Improvements and efficiencies have been made in key areas of cancer care since the Cancer Reform Strategy was published in 2007. The NAO estimates that cancer cost the NHS approximately £6.3 billion in 2008-09, but it is not clear if the implementation of the Strategy is achieving value for money. Reported spending on cancer care varies between PCTs - in 2008-09 varying from £55 to £154 per head - and there is unexplained variation from year to year. Significant reductions have been made in the number of days cancer patients spend in hospital - largely as a result of increasingly treating patients as day cases. The Strategy aimed to minimise emergency admissions for cancer patients, but these are still increasing, with wide variations between PCTs and poor understanding of the reasons for those variations. There are opportunities to achieve better outcomes and free up resources. Reducing the average length of stay in hospital to the level of the best performing PCTs, efficiencies worth some £113 million a year could be achieved. If the number of inpatient admissions per new cancer diagnosis was reduced to the level of the best performing PCT, bed days equivalent to around £106 million each year could be saved. Radiotherapy machines could be used more productively to help the NHS meet increasing demand. High quality information is essential to be able to commission services successfully and to monitor performance. Some information on cancer has improved, but significant gaps still remain.

This report examines the Department of Health's and the NHS's performance in delivering cancer services; improving information on activity, cost and outcomes of cancer services; and how the Department intends to deliver cost-effective cancer services in the new NHS. The NHS spent £6.3 billion on cancer services in 2008-09. Tackling Cancer has been a priority for the Department since its ten year NHS Cancer Plan was published in 2000. In 2007 the Department published its five year Cancer Reform Strategy (the Strategy) to deliver improved patient outcomes. The NHS has made significant progress in delivering important aspects of cancer services, with falling mortality rates and consistent achievement of the cancer waiting times targets. However, early diagnosis does not happen often enough. And the gap in survival rates between England and the best European countries has not been closed. There remain wide, unexplained variations in the performance of cancer services and in the types of treatment available across the country; and significant gaps in information about important aspects of cancer services, in particular information on chemotherapy, on follow-up treatment, and on the stage that a patient's cancer has reached at the time of diagnosis. The Department cannot yet measure the impact of the Strategy on key outcomes, such as survival rates, and does not know if cancer services are being commissioned cost-effectively, due to poor data on costs and because outcomes data are not sufficiently timely. The Department must ensure the collection of high quality, comprehensive and timely data.

NCATs role is to support the NHS to develop world class cancer services and to implement the NHS Cancer Reform Strategy. This page summarises the following topics: Information pathways and information prescriptions: Improving patient experience is a key theme in the Cancer Reform Strategy. NCAT has developed its National Cancer Patient Experience Team to provide leadership on the patient experience agenda including the establishment of information pathways and prescriptions. To date 11 national information pathways have been developed and launched. These include: breast, bowel, lung, prostate, palliative care and end of life, vulva, womb, cervical, ovarian, vaginal and an all cancer types pathway. These pathways were developed in partnership with charities and cancer networks. National Cancer Survivorship Initiative: Improvements in the quality of life of those living with or beyond cancer were identified as essential in the Cancer Reform Strategy. Therefore NCAT has been s ...