The ACE programme

ACE seeks to develop the knowledge base on early diagnosis in order to identify and evaluate good practice, which can reduce system delays and improve early diagnosis of cancer. ACE supports the NHS outcome 'preventing people from dying prematurely'.

The ACE programme: accelerates progress, coordinates implementation and consistently evaluates best practice and innovative approaches to early diagnosis of cancer. 

Wave 1 of the ACE programme has produced several reports and individual project outputs. Read these and more about the 54 projects within Wave 1 on our Clusters page.

For a summary of the key themes and reports in Wave 1, download the overview report [PDF].

Wave 2

The ACE Programme is piloting a new diagnostic pathway, for patients with ‘non-specific but concerning symptoms’, which incorporates a Multidisciplinary Diagnostic Centre (MDC).

Learn more

About ACE

The ACE programme aims to develop the knowledge base on early diagnosis by evaluating and sharing good practice, to inform future commissioning of cancer services.

ACE has two key aims: help NHS organisations implement best practice, including identifying and tacking system blocks, and test innovative ideas such as streamlining current pathways and developing new pathways for vague but concerning symptoms.

ACE seeks to drive:

  • A shift from late to early diagnosis of cancer at stages I & II
  • A decrease in cancer diagnoses via emergency presentations
  • Improvements in overall patient experience

For more information about how the ACE programme was developed, please download this PDF.


ACE structure and funding

ACE programme structure

The Senior Responsible Officer (SRO) for the ACE programme is the NHS England National Clinical Director for Cancer, Chris Harrison. The programme is in the NHS England Early Diagnosis work stream which reports to the Cancer Transformation Board. Rosie Loftus, joint Chief Medical Officer represents Macmillan on the Cancer Transformation Board.

Finance

ACE is funded by Cancer Research UK, Macmillan Cancer Support, NHS England and the Department of Health's Policy Research Units. As ACE provides only limited financial support to projects, the majority of project funding has come from local, mostly NHS sources.

For more information on ACE funding, please download this PDF.


Why ACE?

England lags behind comparable European countries when it comes to cancer outcomes including one- and five-year survival rates, more details of which can be found in the international cancer benchmarking initiative.

One key factor for poorer cancer outcomes is late diagnosis, namely too many patients being diagnosed at later stages of cancer when treatment options can be limited, more onerous for the patient, and may no longer be curative. Improving early diagnosis therefore has the potential to drastically improve cancer outcomes.

Late stage diagnosis happens for a number of reasons including late presentation by patients and system delays including in referral to secondary care or for diagnostic tests. The ACE programme focuses on addressing system delays including the development and evaluation of new streamlined diagnostic pathways.

Other initiatives, such as 'Be Clear on Cancer', seek to raise public awareness and understanding of the signs and symptoms of cancer, to encourage people to present to their GP when they first notice symptoms that may be cancer.

Cluster programme reports and executive summaries

Bowel screening uptake

The projects in this cluster are exploring different ways to encourage people to undertake bowel cancer screening to increase screening uptake. A number of the projects include direct contact from GPs to individual patients.

It is hoped that the cluster can identify which methods of encouraging uptake work best, and how those methods can be implemented in a sustainable way.

Programme reports and outputs

Bowel screening uptake - Final report [PDF]

For more information on this cluster visit our ACE clusters page.

Close

Colorectal pathways

The projects in this cluster aim to streamline diagnostic pathways for colorectal cancer. Some projects do this via straight to test approaches such as GP direct access to endoscopy, others undertake triaged access to diagnostics.

It is hoped this cluster will identify the 'best first test' and 'best test mix' for diagnosing colorectal cancer as well as comparing straight to test and triaged approaches.

Programme reports and outputs

Colorectal pathways - Interim report [PDF]

Colorectal pathways - Executive summary [PDF]

Colorectal pathways - Final report [PDF]

For more information on this cluster visit our ACE clusters page.

Close

IT tools

The projects in this cluster seek to embed use of the Macmillan electronic Cancer Decision Support (eCDS) tool in general practice to identify high risk patients and improve the appropriateness of cancer referrals.

It is hoped that this cluster will evaluate the impact of using the eCDS tool in general practice and identify how best to encourage and support GPs to incorporate the eCDS into their daily practice.

Programme reports and outputs

IT tools - Final report [PDF]

IT tools - Executive summary [PDF]

For more information on this cluster visit our ACE clusters page.

Close

Lung cancer pathways

The projects in this cluster are focused on streamlining lung cancer diagnostic pathways through the introduction of direct access to rapid diagnostics, with many projects seeking to implement 'straight to CT' pathways, i.e. diagnostic pathways which undertake a CT scan on a patient after a first unclear chest x-ray.

It is hoped that the cluster will identify the best way to integrate CT into the lung cancer diagnostic pathway and what is the best first test for lung cancer.

Programme reports and outputs

Lung cancer pathways - Executive summary[PDF]

Lung cancer pathways - Final report [PDF]

For more information on this cluster visit our ACE clusters page.

Close

Pharmacy/other primary care

The projects in this cluster use non-GP primary healthcare professionals such as community pharmacists and optometrists to play a role in early diagnosis of cancer through awareness raising and direct referral to secondary care or diagnostics.

It is hoped that this cluster will identify how best non GP primary healthcare professionals can be utilised to contribute to early diagnosis of cancer including the effectiveness of direct referrals and patient engagement methods.

Programme reports and outputs

Direct referral by non-GP primary healthcare professionals report [PDF]

Pharmacy training for early diagnosis of cancer - updated June 2017 [PDF]

emptyDoncaster pharmacy direct CXR referral project summary [PDF]

Be Clear on Cancer pharmacy teams briefing sheet [PDF]

Cumbria GP referral form [PDF]

Cumbria patient consent form [PDF]

For more information on this cluster visit our ACE clusters page.

Close

Proactive approach to patients at high risk of lung cancer

The projects in this cluster are developing interventions to identify symptomatic patients who may be at high risk of lung cancer. One project includes a small pilot of patient self referral to chest x-ray.

It is hoped this cluster will identify the best ways to find people at high risk of lung cancer as well as assess the effectiveness of interventions offered to high risk people.

Project reports will be uploaded here when they are available.

For more information on this cluster visit our ACE clusters page.

Close

Screening uptake for vulnerable groups

The projects in this cluster seek to use opportunistic and community outreach approaches to encourage screening uptake in vulnerable groups such as people with learning disabilities and some ethnic minority groups. Projects use a mixture of GP outreach activity and community outreach in collaboration with voluntary sector organisations.

It is hoped that this cluster will identify best practice approaches to increasing screening uptake in vulnerable groups.

Project reports will be upload here when they are available.

For more information on this cluster visit our ACE clusters page.

Close

Vague symptoms pathways

The projects in this cluster seek to implement diagnostic pathways for patients with vague but concerning symptoms, which may be indicative of cancer, but do not have an obvious possible tumour site. Projects include the establishment of Cancer of Unknown Primary/Malignancy of Unknown Origin pathways, acute oncology services and one project establishing a Multidisciplinary Diagnostic Centre (MDC).

It is hoped this cluster will identify the most efficient diagnostic pathways for patients with vague but concerning symptoms that may be cancer.

Programme reports and outputs

Vague symptoms pathway - Final report [PDF]

Vague symptoms pathway - Executive summary [PDF]

For more information on this cluster visit our ACE clusters page.

Close

Implementing change