Recovery and redesign: cancer services - action plan

The Recovery And Redesign Of Cancer Services

The Re-mobilise, Recover and Re-design Framework aims to effectively mobilise the NHS to a better health and care system through: 1) innovation and integration, 2) ensuring equity of access, 3) achieving better outcomes for people in Scotland, and their families. These three aims are also central to this plan for cancer services.

NHS territorial Health Boards have submitted Local Mobilisation Plans in which cancer is a key clinical theme and priority. This plan will help deliver against that priority. Boards continue to follow the Framework for Recovery of Cancer Surgery to ensure the most urgent patients are prioritised and treated first.

This plan will set out the operational priorities for adult cancer services during the recovery and redesign phases to March 2023. Our recent Cancer Strategy Refresh, published in April 2020 and produced pre-COVID-19, will be superseded by this recovery plan with most actions brought forward. Emphasis will be placed on cancer diagnosis and treatment, although we acknowledge the potential to prevent up to 40% of cancers through lifestyle changes and wider public health initiatives. This work on prevention will continue to be driven forward through our public health strategies, working alongside Public Health Scotland. The managed service network (MSN) for children and young people with cancer have also reviewed their services this year, over the pandemic, and drafted a plan for paediatric and young adult cancer services. We are working with the MSN to ensure alignment across adult and children and young people’s cancer services, by sharing our three key aims outlined in this plan. Where some teenagers or young adults are treated in adult cancer services this plan will cover their services, and we will work with the MSN on smooth transitions for patients where these services interface.

Patients’ experience of their care and treatment is central to this plan with patient-centred care and shared decision-making remaining key principles. Third sector organisations, including members of the Scottish Cancer Coalition and the Less Survivable Cancer Taskforce, have represented the interests of a range of people affected by cancer. Additionally, some have provided crucial insight from surveys of these groups. An extensive review of emerging themes from the Scottish Cancer Patient Experience Survey and Care Opinion has also been conducted and common themes from all are addressed in this plan.

The actions outlined will ensure the delivery of cancer services are resilient to potential future peaks of COVID-19, and to the projected increase in cases of cancer. Previous projections have predicted the number of new cases to rise by 33% from 2008-2012 to 2023-2027^[1]. A range of actions will support and improve wider wellbeing and overall quality of life. Where possible, diagnostics and treatments will be delivered in the community or at home to help minimise individual risks. In certain circumstances patients will inevitably need to enter secondary care; this will be done as safely as possible. This plan will promote equitable access to treatment and care across Scotland, ensuring each cancer patient has the same opportunity to receive the same high-level of care available.

We will also work towards optimal pathways and treatments, seeking to improve both clinical outcomes, and patient’s experiences as set out in the National Performance Framework. The Scottish Access Collaborative has designed a number of toolkits and approaches to health and social care challenges. All of these approaches are applicable to cancer pathways and we will promote their application to ensure services are designed to optimise capacity and, where appropriate, reduce demand.

As COVID-19 vaccinations begin to impact, we will ensure services adapt to the new benefits and reduction to risks that they offer.