Cancer

Background

The NHS Plan (July 2000) presents the government's strategy for investment and reform across the NHS, and gives cancer services high priority. This document provides a detailed account of the government's comprehensive national programme for investment in and reform of cancer services in England, which aims to reduce death rates and improve prospects of survival and quality of life for cancer sufferers by improving prevention, promoting early detection and effective screening practice, and guaranteeing high quality treatment and care throughout the country. The cancer plan is particularly committed to addressing health inequalities through setting new national and local targets for the reduction of smoking rates, the setting of new targets for the reduction of waiting times, the establishment of national standards for cancer services, and investment in specialist palliative care, the expansion and development of the cancer workforce, cancer facilities, and cancer research. There have been a number of update reports since the plan's release in July 2000. They can be found here >>>

The Cancer Reform Strategy, published on 3 December 2007, builds on the progress made since the publication of the NHS Cancer Plan in 2000 by spreading best practice and recommending what more needs to be done by cancer networks and the NHS to improve clinical outcomes, drive up quality and increase value for money. It sets out a clear direction for cancer services over the next five years and shows how we will deliver cancer outcomes that are amongst the best in the world.

In the first annual report of the Cancer Reform Strategy, Professor Mike Richards, the National Cancer Director, sets out the considerable amount of progress made in implementing the strategy since its publication in December 2007. The report covers the wide range of actions that were set out in the strategy, highlighting areas of particular progress and setting out a range of priorities for the future.

It aims to improve cancer prevention, speed up the diagnosis and treatment of cancer, reduce inequalities, improve the experience of people living with and beyond cancer, ensure care is delivered in the most appropriate settings and ensure patients can access effective new treatments quickly.

The second annual report of the Cancer Reform Strategy - Achieving local implementation was published in December 2009, outlines that considerable progress has been made in national implementation over the past year and that good progress has been made on the large majority of the components of the National Cancer Programme. This report focuses on achieving local implementation and provides an opportunity to identify major priorities for the coming year.

The cancer commissioning guidance announced as part of the Cancer Reform Strategy has been developed to support world class commissioning of cancer services across the NHS. The guidance sets out, in an easy to use format, key issues and questions that commissioners and cancer network teams will want to take into consideration when assessing health needs, reviewing services, developing their contract service specifications and monitoring performance.

The cancer commissioning guidance sits alongside the linked web-based cancer commissioning toolkit which supports commissioners of cancer services by providing a range of benchmarked information and data.

Workforce Planning
The cancer workforce is diverse. Some staff, such as oncologists and therapeutic radiographers, work exclusively with cancer patients. For other staff, such as pathologists, diagnostic radiographers and surgeons, cancer care forms a greater or lesser part of their overall workload. And for some cancer patients dieticians, physiotherapists, occupational therapists and social workers provide important support.

New investment alone is not enough. Services need to be redesigned and streamlined, and new approaches are needed to make best use of skills in the cancer workforce.

Specific work to increase the size and skills of the cancer workforce includes:

• pilot projects exploring new roles in radiography, pathology and chemotherapy
• training and support for district nurses in palliative care, to reach 10,000 nurses over three years
• training initiatives for endoscopy and for SHOs in histopathology
• an additional 569 cancer consultants between 1999 and 2002, meaning we are on track to increase the total by almost a third by 2006
• radiology, histopathology, clinical oncology and thoracic surgery included in international fellowship scheme.

Workforce planning raises several issues, for example

• Potential new or extended roles
• New models of care
• New types of team working across organisational boundaries and new settings
• New education and training needs
• A stronger emphasis on self care and patient empowerment

Skills for Health - Workforce Projects Team (WPT) has developed the Six Steps Methodology to Integrated Workforce Planning to address these issues. The main aim of the six steps is to set out in a practical framework those elements that should be in any workforce plan.

Workforce planning resources

• Six steps guide >>>