Can Cancer Alliances live up to expectations?

In our first look at the state of Cancer Alliances, Niamh Kelleher and Louisa Petchey ask how they can cope with the weight of responsibility that is being placed on their shoulders

24 November, 2016

Map of Cancer Alliances

16 Cancer Alliances have been set up across England to deliver the Cancer Strategy (Source: NHS England)

The UK’s population is getting bigger and it is getting older. That means more people than ever before are being diagnosed with cancer. But thanks to improvements in treatment, more people are surviving.

While this is obviously great news, it doesn’t mean the pressure on our health system is any less, it is just different — and potentially even greater and more expensive.

Eye on the prize

As set out in the Cancer Strategy for England in July 2015, we want our health system to deliver world class cancer outcomes by 2020, not just in terms of survival but quality of life. If this ambitious vision is to be met, there is much to do and it is not going to be straightforward.

There are now an array of ‘place-based’ policy initiatives — new models of care, vanguards, and Sustainability and Transformation Plans — all trying to find a way to improve care for their communities while often significantly reducing costs. It is important that during this challenging time we don’t allow ourselves to lose sight of or compromise the recommendations in the Cancer Strategy.

A long to-do list

That is where we are hoping Cancer Alliances will come in. Cancer Alliances have long been a priority for Macmillan. We view them as a vital for providing effective oversight and co-ordination of the whole cancer pathway at a local level. Among other things, they should:

  • drive the delivery of national strategies and priorities
  • ensure meaningful user involvement takes place
  • promote whole-system coordination
  • provide strategic support and leadership
  • facilitate alignment and support local providers
  • support cost efficiency within local systems

So we were pleased to see in their response to the Taskforce report that NHS England share this view and that Cancer Alliance “footprints” have now been announced.

Will Cancer Alliances deliver?

But how confident can we be that Cancer Alliances will live up to the weight of responsibility that is being placed on their shoulders to deliver the Cancer Strategy?

Their task is no easy one. They are being expected to come up with a plan for the future of cancer care tailored to the needs of their local population, involving local people while also coordinating day-to-day improvements in cancer care and support. This includes working with multiple commissioning bodies, potentially dozens of providers and, most difficult, ensuring the transformation of cancer care and support in their area’s Sustainability and Transformation Plans (STPs); a process that in itself has been fraught with controversy and difficulty. All of this is expected with limited resource or dedicated staff time.

Reasons to be cheerful

But there are several important reasons to be optimistic. For one thing, Cancer Alliances exist. So now at least we have a structure that can focus on driving improvements in cancer care in an ever-changing environment. And amid so much negative publicity about planning rounds with STPs and service transformation, Cancer Alliances now have a unique opportunity to lead the way in working collaboratively with their communities.

We also expect that NHS England will soon make money available to Cancer Alliances so they can make improvements to diagnostics and ongoing support for people beyond the end of active treatment. This will be the first time we get to see Cancer Alliances in action, spearheading the transformation of cancer care in line with the Cancer Strategy recommendations.

Big test

Cancer Alliances will soon need to face their first big test since their footprints were announced. No two Cancer Alliances will be facing the same challenges, from the differing needs of their local cancer population to the impact of STPs on their local area. We will be looking on with expectation and qualified optimism — and as ever, Macmillan will be working with the rest of the cancer community to help make a success of the Cancer Strategy.

Niamh Kelleher and Louisa Petchey are Policy Analyst and Senior Policy Analyst (respectively) at Macmillan Cancer Support