Education And Debate

Redesigning cancer care

BMJ 2002; 324 doi: (Published 19 January 2002) Cite this as: BMJ 2002;324:164
  1. David Kerr, Rhodes professor of therapeutics and clinical pharmacology (,
  2. Helen Bevan, director of redesignb,
  3. Ben Gowland, managerb,
  4. Jean Penny, senior fellowb,
  5. Don Berwick, chief executive officerc
  1. a Department of Clinical Pharmacology, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE,
  2. b National Patients' Access Team, 2A New Walk, Leicester LE1 6TF,
  3. c Institute for Healthcare Improvement, 375 Longwood Avenue, Boston, MA 02215, USA
  1. Correspondence to: David Kerr

    We have known for some time that cancer treatment in the United Kingdom needs to improve. This report looks at an attempt to use the collaborative improvement model to enhance services. We made considerable progress in the first year, and the model is now being applied to other cancers and other medical areas.

    Summary points

    Patients with cancer in the UK suffer more delays and worse survival than those in many other European states

    The national cancer plan has set ambitious targets for improved care

    The cancer services collaborative is using improvement methods to reduce delays and improve the service for patients

    The nine cancer networks using these methods have cut waiting times and improved patients' experiences of care

    Background: the cancer services collaborative

    Cancer patients in the UK face long delays before treatment1 and their survival rates compare badly with those in the US and many European countries.2 As a response to this, the Department of Health produced the National Cancer Plan,3 which ranges from prevention to palliative care, and made cancer networks responsible for improving care. As a central part of this strategy, the cancer services collaborative was set up, initially to improve care in specific areas, and then throughout the NHS.

    The collaborative involves nine cancer networks, at least one in each English region (see box), covering a population of 14 million, and coordinated by the National Patients' Access Team. This team is part of the NHS's Modernisation Agency, funded by the Department of Health to implement various aspects of the NHS's National Plan. In each network we funded a programme director and a facilitator for each of five tumour types: bowel, breast, lung, prostate, and ovary. We also appointed clinical leads to work with the facilitators, and bought clinical sessions when needed. The networks are autonomous but have to submit …

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