Getting Cancer Care Back on Track

With COVID-19 severely disrupting the care of cancer patients — patients missing routine scans, regular appointments, and even rounds of vital treatment — Jackie Williams, General Manager of Astellas UK, talks to Pharm Exec about how UK pharma can partner with the NHS to address patient backlogs and support continuity of care.

Pharm Exec: What have you seen in terms of the impact of COVID-19 on cancer diagnoses and treatment in the UK, and how has that affected Astellas?

Jackie Williams: The impact of COVID-19 on cancer diagnosis and care has been immense. In October 2020, MacMillan Cancer Support estimated that 50,000 people were missing a cancer diagnosis.¹ That number has surely gone up as a result of the second and third lockdowns.

Jackie Williams

The immediate necessities of the pandemic meant that both resources and the time of healthcare professionals were redirected to manage the huge volume of critical COVID-19 patients. Face-to-face appointments were reduced to protect patients from potential exposure, and high-risk groups were advised to shield. While these measures were put in place with the best of intentions, the result has been that for many, screening and urgent referrals have been delayed, along with treatment, creating a backlog of cancer patients that urgently needs addressing.

At Astellas, our focus was to ensure the NHS had access to the treatments they needed. In the face of the disruption we needed to quickly adapt. In partnership with the NHS, we opened discussions to identify and implement solutions that would ensure continuity of care.

The result of the collaboration with the NHS was a flexible care model that delivered cancer treatments to certain patients in a home-based setting. Many cancer patients are treated with immuno-compromising therapies, such as chemotherapy, meaning they are at increased risk of severe COVID-19 symptoms, if exposed. Through home-based treatment, we were able to support the potential reduction of hospital footfall and the anxiety that some patients felt about attending ‘in hospital’ consultations.

What is Astellas doing to help to overcome hurdles such as oncology capacity?

The pandemic required us to be agile and flexible. We were, and have continued to be, quick to do this. What we mustn’t lose sight of is that many of these projects and the spirit of partnership were in place long-before the pandemic. The pandemic has brought these efforts into sharp relief. Without an open dialogue already in existence between Astellas and the NHS we wouldn’t have been able to act as quickly we did.

Even before the pandemic, Astellas saw the capacity issues that some cancer clinics faced and began discussions with various hospitals to identify where we could be part of the solution. The result was a series of pilot workshops to assist non-medical practitioner (NMP) training and help to facilitate the establishment of NMP-led oncology clinics. The NMP program helps highly trained individuals, without a medical degree, support the care of cancer patients by performing medication reviews such as assessments for side effects, response and patient fitness for new therapies. It’s a fantastic way we can help address capacity issues and support cost efficiencies for the NHS whilst maintaining good standards of care.

To date, we have hosted 12 workshops within the UK — leading to the establishment of 15 new NMP-led clinics. The response from those who have attended workshops so far has been very positive. The opportunity to further enhance the NMP program for the cancer community is something I am excited to see progress. As we look towards recovery, we can continue to build upon this model and can help to address capacity challenges within oncology.

What is Astellas doing to support cancer patients in a virtual setting?

Our role as the pharmaceutical industry is no longer solely about the provision of medicine. We consider, in partnership with the NHS and medics around the world, what is the best care pathway for that group of patients. The shift of patients to a virtual setting has been difficult for some. The obvious benefits of less travel to and from clinics being diminished against lack of time with their consultant or oncology nurse. Once again, the pandemic has brought a challenge in care, the emotional and psychological support of patients, into sharper focus, but the solution goes back to before the pandemic.

In the summer of 2020, Astellas piloted a digital patient support program for specific cancer patients. Through agreement with their doctor, patients can access support in their own time, at their own pace and on their own terms - a suite of holistic resources including mindfulness, disease education, fatigue management and nutritional advice. The aim is to support understanding during their cancer journey.

The platform also provides support for nominated carers who may have questions they feel unable to address during virtual consultations as they believe that the focus should be placed on the immediate care of their loved one. The platform offers a space to ask those questions and access support if needed. Cancer affects not just the patient themselves but also their friends and family members.

Further, how can the wider pharma industry help to alleviate the current cancer care challenges?

Out of necessity, the pandemic has pushed pharma to go further in innovating and elevating the collaboration we have with the NHS. What has been, and will continue to be critical, is the need for an open dialogue and for pharma to be agile, so that we can create solutions that address what matters most — patient care.

It will mean looking to enhance every stage of the patient journey — from diagnosis to treatment and beyond. The pharma industry has a responsibility to demonstrate new ways we can deliver value. The integration of technology into diagnosis, management and treatment, is one such example.

As an industry, we should be proud of the recent progress in cancer care. However, not all forms of cancer have received the attention and advances of areas such as breast cancer. There’s still a need to focus our research and development efforts on solutions where unmet patient need is high, or in cancers that are still underserved. It will mean focusing on immuno-oncology approaches that harness a patient’s natural immunity to develop innovative solutions that can target hard to treat cancers. Our goal is that every patient has an equal chance for hope and access to potentially life-saving treatments.

You took up your role in the UK after the pandemic had started. How did that affect the transition from your previous position?

I have worked for Astellas since 2015 and can confidently say that the culture and attitude of the team in the UK would always have made my transition into this role seamless. As a global organization, we’ve been used to working with colleagues remotely for many years. Yet, the completely remote working environment that the pandemic made necessary, still posed challenges.

A big part of my role is bringing the team together. I’ve seen some people grow in confidence through remote working, while others who thrived in the office environment have found it harder. Like healthcare professionals in a virtual consultation, picking up non-verbal cues is more difficult, and it requires more regular touch points to ensure the continued physical and mental well-being of colleagues. The experience has naturally been different. Yet, it has been a refreshing challenge and an opportunity to connect with colleagues in new and different ways.

What for you have been the key leadership challenges and opportunities of the last year?

I am proud of the enhanced engagement we have built across all levels of the organization and indeed beyond Astellas during the pandemic.

Ensuring that every employee at Astellas feels heard and included has been an unwavering priority for the Leadership team. We encourage and welcome diversity and we’ve maintained this throughout the pandemic — continuing the valuable work of our Employee Impact Groups (EIGs) to give all parties an equal voice and encourage career progression. With over 1,000 members of EIGs worldwide at Astellas, we continue to build on our commitment to embracing diversity. I am proud to have recently launched our latest UK chapter — Stellar Women. The group aims to support and transform the impact of the many impressive women who make up our sector by creating an environment of empowerment and advocacy.

The pandemic has also been both an opportunity and a responsibility to drive forward timely and relevant solutions with those outside of our organization. It has meant accelerating conversations and finding partnerships that could quickly deliver critical solutions at times when they were needed most. At times, it has meant pulling back – which can be the hardest decision of all, but a necessary one. Ultimately, we always try to approach a decision by putting patient needs first.

As hard as the pandemic has been, it has pushed pharma to re-evaluate the ways we work and how value is demonstrated and communicated to those within the healthcare sector. The opportunity has been for me to challenge some of the ways we have traditionally worked and engaged. To ensure we are asking the right questions and proposing the right solutions.

Jackie Williams is General Manager, Astellas UK & Ireland. She first joined Astellas in 2005. Prior to that, she worked for Novo Nordisk and Baxter Healthcare.

Note

1. Macmillian Cancer Support, The forgotten ‘C’? The impact of COVID-19 on cancer care, October 2020. Available at: https://www.macmillan.org.uk/assets/forgotten-c-impact-of-covid-19-on-cancer-care.pdf. Last accessed: March 2021.