England’s new cancer strategy – what happens next?

Last month, the Independent Cancer Taskforce published its strategy for improving cancer outcomes in England over the next five years.

By making the changes suggested in its report the Taskforce estimates that, by 2020, the NHS could be saving 30,000 more lives each year.

Strategies like this are important. They set ambitions and dedicate resources in the right places across the NHS to improve things for patients – something that’s been recognised at the highest level: the World Health Organisation believes that all countries should have a plan for cancer. And over the years, there’s evidence that previous strategies have made a big impact.

That’s why, at Cancer Research UK, we campaign for each UK nation to have up-to-date cancer strategies.

Our chief executive, Harpal Kumar, chaired the Independent Taskforce and has already blogged about what’s in the strategy. To refresh your memory, the six priorities are:

1. A renewed focus on prevention and public health
2. A national ambition to achieve earlier diagnosis
3. Establishing patient experience as being on par with clinical effectiveness and safety
4. Transforming support for people living with and beyond cancer
5. Investing in modern high-quality services
6. Overhauling the way the NHS commissions and provides services

At Cancer Research UK, we’re strongly backing the strategy, particularly its focus on better prevention, swifter diagnosis and modernising the NHS to provide better access to treatments – all things we’ve also identified as priorities for the NHS.

But now it’s out, what happens next? What needs to be done to make sure the priorities put forward by the Taskforce become a reality?

There are a lot of challenges ahead, but there are two crucial things that need to happen.

First, the organisations that lead the health service need to develop clear, detailed plans for putting the Taskforce’s recommendations into practice.

And second, the Government needs to invest the money to make it happen.

Putting it into practice

We want to see clear plans for putting the strategy into action

The Taskforce was created by NHS England and six other organisations involved in running the different aspects of the health system – the Care Quality Commission, Health Education England, Monitor, Public Health England, NICE and the NHS Trust Development Authority.

It was deliberately established as an independent group so that it could take a critical look at the health service as a whole.

This made sense – achieving world-class cancer outcomes is a challenge that needs to be tackled on many fronts, so changes will be needed across each part of the health system, and this means cutting across the remits of each of those lead organisations. So for example, improving screening services will need to involve both Public Health England and NHS England, as well as some of the others.

But since the Taskforce was independent, there’s a catch – the strategy isn’t really ‘owned’ by the organisations that created it. So it’s now critical that these organisations now develop well-integrated plans for how they will put the recommendations into practice – and Harpal wrote to the chief executives of each organisation saying as much.

The good news is that each of them has come out in support of the strategy – for example, the NHS England board was vocal in its support at its meeting in July, and it says that it will provide regular updates on progress.

But it’s also vital that one of the first priorities should be setting up two new groups: a National Cancer Team that will work across all of these organisations to put the strategy into practice, and a National Cancer Advisory Board that will oversee progress. But until we see clear plans, we will be keeping up the pressure.

Making the investment

Money is the other crucial factor.

In November, the new Government will carry out a Spending Review – the process by which it decides its spending priorities up to 2020.

In their manifesto before the election, the Conservatives promised:

We will work with the NHS, charities and patient groups to deliver the new strategy recommended by NHS England’s Cancer Taskforce

And they have already said the Spending Review will also focus on investment for the NHS.

We also need to see government investment to make it happen

The NHS spends about £6.7bn on NHS cancer services each year. But as we have said before, these services are in desperate need of more resources. The Taskforce estimates that, as the NHS has to cope with more people getting cancer – about 1 in 2 of us – and more people surviving for longer, cancer services could cost around £13bn by 2020.

But to put the recommendations in the strategy into practice, the Taskforce estimates it will cost around £400 million per year – a fraction of what the NHS spends on cancer already.

This money will be crucial to pay for some key items in the strategy that we believe are really important to make the improvements needed, such as:

• To help the NHS diagnose cancer more swiftly, a £125 million fund to upgrade equipment – like MRI and CT machines – and address shortages of staff in diagnostic services.
• £22.5 million to provide a national molecular diagnostic service so that suitable cancer patients can be offered tests to tailor treatment to their cancer.

On top of this, a one-off investment of £275 million is needed to urgently replace old radiotherapy machines and upgrade existing equipment, to ensure all patients have access to the latest evidence-based treatments for their cancer.

All of this might sound like a lot of money, but in the grand scheme of a health budget of over £100 billion, it’s not. And, crucially, this investment is expected to produce savings in the long run of around £380-£575 million per year.

Ultimately, investments such as these are needed to make the major improvements in cancer outcomes the strategy strives for.

So it’s vital the Chancellor, George Osborne, and the Treasury fulfil the manifesto promise and provide the money needed to see the strategy is properly supported.

Keeping an eye on progress

The Taskforce has laid the foundations by producing an ambitious strategy. But it’s now up to the NHS organisations to make it a reality, and for the Government to invest to ensure this can happen.

Through this strategy, we have a huge opportunity to reduce the number of people who get cancer, and improve the outcomes for the many thousands who do develop the disease each year in England.

At Cancer Research UK, we will be keeping a close eye on progress.

We’ll be working hard to ensure the work of the Taskforce is put into practice – so that ultimately we will all feel the benefits of the ambitions it sets out.