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Influencing the future of cancer care

Published: 24 July 2023

In this blog, Professor Richard Simcock introduces our work to understand and influence the future of cancer care.

Dr Richard Simcock Consultant Clinical Oncologist and Consultant Advisor for Macmillan.

Professor Richard Simcock Chief Medical Officer for Macmillan

Standing for betterness

Douglas Macmillan stood for ‘betterness’ when he founded our organisation in 1911 and we believe his ethos is as important and relevant today as it was over 110 years ago. With this front of mind, we commissioned Deloitte last year to support us in producing a report to understand how to bring about a better experience of cancer care and better outcomes for people living with cancer in 10 – 15 years’ time, by taking action in the here-and-now. Much of our future, after all, depends on our attitude to the present.

This work stems from our belief that we will achieve more in the future if we prepare for it now, and it has been grounded in lived experience of cancer, as well as the expertise of over 100 healthcare leaders and professionals from across the UK. We remain hugely grateful to everyone who has generously shared their time and experiences as part of the process so far.

Only by working together can we build momentum to go further faster, sharing and learning from what we each know already and designing the future of cancer care. We – policy makers and regulators, clinicians and professional bodies, healthcare organisations and local governments, academics and research funders, life sciences industry, and voluntary and community sector organisations – must collaborate to create the future we all want to see.

Setting our brief

As a starting point, we chose an unashamedly broad brief with a distant horizon – to identify the factors influencing the evolution of cancer care and consider how it might be possible to influence these factors to bring about a better healthcare experience for people living with cancer by 2035. As a forward-thinking organisation we routinely use horizon-scanning and forecasting approaches, but by contemplating cancer care more than 10 years in the future we deliberately gave ourselves the freedom to imagine significant transformation, while challenging ourselves to consider the changes that will be most impactful and what it would take to realise them.

We know that cancer care is delivered within a complex and organic system where change in isolation is rarely transformative and this project has demonstrated the significant value of working collaboratively to think holistically. We deliberately asked contributors to consider all aspects of their experience rather than developing a narrow document that focuses on a single domain; the result is a massive wealth of insight that ranges from individual concerns to system-wide thinking. 

The 12 factors

It would be too easy to be overwhelmed by such a mass of data and opinion, so we have identified clear areas for influence and change and used these to structure the insight in a way that makes it searchable and constructive; we refer to these as the 12 factors. We have found them to be a useful way of making the unimaginable manageable and of facilitating productive and constructive dialogue about future change. 

Our factors capture the themes of our varied conversations and they can be used individually or considered as groups:


  • Advances in science and technology
    - Early diagnosis (including targeted screening)
    - New and precision treatments
    - Data and digitalisation of healthcare

  • Equity in cancer care
    - Health equity
    - People’s understanding and awareness of cancer risks and symptoms
    - Location of care

  • The future workforce delivering cancer care
    - Workforce availability
    - Workforce skillset

  • Personalised care
    - Personalised care (including wellbeing)
    - Living with and beyond care (including multiple health conditions) and end of life care

  • Policy and collaboration 
    - Prioritisation of cancer in policy (including funding of cancer care)
    - Collaboration between public, independent and voluntary sector healthcare organisations

Understanding the 12 factors

Behind each factor we have rich data and insight from our contributors that can be used separately if required. Although all of the factors are interrelated, the factor around health equity is the one that has the greatest need to always be considered hand-in-hand with the other 11 factors. It is the golden thread that runs through the work and speaks to a persistent anxiety that was raised in almost every conversation we had; that future progress must work to narrow health inequity rather than widen it. Furthermore, the issue of the cancer workforce is so prevalent, massive in scope and dominant in influence that we believe it is necessary to divide it into two issues: ‘availability’ and ‘skillset’. 

It is also worth noting that the factors are not presented in any order of importance or priority. Stakeholders will apply differential weighting and attention to the factors according to their own needs and expertise. Additionally, while Macmillan is based in the UK, like the majority of experts and people with lived experience of cancer who have been involved, we believe that these factors are not unique to the UK perspective and they have resonated with healthcare leaders from across the globe; they facilitate both focussed and broad conversations and can inform future strategies and work, in cancer care and potentially also care relating to other health conditions both in the UK and abroad.

Moving the conversation on

At Macmillan, we are now developing the next chapter of our own strategy. This report and the questions that have been raised on the journey give us invaluable insight into the opportunities and challenges of the future for cancer care. It is a critical input for our strategy development, helping us to determine where we focus our efforts to have the most impact for people in the future.

In parallel, we want to continue to catalyse the conversations we have started. Collectively we - the various individuals and organisations involved in delivering care for people with cancer - must develop our call to action to shape the future healthcare experience for people with cancer.

Find out more

I have been personally inspired by being part of these conversations and hearing about the potential in innovations. We cannot guarantee the future, but we are able to shape it and we should do so with optimism.

The work we’ve led so far is really just the start of the conversation and there are a number of different ways that you can join in:


  • - Read the report: If you’d like to find out more about the work, you can read a report summarising our conversations and findings so far, by clicking here.
  • - Watch this space: I’ll be running a series of blog posts over the coming months to explore the different groups of factors, so watch this space.
  • - Get in touch: If you have questions about the work, please feel free to contact the team at Macmillan responsible for the work, by emailing futurecancercare@macmillan.org.uk