Press Release - The NHS Cancer Plan: A Progress Report
11 March 2005
The National Audit Office reported today that, four years into
the 10-year NHS Cancer Plan, substantial progress has been made in
meeting the Plan’s targets. The thirty-four cancer networks which
have been established have achieved important improvements in
delivering cancer services across England. However, the networks
need to be more effective and to develop partnership working
further if the targets in the Plan are to be fully met by 2010.
According to today’s report to Parliament by head of the NAO Sir
John Bourn, the NHS Cancer Plan, published in September 2000, is
broadly comprehensive, impressive in its coverage, and well
regarded by cancer networks, the organisations established to bring
together all local cancer services. There are ways in which the
strategy for tackling cancer in England could be improved, however,
and decisions need to be taken now on how to update and bring
together all elements of the current cancer strategy in a unified
way that ensures it remains the central guiding approach for
improving cancer services and outcomes.
The NHS Cancer Plan contains a wide range of targets and
commitments. There has been good progress against most of the major
targets, with many either met or on course to be met, and little
slippage. The Department recognises that there are challenges to be
met and more to be done if all the Plan’s targets and commitments
are to be fully achieved.
Cancer networks have helped improve cancer services and have
achieved some particular successes. These include planning for the
introduction of new cancer drugs and developing plans for funding
specialist palliative care. In addition to the NHS Cancer Plan, the
Department has launched other initiatives to improve cancer
services, including a tobacco advertising ban and a strengthening
of the partnership between the NHS and the voluntary sector.
The 34 cancer networks in England were established by 2001. But
the extent to which they have become fully established and fully
effective varies. The NAO found that sufficient resources were not
always available to enable networks to operate effectively; and an
NAO survey found that not all cancer network management teams were
fully staffed, with some networks having vacancies for essential
posts. Not all networks plan effectively, with only around a third
having produced workforce or education and training strategies.
Primary care trusts (PCTs) are responsible for commissioning
cancer services, using cancer networks plans and advice to contract
for cancer services. With networks usually having many PCTS within
their boundaries, a network-wide approach to commissioning is
important. Many networks adopt this approach but some PCTs continue
to commission services in isolation, and greater collaboration is
required if networks’ priorities are to be appropriately
addressed.
The principles behind cancer networks require that their
constituent organisations have a duty of partnership to work
together effectively to improve cancer services for the benefit of
patients. For the most part relationships work well; but policy and
structural changes in the NHS pose challenges for the
implementation of the Cancer Plan, particularly in terms of
co-operation between network organisations. And there is a need for
the roles and responsibilities of constituent organisations to be
clearly set out and adhered to. While the core freedoms of NHS
foundation trusts should provide greater flexibility and speed in
developing services, they may limit effective partnership working
and collective efficiency.
Among the NAO’s recommendations to the Department are that it
consider what changes are necessary to the cancer strategy and that
it should publish progress against the Cancer Plan annually. The
Department should also ensure that the roles of cancer network
constituent organisations are clearly defined and adhered to. In
addition, the NAO recommends that strategic health authorities
should ensure that cancer networks have the necessary resources
required; and that the networks have appropriate planning
arrangements in place to implement the Cancer Plan.
Sir John Bourn said today:
"Substantial progress has been made in implementing the
NHS Cancer Plan, with many targets in the Plan met or on course to
be met. This should contribute to the downward trend in cancer
mortality rates and continue to bring significant benefits to
patients."
"Cancer networks have achieved much but there is more to
be done if they are all to become fully effective: including better
planning, more co-ordinated commissioning of cancer services,
proper resourcing, and effective co-operation between constituent
organisations. As the mid-point of the Cancer Plan is approached,
the time is right for the Department of Health to consider how
these matters can be addressed and take appropriate
action."
Notes for Editors:
- The NHS Cancer Plan was published in September 2000. It is a
10-year programme to improve cancer services and outcomes, with
targets, actions and milestones to be achieved by 2010. It aims to
save more lives; ensure people with cancer get the right
professional support and care as well as the best treatment; tackle
the inequalities in health that mean unskilled workers are twice as
likely to die from cancer as professionals; and build for the
future through investment in the cancer workforce, through strong
research and thorough preparation for the genetics revolution, so
that the NHS never falls behind in cancer again.
- The 34 cancer networks are responsible for implementing the NHS
Cancer Plan and for securing improvements in local cancer services.
Each network is a ‘matrix organisation’ bringing together all
cancer services in a locality. Headed by a network board, and with
a core management team, networks comprise acute trusts, primary
care trusts, voluntary sector organisations, local authorities and
include patient and carer involvement. They are responsible for
developing guidelines, implementing good practice, co-ordinating
expert clinical advice, management and local strategy; working
together to improve quality of care and address any inequalities in
provision and access.
- This is the third of three reports by the NAO on cancer.
‘Tackling cancer in England: saving more lives’ was published in
March 2004 and examined whether clinical aspects of cancer services
are saving more lives across England and in comparison to other
countries. ‘Tackling Cancer: improving the patient journey’ was
published in February 2005, and examined how patients view
services.
- Press notices and reports are available from the date of
publication on the NAO website,
which is at www.nao.org.uk. Hard copies can be obtained from The
Stationery Office
on 0845 702 3474.
- The Comptroller and Auditor General, Sir John Bourn, is the
head of the National Audit Office which employs some 800 staff. He
and the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 23/05
All enquiries to Barry Lester, NAO Press Office:
Tel: 020 7798 7937
Mobile: 07748 181692