What should the new NHS Commissioning Board focus on?

Changes are afoot in the NHS – what will they mean for cancer patients?

How would you spend £80 billion of taxpayers’ money to ensure that our healthcare services remain among the best in the world?

That’s the challenge faced by the new NHS Commissioning Board, which is set to be formally established in just a few days, on the 1^st October.

The Board is being created as a result of the much-debated Health and Social Care Act 2012, and is set to oversee how a host of new local and regional bodies such as Clinical Commissioning Groups will serve the healthcare needs of their communities.

Yesterday was the last day of an important public consultation about the proposed priorities and aims of the NHS Commissioning Board. To make sure the new NHS meets the needs of people with cancer, we submitted an in-depth response to this consultation to the Government.

The full document can be found here , and we’ve summarised exactly why this consultation matters for cancer patients in this article.

Why is this important for Cancer Research UK?

As part of the NHS reforms, the Government decided that the objectives for the NHS Commissioning Board should be set by it each year in a ‘mandate’ document.

The first draft mandate was published in July, and the Government invited healthcare experts and organisations such as Cancer Research UK to submit their thoughts.

The Board will have extremely important responsibilities in setting out how cancer diagnosis, services (such as how quickly patients get access to test results), treatment and research are carried out within the NHS.

As a result, the Board’s objectives matter greatly to us. As we’ve said before, we’d like to see it making sure that:

• research is promoted and embedded throughout the NHS,
• cancer is diagnosed early,
• public health is promoted,
• inequalities are tackled and
• patients receive the treatments that doctors think are best for them.

What do we think of the draft mandate?

Overall we think that the draft mandate broadly addresses these key issues.

For example, there’s a specific objective on the Board’s duty on research, and it’s crucial that this remains in the final mandate.

It covers essential ways to make sure that the NHS meets treatment costs associated with research studies, and that patients can access appropriate treatments. We also support the Association of Medical Research Charities’ response to the consultation, which highlights that this is not only relevant for cancer but for a wide range of other diseases that benefit from vital research in the NHS.

We’re also pleased to see research mentioned in the accompanying draft ‘Choice Framework’, published as an ‘Annex’ to the draft mandate, which outlines the choices that should be available to patients in the new NHS. We’d like to see our award-winning CancerHelp UK website listed as a patient resource in this framework – it has an excellent, and unrivalled ‘plain English’ database of clinical trials for patients.

In its first year the Board will need to focus on setting up and overseeing the new health system created by the Act, and we’re glad to see that there is an objective on this in the draft mandate.

But going further, given that bodies such as Cancer Networks have real expertise in the planning of local cancer services, we’d like to see the Board ensure that the new Clinical Commissioning Groups (which the Board will oversee from April 2013) get advice from these experts while planning local cancer services.

Again, this is in line with the recent Act, and is something that we called and lobbied for.

We’d also like the Board to ensure that Clinical Commissioning Groups take into account whether the services that they are planning to use are involved in medical research. This step would really help research to be embedded throughout the NHS, benefiting patients.

Early diagnosis is also crucial for cancer patients. If cancer is diagnosed early, treatment is more likely to be effective. That’s why we’re very pleased that the draft mandate includes two service performance standards for cancer:

Firstly, suspected cancer patients should be seen by a specialist within two weeks (as is the case at the moment).

Secondly, it states that they should receive diagnostic tests within six weeks.

These standards are really important to patients and their treatment, and again we want them to remain in the final mandate.

There are a number of other things that we are pleased are in the draft mandate. For example, it asks the Board to:

• increase the proportion of patients who rate their experience as ‘good’,
• ensure improvement in tackling inequalities in cancer care, and
• develop a programme of action to ensure that people are supported in improving their health by healthcare professionals.

Next steps

As the new Board continues to set up its structures and recruit staff, its final mandate is crucial. We hope that much of what is in the draft mandate remains. We have also suggested a number of small additions to the draft, particularly to strengthen the Board’s objectives in terms of research.

From next month, the NHS Commissioning Board will no longer be a theoretical entity, but an established independent body, at arm’s length to the Government. To begin with, it will carry out functions such as establishing and authorising local Clinical Commissioning Groups.

But in just a few short months – by April 2013 – it will take on full statutory responsibilities, and the planning and delivery of care by the NHS will no longer directly be the responsibility of the Department of Health, Strategic Health Authorities, or Primary Care Trusts.

This is the biggest ever change made to the structure of the NHS.

So, as we move towards April 2013 we will continue to monitor what the changes will mean for cancer patients. For example, we are closely examining Clinical Commissioning Groups’ plans, to ensure that they focus on cancer issues and promoting research. And we’re working with other parts of the new NHS such as Health and Wellbeing Boards and with Local Authorities to ensure that they prioritise cancer as much as possible.

You will be able to read more about this work here on this blog, in the run up to April 2013.

Simon

• Simon Kirkland works in Cancer Research UK’s Policy and Public Affairs team