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Our ambition to create world class cancer services – Cally Palmer

The NHS’s Independent Cancer Taskforce estimates 30,000 lives can be saved each year by 2020 through earlier diagnosis and better treatment and care. Here NHS England’s National Cancer Director sets out the plan to meet the Taskforce’s ambition:

More people are surviving cancer than ever before, but as half of those born after 1960 will be diagnosed at some point in their lives, we know there is more we can do to ensure we deliver truly world-class cancer services for all patients in England.

In its report last year, the NHS’s Independent Cancer Taskforce, established as part of the NHS Five Year Forward View, set us a significant challenge – but it is one that we are committed to meet.

It has given us a great opportunity to refocus our efforts and shift resources to ensure we deliver better prevention and earlier diagnosis, while providing modern treatments and compassionate care.

Since publication of the Taskforce report, rapid progress has been made on how best to implement some of the key recommendations.

And now, in our new publication “Achieving World-Class Cancer Outcomes: Taking the Strategy Forward”, we have set out plans to take action across all strategic priorities, with more cancers prevented, more people surviving for longer following a cancer diagnosis, everyone with cancer having consistently good experiences of treatment and care, and a better long-term quality of life.

We will achieve these goals by supporting strong local leadership and with the robust use of data across cancer pathways.

Our plan explains how we will establish Cancer Alliances across the country from September this year.  These will see clinicians from across primary, secondary and tertiary care working together with other local healthcare leaders to improve services for their populations.

We are also launching the first phase of our new integrated cancer dashboard.  This brings together data from across patient pathways into one, simple-to-use portal, to provide the basis of evidence and intelligence for conversations in Cancer Alliances about where to direct improvement support and focus.

The development of Sustainability and Transformation Plans (STPs) by the 44 STP footprints in England provides the context in which this new approach to collaborative, cross-organisation, whole-pathway planning and improvement in cancer services sits.

Improving cancer survival, the stage of diagnosis and long-term quality of life require action in primary, secondary, and tertiary care and beyond.

By sharing a sense of responsibility – if not yet formal accountability – for outcomes for all cancer patients in their patches, the aim is that those individual organisations that make up Cancer Alliances – and the people working within them – are empowered to work more closely together to improve pathways of care transcending organisational boundaries.

And as part of the new models of care programme we are seeing how we could go a step further.

Three sites – led by the Royal Marsden, the Christie and University College London Hospitals – will test models that introduce more formal accountability for whole-pathway and whole population service planning and provision.

As this national cancer vanguard project progresses, we will share learning with Cancer Alliances across the country, as well as share valuable experiences from the Cancer Alliances as they develop.

When cancer is diagnosed at an early stage, treatment options and chances of a full recovery are greater. For example, around 67 per cent of people diagnosed with oesophago-gastric cancers at the earliest stage survive for at least five years, which falls to only around three per cent for those diagnosed at a late stage.

So, we are making an additional £15 million initial and immediate investment to explore how we can improve access to diagnostics for those suspected of having cancer, both by looking at new models of delivery and by increasing current capacity.

As more people survive longer following a cancer diagnosis, we need to ensure that people are supported to live as healthy and happy lives as possible.  All people who have had a cancer diagnosis should be able to access the right support services at the right time.

We have published guidance for the NHS on the commissioning of those support services, and are working to develop a clearer measure of long-term quality of life so that it can be included in the cancer dashboard for Cancer Alliances.

I believe we can build on the good work already being done and deliver truly world-class cancer outcomes in every part of England.  I cannot imagine a more important mission.

Success will only be possible if we support and empower strong local leaders to drive the changes that we all want to see for our patients.


Cally Palmer is NHS England’s National Cancer Director leading the implementation of the NHS Cancer Taskforce’s five year strategy for cancer care improvement, as well as new cancer Vanguards using outcomes-based commissioning to redesign care and the patient experience.
She is also Chief Executive of The Royal Marsden Hospital NHS Foundation Trust, and retains this role while seconded to NHS England.

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