2 Mar 2026
A catalyst for working together to deliver a step change in improvement.
A step change in cancer care will only happen if we act as one system, and make the very best use of our national clinical audit and outcomes data. Now the dust has settled following the release of the Government’s National Cancer Plan for England, HQIP’s Medical Director Professor Danny Keenan, offers some reflections on its importance in improving care and outcomes for those with cancer, and on the importance of working together and making the most of data, to deliver its aims…
“The National Cancer Plan is very timely and will be well received. We have already been consolidating activities related to cancer care, but now is the time to make a step change and improve the key indicators of long-term outcomes for all patients.
The building blocks are in place. We are surrounded by standards related to most cancers. In terms of clinical audit to measure against these standards, we now have structural, process and outcomes measures for many of the most common cancers (see the list of national cancer audits at the end of this article). However, we need to take this further. This is where the Cancer Plan will help. The areas where we can focus our efforts on working together, to deliver its aims, are:
Earlier diagnosis
This will not be solved by one sector, such as primary care, working alone, but by all areas contributing. The NHS Ten-Year Health Plan for England has placed great emphasis on the “Left Shift”. This is the move to collaboration between sectors, ‘knocking down the walls’ of hospitals, and all working together between sectors to move expertise to where it benefits patients most – so that they have the best experience of care. In relation to early diagnosis, this means the different sectors combining into a more seamless service and reaching out to the population to drive improvement.
This is where the other tool that is available to us comes in, Cancer Alliances. We already have strong alliances in place, and we need to capitalise on their strengths so that they, working between sectors (as they currently do), help to seek out and bring forward patients to tackle the problem of late diagnosis.
Following the data
The improvement that follows from audit and reviews of service, to understand how to help providers that are performing less well, should play a fundamental part in this step change in cancer care.
We have, with the increased funding into the cancer programme, more and extremely useful information concerning the performance of the sector. We need to capitalise on this excellent information. It needs to be more widely disseminated, and we need to address the “so what” question more aggressively.
To disseminate this information more widely is important. It needs, particularly, to be made available in easy-to-use formats to front-line clinicians. Colleagues absorb information in diverse ways, and therefore several mechanisms need to be used. Using dashboards, designed to be used with minimum fuss, alongside social media and traditional media are all important.
To address the “so what” question, the Cancer Plan uses quite strong language. While we all agree that we need to tackle “eradicating variation”, this needs to be managed in a supportive way. All clinicians are working flat out, and we need support to work more cleverly not harder. That is where we, with the National Clinical Audits, can help. Those who provide the audits can develop quality improvement messages and tools that clinicians can use in their day-to-day work, driving improvement in the services that they offer. That will lead to reduced variation and eventually to improved outcomes.
This is another area where the Cancer Alliances can help. They are in the best position to influence clinicians and drive many of these quality improvement initiatives flowing from the National Clinical Audit programme.
The Cancer Alliances also have a role in bringing patient voice to the forefront. We need to ensure that their voice is centre stage as we develop services. The “Left Shift” is likely to be applauded by patients, but they need to understand why and how any change is taking place – and that it is there to improve their experience of care, as well as improve outcomes.
Cancer is cancer
Finally, I want to make a point about what the Cancer Plan calls “rare cancers”. That is an unhelpful term, in my view. If you were unlucky enough to suffer from one of these, you would not feel that its likelihood of occurring is relevant. You would expect exactly the same treatment and support as anyone with a “mainstream cancer”. There are a multitude of audits and registries assimilating data on these cancers with little support nationally. The information is therefore variable. However, we need excellent data on these cancers, as we do with others. HQIP can help here, through the development of an Association of Clinical Audits and Registries (ACAR). We could use our knowledge and skills to support these registries and audits to maintain excellent governance, and ensure that the service and information that patients receive are second to none.
In summary, we in HQIP appreciate the National Cancer Plan for England. We look forward to working with a wide spectrum of colleagues, and with patients, to work collaboratively to use data to implement it. National clinical audits are the backbone of accountable improvement in cancer care, while Cancer Alliances are built to deliver change across pathways. Now is the time to use both with greater ambition. It is not enough to measure variation. We must translate insight and collaboration into action that improves care, and supports teams to make progress with the time and capacity they have.
If we can bring all this together then I, for one, can see that the National Cancer Plan for England will take us a (significant) step closer to vast improvements in cancer care and outcomes for everyone.
National cancer audits
HQIP-commissioned cancer programmes, all within the National Cancer Audit Collaborating Centre (NATCAN), are:
