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NHS Cancer Plan Summary

a plan for investment - a plan for reform


One in Four People will Die of Cancer Go to top

  • The NHS Cancer Plan sets out the first comprehensive national cancer programme for England. It has four aims:
    • to save more lives
    • to ensure people with cancer get the right professional support and care as well as the best treatments
    • to tackle the inequalities in health that mean unskilled workers are twice as likely to die from cancer as professionals
    • to build for the future through investment in the cancer workforce, through strong research and through preparation for the genetics revolution, so that the NHS never falls behind in cancer care again
  • This plan builds on the NHS plan. It provides a comprehensive strategy for bringing together prevention, screening, diagnosis, treatment and care for cancer and the investment needed to deliver these services in terms of improved staffing, equipment, drugs, treatments and information systems

  • Three new commitments:
    • In addition to the existing Smoking Kills target of reducing smoking in adults from 28 to 24% by 2010, new national and local targets to address the gap between socio-economic groups in smoking rates and the resulting risks of cancer and heart disease
    • New goals and targets to reduce waiting times for diagnosis and treatment
    • An extra £50 million NHS investment a year by 2004 in hospices and specialist palliative care, to improve access to these services across the country

Action and MilestonesGo to top

Improving PreventionGo to top

  • 2000
    • Health Development Agency guidance on effective interventions on smoking, diet, physical activity and obesity
    • Local five-a-day pilot initiatives begin
  • 2001
    • National network of local alliances for action on smoking
    • NICE advice on best prescribing regimes for bupropion (Zyban) and nicotine replacement therapy
    • Local action on smoking, diet, physical activity and obesity
    • National five-a-day communications campaign begins
    • Development of a cancer public awareness programme
  • 2002 onwards
    • Trained healthcare professionals to support smokers wishing to quit in every PCT
    • National roll-out of five-a-day initiatives

Improving ScreeningGo to top

  • 2000
    • Breast screening development sites trial new workforce arrangements
    • National guidance and booklets on screening for women with learning disabilities published
  • 2001
    • Prostate cancer risk management programme launched
    • All women to receive results of their smear tests in writing
    • All women to receive national information leaflet on breast or cervical screening
    • All PCGs to review their screening coverage rates and draw up plans to improve accessibility of screening for women in socially excluded and minority ethnic groups
    • Cervical screening development sites trial new workforce arrangements
  • 2002
    • Colorectal screening pilot completed
    • National pilots using HPV testing as triage in women with mild or borderline smears to report
  • 2003
    • All HAs to have introduced two-view mammography
    • Subject to evidence of effectiveness, national colorectal screening programme to be introduced
  • 2004
    • All HAs to invite women aged 65–70 for breast screening

Improving Cancer Services in the Community Go to top

  • 2000
    • PCGs and Trusts represented on cancer network management groups
  • 2001
    • Electronic referral guidelines pilots begin
    • PCGs and Trusts appoint cancer lead clinicians
  • 2003
    • New primary care clinical datasets

Cutting Waiting for Diagnosis and TreatmentGo to top

  • 2000
    • Roll out of 2-week maximum wait for an urgent outpatient appointment for all suspected cancers completed
  • 2001
    • Maximum 1-month wait from urgent GP referral to treatment guaranteed for children's and testicular cancers and acute leukaemia
    • All cancer networks enter Cancer Services Collaborative (CSC) second wave
    • All cancer networks set local improvement targets
    • All cancer networks to commence pre-planning and booking arrangements
  • 2002
    • Maximum 2-month wait from urgent GP referral to treatment for breast cancer
  • 2003–2004
    • Roll out of CSC complete
  • 2005
    • Maximum 2-month wait from urgent GP referral to treatment for all cancers

Improving TreatmentGo to top

  • 2000
    • All Regional Offices to set up Regional Cancer Steering Groups
  • 2001
    • All cancer networks to assess local services against national standards as basis for peer review visits
    • All Regional Offices to begin peer review visits
    • All HAs to take full account of NICE recommendations on cancer drugs
    • National minimum data sets for breast, colorectal, lung and head and neck cancers introduced
  • 2002
    • All HAs, PCTs and NHS Trusts to take full account of NICE guidance on cancer services when published
    • National minimum datasets for all other cancers developed

Improving CareGo to top

  • 2000
    • Cancer Information Advisory Group set up by Department of Health
    • National electronic Library for Health – Cancer library to be launched
  • 2001
    • All cancer networks to draw up training and development plans to ensure all health professionals working in cancer units and centres are to be trained and supported in communication skills, including a policy on breaking bad news
    • Cancer networks should take account of the views of patients and carers when planning services
    • All HAs should identify current investment in specialist palliative care services and in the voluntary sector and work with cancer networks to agree investment strategies for palliative care
    • Cancer Information Advisory Group to review information available for patients, identify gaps and to develop guidance on production of cancer information

Investing in StaffGo to top

  • 2001
    • Cancer networks to develop workforce plans including education and training
    • Endoscopy training scheme introduced

Investing in FacilitiesGo to top

  • 2001
    • All cancer networks to audit diagnostic facilities
    • All Regional Offices to develop regional cancer facilities strategies
    • National cancer facilities strategy to be prepared

Implementing the NHS Cancer PlanGo to top

  • 2000
    • Configuration of cancer networks agreed
    • Health Improvement Programmes (HImPs) and Service and Financial Frameworks (SaFFs) reflect immediate action necessary to deliver the Cancer Plan, in line with emerging network plans
  • 2001
    • All cancer networks to draw up 3-year service delivery plans in line with this Cancer Plan and other cancer guidance
    • All cancer networks to draw up workforce, education and training and facilities strategies to underpin the cancer network service delivery plan

The NHS Cancer Plan: Next StepsGo to top

  • The National Cancer Director will:
    • chair National Cancer Taskforce to drive forward implementation of the NHS Cancer Plan
  • Regional Offices will:
    • agree configuration of cancer networks by November 2000
    • oversee peer review visits from 2001
    • review cancer network service delivery plans
    • develop regional cancer facilities strategies by 2001
  • Cancer networks and their members will:
    • by 2001 develop strategic service delivery plans to cover all aspects of cancer services:
      • prevention
      • screening
      • diagnosis
      • treatment
      • supportive care
      • specialist palliative care
    • by 2001 develop underpinning strategies on:
      • workforce
      • education and training
      • cancer facilities
  • HAs, PCTs and NHS Trusts reflect emerging network plans in HImPs and SaFFs
    • plan targeted action to reduce inequalities in smoking in line with new national and local targets
    • enter CSC second wave:
      • set local improvement targets
      • begin booking arrangements
      • implement national waiting times targets
    • from 2001 implement emerging NICE guidance on:
      • organisation of cancer services
      • cancer drugs
    • from 2001 put in place cancer site specific multidisciplinary teams and ensure all patients are reviewed by them
    • assess local services against national standards as basis for peer review visits

ReferencesGo to top

Department of Health. The NHS Cancer Plan. London: DoH. 2000. The full document can be downloaded free of charge from: Copies of the document are available free of charge from:

Department of Health, PO Box 777, London SE1 6XH. Fax: 01623 724524. Email:

Smoking Kills. A White Paper on Tobacco. London: The Stationery Office, 1998.

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