The Cancer Reform Strategy
The NHS Cancer Reform Strategy for England (CRS), published in December 2007 builds on the progress made since the publication of the NHS Cancer Plan in 2000 and sets a clear direction for cancer services for the next five years. It shows how by 2012 our cancer services can and should become among the best in the world.
The CRS makes some key commitments for delivery with the NCIN. These are highlighted below, with reference to the section in the CRS.
- NCIN Annual Report (March 2009) – (CRS 8.23)
- Early products – (CRS Box 42):
- An electronic toolkit, bringing together information on cancer in an accessible and usable way to enable the benchmarking of services and to inform commissioning;
- Collecting and analysing information on cancers in teenage and young adults;
- Evaluating services for secondary cancers in specific tumour areas;
- Making available to the public, information on clinical outcomes through NHS Choices;
- Following up on the progress of patients who have been in clinical trials over longer periods; and
- Assessment of trends in one year survival rates for different cancers. These are a proxy for early/late diagnosis.
- Management of the delivery and publication of comparative national information on diagnosis, treatment and outcomes for types of cancer and types of patient. Working with others, a new library of available information will be established and new analyses commissioned – (CRS 8.22);
- Development of a framework for accurate comparison (of survival and mortality, awareness, early detection, access to different forms of treatment, clinical outcomes, patient experience and costs) with other countries , closely collaborating with Europe, USA, Canada, Australia, New Zealand – (CRS 11.43).
Other initiatives referenced within Cancer Reform Strategy likely to require NCIN involvement:
- National surveys of cancer symptom awareness in collaboration with Cancer Research UK – (CRS 3.47 & 8.6);
- National audit in primary care of newly-diagnosed cancers in collaboration with the Royal College of General Practitioners (RCGP) and the National Patient Safety Agency (NPSA) – (CRS 3.61);
- A new National Cancer Survivorship Initiative in partnership with Macmillan Cancer Support and other charities – (CRS 5.66);
- A new annual NHS Cancer Patient Experience Survey Programme – (CRS 5.73 & 8.9);
- National Cancer Equality Initiative to optimise data collection to enhance our understanding of the inequalities that exist –(CRS 6.8).
Cancer Standards
Improving Outcome Guidance (IOG) are published by NICE for most of the major cancer sites. They set out the appropriate care and treatment for people with cancer, as well as the preferred model of service organisation, and their implementation has contributed to the improved care and management of cancer patients in England over the last ten years. A process of auditing implementation of IOG is underway.
Peer Review
National Cancer Peer Review (NCPR) is a national quality assurance programme for NHS cancer services. The programme involves both self-assessment by cancer service teams and external reviews of teams conducted by professional peers, against nationally agreed quality measures set out in the Manual for Cancer Services.
Cancer waiting time targets
Prior to the CRS, waiting times covered urgent referral by a GP (2 weeks); a 31 day target from diagnosis of breast cancer to treatment; and a 62 day target from urgent GP referral to treatment. The CRS outlined extensions to the existing cancer waiting times, to include groups of patients that were previously not included. The two week wait standard will now extend to all patients with breast symptoms, whether cancer is suspected or not. The 31 day standard will apply to all treatments for cancer, including after a recurrence; and the 62 day target will apply to patients referred from NHS cancer screening programmes, as well as those deemed urgent by another hospital consultant, as well as those referred urgently by their GP.
