Commissioning responsibility for the cancer pathway in England - image description

The diagram represents the complexity of which commissioning bodies are responsible for different stages of the cancer pathway in England.  This diagram is a rough estimate not an exact representation of commissioning responsibilities.  
The key commissioning responsibilities are held by Clinical Commissioning Groups, NHS England (Primary Care Commissioning, Public Health England, NHS England), Specialised Commissioning, and Local Authorities.

Prevention: Responsibilities are approximately split between Public Health England 50%, Local Authority 25%, Clinical Commissioning Groups 25%.

GP Referral: Responsibilities are approximately NHS England Primary Care Commissioning 50%, Clinical Commissioning Groups 50%.

A&E: Responsibilities are 100% by Clinical Commissioning Group

Screening: Responsibilities are approximately split, Public Health England 90%, NHS England – Primary Care Commissioning 10%.

Diagnostics: Responsibilities are approximately, Clinical Commissioning Groups 90%, NHS England – Specialised Commissioning, 10%.

Treatment (Radiotherapy, Chemotherapy, Specialist Surgery, and Non-Specialist Surgery): NHS England – Specialised Commissioning hold 100% of the responsibility for Radiotherapy, Chemotherapy and Specialist Surgery. Clinical Commissioning Groups hold 100% of the responsibility for Non-Specialist Surgery.

Follow up/Surveillance: Responsibilities are approximately split Clinical Commissioning Groups 95%, NHS England Specialised Commissioning 5%.

Rehabilitation & Survivorship, and Palliative Care/End of life Care: Responsibilities are approximately split Clinical Commissioning Groups 80%, Local Authorities 20%.