Accountability and incentives for improving cancer services

The session discussed the challenges of data capture in creating the right incentives for commissioning services, the opportunities and challenges for embedding effective commissioning processes, and the power of patients’ voices in shaping policy and practice across the whole cancer pathway.

Mike Hobday –  Macmillan Cancer Support Back to top

Mike Hobday is director of policy and research at Macmillan.

• Indicators on one and five year survival rates that cover all types of cancer, have been included in the NHS Outcomes Framework (OF) 2013/14. However, since cancer survival rates in the UK still lag behind other  European countries a similar indicator must be included in the Commissioning Outcomes Framework (COF) as a clear incentive to local commissioners.  This indicator must cover all cancers, not just breast, lung, and colorectal cancers.
• Patient experience is as important as clinical experience yet it varies widely across the country.  Consequently, the National Cancer Patient Experience Survey (NCPES) needs to be conducted annually and there must be an indicator on cancer patient experience in the OF and COF.
• There needs to be clear accountability mechanisms within the reformed NHS to drive cancer standards up and indicators on cancer survival rates and patient experience are key to this.

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Chris Carrigan – National Cancer Intelligence Network Back to top

Chris Carrigan is head of the NCIN Coordinating Team.

• A look at indicators and how they contribute to accountability frameworks. Are chosen indicators the right ones?  Do they ask the right questions and test the right things?  What other data do we need?

Dr Clare Stephens – Barnet Clinical Commissioning Group Back to top

Clare Stephens is clinical lead for Cancer at Barnet Clinical Commissioning Group.  

• There needs to be a unified approach among CCGs if clinically-led commissioning is to be innovative and rigorous.  Cluster data could be used between CCGs of a similar geographical area to allow smaller CCGs to benchmark performance.  Most importantly, people must remain at the centre of the cancer commissioning process, especially through the transition period when there is a real danger that patients could fall through the cracks.
• Opportunities exist around improving diagnostic tools for GPs, having them fully integrated into GP IT systems, and on the desktop of every clinician.
• CCGs need to think about the bigger picture.  They need to encourage the public to become more engaged in the early diagnosis of their families and friends.   Schools and the wider education system need to become more involved in the dialogue about cancer diagnosis.   Local Authorities need to be incentivised to deliver truly healthy town centres and recreational space for their populations.

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Christine Allmark – Independent Cancer Patient Voices Back to top

• Christine discussed how her experiences as a cancer patient empowered her to become an important voice in campaigning for better outcomes and quality of care for people affected by cancer.
• Cancer patients have first-hand experience of the ill effects of issues such as poorly trained hospital staff, lack of appropriate skills training for community nurses, and the burden of care for unsupported relatives and carers.  Therefore patient experience is vital in shaping policy and practice across the full cancer pathway.
• Cancer patient involvement is vital at all levels and in all processes, including the design of accountability frameworks.  However, for this to be effective, the process must be transparent with all information and data made publicly available as soon as possible.

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