Making a step change in cancer services

NHS England’s National Clinical Director for Cancer, Sean Duffy, looks again at the report of the Independent Cancer Taskforce and some key areas for early progress:

In my last blog I reflected on the strategic priorities laid out by the Independent Cancer Taskforce report in July, their relevance to our work, and how we need to all start thinking about how we can translate them into our everyday business.

While we work with partners across the health and care system to develop a comprehensive plan for implementation of the Taskforce’s report, I thought I would take the opportunity today to lay out some of the specific areas which NHS England is making early progress on:

In terms of early and fast diagnosis, we are all acutely aware of the need to meet the 62 day waiting times standard, which has been missed nationally since April last year.  The recommendations in the Taskforce report on increasing diagnostics capacity and speeding up the time between referral and diagnosis can help us to do this, and ultimately vastly improve patient outcomes and experience.  We are urgently looking at how we can support a rapid increase both in GPs’ direct access to diagnostic tests and diagnostics capacity more generally.

Health Secretary Jeremy Hunt recently committed to the Taskforce recommendation to ensure that all those referred for tests with a suspicion of cancer receive a definitive diagnosis or non-diagnosis of cancer within four weeks. This new standard offers us a great opportunity to innovate, foster links between primary and secondary care and improve the diagnostic process for patients.

Over the next few months, we will be inviting Trusts and other local NHS organisations to work with us to help define the rules for the new standard, identify the specific technical and practical challenges that we will face putting it into practice, and look at how we can overcome these together.

Cancer Alliances were proposed by the Taskforce to bring together commissioners, providers, professionals and patients across geographical areas defined by patient flows, to lead and guide improvements in cancer services. NHS England is leading work to identify guiding principles for the Alliances, which will then be refined and developed together with regional and local organisations.

We need to clearly define the ‘task’ of Alliances; this along with the needs of local areas will then determine the form they will take. Creating Alliances shouldn’t require any changes to existing structures, but are instead a way of bringing a new focus to the way we work together to improve cancer services.

Two other major recommendations from the Taskforce further focus on the way in which cancer services are commissioned and provided. Like alliances, they focus particularly on the way in which organisations work together to deliver and commission high-quality cancer services. The Taskforce suggested pilots of a ‘lead provider’ model and a ‘whole pathway’ model of commissioning.

Both models are aimed at improving patient outcomes by making better use of our resources, and by integrated services more effectively.  We are planning to test these ideas as part of our work to develop Alliances, building on those collaborations further to look specifically at these ways of pooling resources.

These are complex areas that require significant scoping and thought, but which could be immensely powerful in transforming the care patients receive. We are working with partners across the health system to work out how best to take these forward, and aim to put more detail on the approach in the coming months.

The Taskforce also proposed a Cancer Dashboard as a key tool to allow commissioners and providers to track their progress against achieving the ambitions laid out in the strategy. A key challenge will be to ensure that we can relate this to the decisions facing commissioners and providers on a daily basis.

We are setting up a new working group to oversee the development of the dashboard, and I hope to engage as widely as possible to make sure that we include the information that will be most useful to all of you.  Again, we hope to be able to announce more detail in the next few months.

The Taskforce report offers a great opportunity for us to work together to make a step change in our cancer services, and I hope you’ll join us in pushing these developments forward over the coming months.

Sean Duffy

Sean Duffy is the National Clinical Director for Cancer. Professor Duffy is also a clinical academic gynaecologist based at the University of Leeds with his clinical practice at the city’s St James’s Hospital. His medical expertise is in endometrial cancer and he has an international reputation in the field of endoscopy surgery and training.

He has had senior academic experience in laboratory and health services research and has had national and regional responsibilities for undergraduate and postgraduate education in obstetrics and gynaecology with senior roles in the Royal College of Obstetrics and Gynaecology and the University of Leeds. For the eight years before he was appointed National Clinical Director for Cancer, he was leading the Yorkshire Cancer Network as medical director and over the last four as director as well.


  1. Chrissy Marshall says:

    Reiterating Julie Macadams comments about engaging with and investing in CNS is fundamental to bridge the communication gap between Consultant specialists and patients in shock from Cancer diagnosis.
    As Chair of West Suffolk Cancer Services User Group,and Cancer patient, recent patient Forum feedback identified need for community and GP support for more Body Awareness by patients. An education and advertising programme on knowing your body would support the early diagnosis and treatment for all patients. They say a picture saves a thousand word.
    We work hard at improving the patient experience, in partnership and understanding needs does mean asking what patients want. Communication and understanding are fundamental.
    Chrissy Marshall, Chair, West Suffolk Cancer Services User Group.

  2. steve williamson says:

    Good Blog Sean, prehaps we wouldn’t have needed Cancer Alliances if the 2013 restructure has kept Cancer Networks intact and fully functional, we know the strategic clinical Networks are stretched too thin, great that the focus was broadened from just cancer, but we did loose a successful model.

    So wehave the basis for the Alliance structure – look to the best of the old Cancer Network models, which did intergrate, commissioners and providers, so let’s use our organisational memory

  3. Julia McAdam says:

    We need to harness the expertise of Clinical Nurse Specialists and use them appropriately: more investment in non-clinical support staff would allow the CNS to practice more efficiently and support the Cancer patients at the point of need. Vast resource of “expensive ” staff being used for non clinical work.
    I also believe that investment in data input would also pay dividends as it would help to support the work being undertaken, and allow us to understand more fully where the gaps in our services lie. I am passionate about improving patient experience, but I need to understand what the patient needs, not dictate to them what I think they need.
    Julia McAdam, Macmillan Lung Cancer Clinical Nurse Specialist, Shrewsbury & Telford NHS Trust.