To improve the information supplied to nurses providing care and support for pancreatic cancer patients, the Department funded the National Cancer Action Team (now part of NHS Improving Quality) to undertake a series of actions to improve the experience of cancer patients. This included developing a national advanced communication skills training programme; developing an assessment and feedback tool to promote better working between cancer teams in trusts and a quality improvement toolkit for nurses.

An information prescription provides up-to-date and accurate information from the national health service and from patient organisations. There are over 70 site-specific information pathways for cancer, including one for pancreatic cancer. The Pancreatic Cancer pathway on the Information Prescription Service provides

information on all aspects of the patient journey, which can be shared with the health care professionals who are responsible for the patient's care.

The pathways include prevention, symptom awareness, referral, diagnosis, staging, treatment, follow up, recurrence and advanced disease. The pathway explains what pancreatic cancer is and how it can be treated and provides advice on the side effects of treatment. A variety of supportive care information is also available which covers diet, free prescriptions, getting travel insurance and advice on living with the disease.

The Improving Outcomes in Cancer guidance published by the National Institute for Health and Clinical Excellence (NICE) sets out best practice treatment and support for patients in the provision of care for a range of cancer types, including pancreatic cancer.

To support a positive experience of care, the guidance highlights the importance of effective communication, providing good quality information to patients and supporting access to Clinical Nurse Specialists (CNS). The role of CNS is especially important in facilitating continuing good communication; contact with a trained and experienced nurse can reduce patients' anxiety, depression and physical symptoms. The guidance recommends that cancer patients should have the name and contact number for a particular nurse, and should, whenever possible, see and speak to the same nurse.

The above elements of NICE'S Improving Outcomes guidance will continue to be a feature of all commissioned cancer services from April 2013.

Through the 2010 and 2011-12 National Cancer Patient Experience Surveys, published in August last year, we have continued to monitor patients' experience of NHS cancer care. Questions within the surveys have covered important issues such as access to CNS, patient information and effective communication, as well as a range of other areas key to the delivery of high quality cancer care and improved outcomes.

The 2011-12 survey recorded the views of over 71,000 cancer patients, including those with pancreatic cancer. 88% of pancreatic cancer patients said their care was excellent or very good.

Quality Health, the survey provider, has identified the responses of pancreatic cancer patients from the upper gastro-intestinal cancer grouping to enable comparison of their experience against those of other cancers. The survey results are helping trusts to identify areas in cancer care that need improvement locally and to raise standards across the service.

The Medicines and Healthcare products Regulatory Agency (MHRA) is the agency responsible for the safety and licensing of medicines.

Reports of suspected adverse drug reactions (ADRs) are collected by the MHRA and Commission for Human Medicines (CHM) through a spontaneous reporting scheme, the Yellow Card Scheme. The scheme collects ADR reports from across the whole of the United Kingdom and includes all medicines and vaccines, including those from prescriptions, over-the-counter or general retail sales, and also reports for herbal and unlicensed medicines. Patients as well as health care professionals can report suspected adverse drug reactions directly to the MHRA using the Yellow Card website, paper forms or by telephone. The scheme relies on voluntary reports received from health care professionals and patients although there is a legal requirement for companies to report serious ADRs to their drugs to the MHRA.

All ADR reports received by the MHRA are entered onto their database for rapid analysis and assessment. These reports are reviewed by a team of physicians, pharmacists and scientists using statistical tools in a process known as signal detection, in order to identify potential new safety concerns. When a potential drug safety hazard is identified, an assessment of the risks and benefits of the medicine is undertaken to determine what action, if any, is necessary.

The Yellow Card Scheme contributes to the process of monitoring the safety of all medicines throughout their marketed life, known as pharmacovigilance, which works to identify previously unrecognised safety hazards. When a potential drug safety hazard is identified, an assessment of the risks and benefits of the medicine is undertaken to determine what action, if any, is necessary. The objective of regulatory action is to ensure that the benefits of a patient taking the medicine continue to outweigh risks.

A number of options for communicating information on drug safety hazards to health care professionals and the public are available to the MHRA. New warnings about medicines, arising from pharmacovigilance activities, are published in Drug Safety Update, an electronic monthly bulletin for health care professionals issued by the MHRA, published on the MHRA website and emailed to approximately 170,000 health care professionals. Some articles relating to major regulatory actions such as a withdrawal/suspension of a medicine, or a serious side effect for a widely used or high-profile medicine or vaccine, are linked to an MHRA public assessment report (also published on the website) which summarises the scientific and clinical evidence for the safety issue in question.

If information of particular clinical importance emerges, it is common practice that a ‘Dear health care professional’ letter is sent to relevant clinicians by the pharmaceutical company, consistent with MHRA advice. The letter outlines any new risk and advises on how the risk can be minimised and managed. Urgent messages are also cascaded to health professionals by the MHRA, using the web-based NHS Central Alerting System (CAS); this includes dissemination to some independent providers of health and social care. Warnings are also published on the MHRA website.

These safety messages issued by the MHRA are taken up by external organisations which are responsible for issuing clinical guidance; MHRA works closely with such organisations to ensure that safety information is consistent and up to date. This includes, for example, the British National Formulary, which many clinicians use in practice for obtaining information on medicines, including their adverse effects. Health care professionals may also receive information from the Medicines and Prescribing Centre's Evidence Summaries, which provides a current awareness service by appraising new information and placing it in the context of other evidence.

The MHRA's Defective Medicines Report Centre plays a major part in the protection of public health by minimising the hazard to patients arising from the distribution of defective medicinal products. It does this by providing an emergency assessment and communications system between suppliers of medicinal products, the regulatory authorities and health care professionals.

The Medicines and Healthcare products Regulatory Agency (MHRA) is the agency responsible for the safety and licensing of medicines.

Reports of suspected adverse drug reactions (ADRs) are collected by the MHRA and Commission for Human Medicines (CHM) through a spontaneous reporting scheme, the Yellow Card Scheme. The scheme collects ADR reports from across the whole of the United Kingdom and includes all medicines and vaccines, including those from prescriptions, over-the-counter or general retail sales, and also reports for herbal and unlicensed medicines. Patients as well as health care professionals can report suspected adverse drug reactions directly to the MHRA using the Yellow Card website, paper forms or by telephone. The scheme relies on voluntary reports received from health care professionals and patients although there is a legal requirement for companies to report serious ADRs to their drugs to the MHRA.

All ADR reports received by the MHRA are entered onto their database for rapid analysis and assessment. These reports are reviewed by a team of physicians, pharmacists and scientists using statistical tools in a process known as signal detection, in order to identify potential new safety concerns. When a potential drug safety hazard is identified, an assessment of the risks and benefits of the medicine is undertaken to determine what action, if any, is necessary.

The Yellow Card Scheme contributes to the process of monitoring the safety of all medicines throughout their marketed life, known as pharmacovigilance, which works to identify previously unrecognised safety hazards. When a potential drug safety hazard is identified, an assessment of the risks and benefits of the medicine is undertaken to determine what action, if any, is necessary. The objective of regulatory action is to ensure that the benefits of a patient taking the medicine continue to outweigh risks.

A number of options for communicating information on drug safety hazards to health care professionals and the public are available to the MHRA. New warnings about medicines, arising from pharmacovigilance activities, are published in Drug Safety Update, an electronic monthly bulletin for health care professionals issued by the MHRA, published on the MHRA website and emailed to approximately 170,000 health care professionals. Some articles relating to major regulatory actions such as a withdrawal/suspension of a medicine, or a serious side effect for a widely used or high-profile medicine or vaccine, are linked to an MHRA public assessment report (also published on the website) which summarises the scientific and clinical evidence for the safety issue in question.

If information of particular clinical importance emerges, it is common practice that a ‘Dear health care professional’ letter is sent to relevant clinicians by the pharmaceutical company, consistent with MHRA advice. The letter outlines any new risk and advises on how the risk can be minimised and managed. Urgent messages are also cascaded to health professionals by the MHRA, using the web-based NHS Central Alerting System (CAS); this includes dissemination to some independent providers of health and social care. Warnings are also published on the MHRA website.

These safety messages issued by the MHRA are taken up by external organisations which are responsible for issuing clinical guidance; MHRA works closely with such organisations to ensure that safety information is consistent and up to date. This includes, for example, the British National Formulary, which many clinicians use in practice for obtaining information on medicines, including their adverse effects. Health care professionals may also receive information from the Medicines and Prescribing Centre's Evidence Summaries, which provides a current awareness service by appraising new information and placing it in the context of other evidence.

The MHRA's Defective Medicines Report Centre plays a major part in the protection of public health by minimising the hazard to patients arising from the distribution of defective medicinal products. It does this by providing an emergency assessment and communications system between suppliers of medicinal products, the regulatory authorities and health care professionals.