Cancer Alliances – transforming cancer services, leading whole-system planning and delivering cancer care on behalf of ICSs
What are Cancer Alliances?
Cancer Alliances are unique. As the primary vehicle for delivery of the NHS Long Term Plan ambitions for cancer and improvements in cancer performance, they bring together partners across complex cancer pathways to deliver the best care and outcomes for patients. By leading systems and service delivery, they were central to the success in maintaining cancer services during the pandemic.
Cancer Alliances were established in 2016, following the recommendations of the Independent Cancer Taskforce. The Taskforce recognised the need for capacity and leadership for delivering improvements to cancer services, much of which had been lost following an overhaul of the former cancer networks in 2013.
There are now 21 Cancer Alliances, responsible for leading the planning and delivery of cancer services and for leading work across their local system to deliver The NHS Long Term Plan two core ambitions for cancer:
- 55,000 more people would survive their cancer for at least 5 years by 2028; and,
- 75% of cancers would be diagnosed at stages 1 and 2 by 2028.
To realise these ambitions, Cancer Alliances use their local knowledge to lead delivery of key priorities, including:
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Speed up cancer pathways:
Introducing the Faster Diagnosis Standard (FDS) with faster, more streamlined diagnostic pathways to speed up diagnosis or ruling out of cancer and reduce patient anxiety. whilst improving operational performance
Diagnose cancer earlier and improve survival:
By delivering Long Term Plan projects like Targeted Lung Health Checks and by reducing treatment variation. Establishing Targeted Lung Health Checks (TLHC) to diagnose lung cancer in at-risk communities.
Trial data suggest that around 66% of cancers diagnosed via the programmes will be at stage 1 or stage 2, compared to 28.9% in 2018.
Improve patient experience and quality of life:
Providing Personalised Care and Support (PCS) that meets individual patient needs and ensures rapid access to clinical support when needed after treatment.
Reduce health inequalities in cancer services:
Using latest data and working with partners to identify solutions
Cancer Alliances led efforts to maintain cancer services during the pandemic, including through:
Piloting new technologies like Colon Capsule Endoscopy (CCE) and Cytosponge to reduce demand for endoscopies, offering patients a less invasive test.
Working with providers to establish Surgical Hubs for cancer, helping to maintain cancer treatments at 93% of 2019 levels.
Providing chemotherapy at home to reduce the need for patients to come to hospital and offering COVID friendly treatments with reduced side-effects.
Putting in place mutual aid arrangements to make the best use of resources and clinical expertise across whole systems.
Cancer Alliances and ICSs – future vision
As outlined in the ICS Design Framework (16 June 2021), Cancer Alliances will continue to “use their expertise to lead whole-system planning and delivery of cancer care on behalf of their constituent ICSs, as well as providing clinical leadership and advice on commissioning”. To enable Cancer Alliances to deliver their existing functions, ring-fenced funding will be maintained.
Cancer Alliances will keep bringing together partners from across their area (including representatives from place and system level and from provider collaboratives) to undertake four main functions on behalf of their ICS(s):
Planning:
Alliances will develop and lead the delivery of the cancer element of ICB plans – strategic plans for cancer covering both delivery of the LTP ambitions for cancer and activities to support the delivery of the cancer waiting times standards.
Whole-system delivery:
Alliances will work with Provider Collaboratives to support the effective delivery of cancer pathways; and will provide the link to primary care, diagnostic networks and screening providers to ensure a whole pathway approach.
Clinical expertise:
Cancer Alliances will facilitate clinical networks for cancer to provide clinical leadership for cancer for the local system and to provide the clinical expertise to inform strategic and operational decisions.
Strategic commissioning:
As part of their planning function, Cancer Alliances will advise their ICB(s) on the commissioning of routine and specialised cancer services, including associated diagnostic services, ensuring sufficient capacity to meet the needs of people with cancer or suspected cancer.
Benefits of Cancer Alliances – cross-boundary working:
Partly due to the complexity of the disease, cancer pathways are multi-faceted.
This means, in some areas, patients attend appointments at different providers in primary, secondary and tertiary care across a number of ICSs.
Cancer Alliance boundaries encompass the range of providers a cancer patient will typically use. This gives them an opportunity to organise services across organisational boundaries - reducing variation and inequalities, and overall benefiting patients
Benefits of Cancer Alliances – maximising cancer knowledge:
By bringing together partners from across local NHS (‘neighbourhood’, ‘place’ and ‘system’) and the whole cancer pathway, Cancer Alliances are able to maximise knowledge of their communities to pinpoint key areas for transforming and funding services.
Due to the complexity of cancer pathways, they also facilitate cross-healthcare boundary working, such as between Primary Care and tertiary providers, to improve patient services.
This approach enables whole-system delivery of cancer services for local populations, benefiting patients and NHS staff.
The key partners for a Cancer Alliance include:
- ICSs
- Specialised Commissioning
- Regions
- GPs and Primary Care Networks
- NHS Trusts
- Charities
- Local authorities
- Patient advocates and carers
- Community and voluntary health organisations
