Organising cancer care around people, not systems

The National Cancer Plan, published earlier this week, sets out a clear intent to organise cancer care around people’s lives, rather than the whims of services and providers. That intent is backed by delivery commitments that, if well-implemented, could make a real difference to the day-to-day experiences of cancer patients in England.   

Importantly, the Plan looks beyond treatment to consider patients individuals with their own physical, mental and social needs. This is made explicit in the commitment to providing personalised needs assessments and personal cancer plans as part of the universal offer to cancer patients, each of whom will have a named neighbourhood care lead to coordinate their support and a bespoke end-of-treatment summary designed to prevent a “cliff edge” in care. 

Taken as a whole, this direction aligns closely with what National Voices’ members have been calling for. There is broad support for the Plan’s ambition, particularly its focus on earlier diagnosis, including reducing emergency presentations, alongside expanded and improved screening and diagnostic capacity. Members also recognise the importance of the Plan’s emphasis on research, innovation and clinical trials, and its clearer acknowledgement of groups and conditions that have historically been less well served or less visible within cancer policy, including rarer cancers and certain communities. 

At the same time, experience shared by our members and the patients they represent highlights a persistent gap between ambition and delivery. Cancer care is often experienced as fragmented. It can be clinically excellent, yet hard to navigate. A plan that prioritises coordination and clear handovers is responding to a real problem. The question is whether the mechanisms are strong enough to reach those currently least well served. 

Enabling access 

Evident throughout the Plan is a clear commitment to address the practical barriers that many patients face in accessing cancer services. But these barriers are not experienced equally. Some groups report worse experiences and outcomes, and there are differences in access to support at home and after treatment. 

In this context, it is disappointing that the Plan continues the recent trend of pursuing ‘digital-first’ solutions to access concerns. Positioning the NHS App as the “primary access point” for cancer care, for instance, risks widening disparities in practice without additional support for those who cannot make use of the technology, as well as a guarantee of robust, non-digital routes.  

That said, the Plan’s specific commitment to cover travel costs for the families of children and young people with cancer, up to the age of 24, is a positive example of a practical solution to a very real issue (the BBC estimates that such families spend an average of £250 a month on travel). However, we would like to see the same support extended to adults with financial pressures and/or caring responsibilities.  

Measuring what matters 

The Plan places strong emphasis on real-time patient-reported outcomes and experience measures, intended to allow providers to respond quickly to concerns. Measuring experience in this way can be a powerful lever for change, but again the real issue will be one of implementation. Without clear accountability for acting on what that data shows, feedback risks becoming an audit trail rather than a driver of improvement. If measurement captures symptoms but not the experience of disconnection and uncertainty, improvement efforts will miss what matters most to patients. 

In responding to the Plan, many of our members have applauded the ambition on display but raised similar questions about implementation. There is an obvious need for more detail on responsibilities, timelines, funding and workforce capacity if the Plan is to be translated into a resourced, accountable set of commitments that adequately address barriers to access and inequalities in experience and outcome.