuk.org/sites/default/files/cancer_inequalities_in_the_uk.pdf

[xxvii] CanSEE (MSD funded), Wilmington Healthcare, https://sso.wilmingtonhealthcare.com/


Sept 2021