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NHS England sets out vision for upcoming Cancer Alliances

NHS England has revealed exactly what local Cancer Alliances will be doing, following recommendations from the cancer taskforce last year.

They will plan cancer services for their specific population and design care pathways, particularly when care is required across different providers, and will also provide improvement support, measure outcomes (through the CCG Assessment Framework and integrated Cancer Dashboard) and engage with the public on cancer service changes.

Cancer Alliances were one of the 96 recommendations outlined in the cancer taskforce report published in July last year. They were designed to work beyond the national infrastructure at sub-regional level as “owners of local metrics and the main vehicles for local service improvement and accountability in cancer”.

NHS England, which will outline its vision at its board meeting tomorrow, is working with regional teams, strategic clinical networks and other organisations to develop this proposal. The speed of establishing these alliances will depend on the budget available, but “national coverage by the end of the year will be crucial” to fully implement its recommendations over this Parliament.

According to NHS England’s national clinical director for cancer, Sean Duffy, creating these 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”.

As revealed by the organisation’s chief executive Simon Stevens in September, NHS England is also looking to test an ‘accountable clinical network’ model for cancer at three sites as part of the new care models programme.

At the time, Stevens established these sites would be well-known cancer care providers The Royal Marsden NHS FT, The Christie NHS FT and University College London Hospitals NHS FT.

Rather than having alliances in those areas, the three Vanguards will start testing the next level of integrated working to achieve ambitions outlined in the taskforce, including testing new funding models (potentially including a capitated budget for a population), new workforce models (sharing capacity), and new IT infrastructure models (digital solutions and integrated informatics systems).

NHS England is also establishing a National Cancer Team to lead and coordinate the taskforce’s implementation. It has identified extra cash within the organisation as part of future business planning.

Overall, the taskforce estimated that required costs of implementing the cancer strategy would be between £700m and £1.4bn over five years. NHS England still needs to take final decisions on funding once its overall finances are clear, but it acknowledged that “both revenue and capital funding streams are critical for strategy implementation”.

Although the strategy stretches beyond that, the main goals of the 2016-17 slice of the programme, which seeks to address all six priority areas from the taskforce report, will already include achieving national coverage of the alliances, testing innovative collaborative models of commissioning through vanguards and unlocking greater diagnostics capacity.

The process of implementing these recommendations will be led by Cally Palmer, NHS England’s NHS national cancer director, who works alongside the cancer vanguards to use outcomes-based commissioning to redesign care.

Cancer was also a major centrepiece in NHS England’s 2016-17 mandate and planning guidance for the years ahead, where it featured as one of the nine ‘must-dos’ for all providers in terms of waiting time standards and better diagnostic capacity.

In the mandate, the organisation also said it would publish the results of the CCG assessment framework for 2015-16 by June, which will provide CCGs with an “aggregated Ofsted-style assessment” of their performance. From then on, the Ofsted-style framework will start to include metrics to measure progress on cancer care, amongst other services.