What does the National Cancer Plan mean for influencing cancer policy?

‘International experience shows us that the countries with the best outcomes are not those constrained by the dead hand of a centralised state bureaucracy.'

This, from the National Cancer Plan, is quite the line, isn’t it, and signifies the continued ambitions of the present government to devolve power rather than keep it tightly grasped in the palms of Westminster.

The plan builds on the 10 Year Health Plan for England which set out the blueprint of a new health service operating model. We’re presently at the foothills of this and implementing its three key shifts which, most notably here, include the move to neighbourhood health which makes devolution inherently essential. The plan itself declares it is ‘not a plan limited to incremental improvement within the confines of an obsolete care model.’ It is one that that will put the three shifts into action.

There can be significant prizes to be won in devolving power, and not least in health; setting service standards and key outcomes at a national level, but leaving the detail of operational delivery (with flexibility to innovate and set specific local goals to meet local need), is key to meaningfully driving up outcomes.

But what does all this mean for those of us working to influence the direction of cancer policy? As ever, it’s all in the detail.

Obviously, the ultimate power will remain in Westminster. This is where accountability lies, and where outcome targets and quality measures and standards will be set for delivering cancer care. With the latter, the plan outlines a new approach in the publication of ‘cancer manuals’ by tumour type. These will be digital, and ‘will incorporate clinical-effectiveness, safety, and experience of care.’ ‘Clinical collaboratives’ will identify best practice for them, and with manuals expected from 2027, development will likely need to start imminently. Many in the cancer sector will understandably be keen to influence the shape of these so that they meet the needs of the patient groups they work with.

Yet translating the ambitions of the plan and cancer manuals into world-class care and outcomes can only be done on the ground. The plan makes clear that strengthened Cancer Alliances – regional partnerships made up of clinical and managerial leaders in cancer from across trusts and other settings – will be integral to this and so they will also hold a great deal of responsibility and corresponding power:

‘We will strengthen the role of Cancer Alliances to make sure that they are fit to deliver the transformation in our cancer delivery model envisaged in this plan. Cancer Alliances will bring with them the cancer expertise, clinical leadership and ringfenced funding. They will enable and support their local commissioners and providers to implement the new model of cancer care set out in this plan. Alliances will be firmly embedded among their local family of providers working with them to guide and support their local improvement efforts.’

Ahead of the plan’s publication, there were rumours Cancer Alliances may be scrapped, yet this could not be further from the truth. They will have an integral role in driving both the transformation of how care is delivered and in improving patient outcomes. As such, whilst ‘NHS regional teams will be ultimately accountable for health system performance. Cancer Alliances will work hand in glove with their region to drive up core cancer standards.’ They will be at the top table.

Whilst Cancer Alliances are not new and many in the sector will have relationships with them, their strengthened role means this engagement is no longer optional for those looking to influence and impact how care is delivered. It will be essential and it will be key to watch how these partnerships are operationally strengthened and governed, and to explore how the sector can support them in this new phase. This could be through sharing insight, expertise, training and recommendations from organisational expertise.

More immediately, however, local providers and commissioners are being tasked with amending their local cancer plans where needed to reflect the ambitions in the National Cancer Plan. How can the sector contribute to, and support, this process?

Overall, it is a time to take heed of Minister Ashley Dalton’s words that the ‘plan does not belong to the government or the NHS. It belongs to all of us and we all must play a part in making it work’. This means looking both nationally and locally as we look to influence cancer policy and make it work the best it can for our patient groups.

What will the repercussions be from the decision not to allow GM Mayor Andy Burnham to stand for Parliament?

Whilst time will tell, my take is that the May elections in Wales, Scotland & across many English councils will be even more pivotal than they were already shaping up to be.

If Labour gets a kicking, which is pretty common for the party of Government when mid-term with local elections, the PM could be on very shakely ground, & even more so if Labour loses Gorton & Denton (Reform UK came second there at the General Election, but by some distance, so la be surprised).

And what could happen if Reform UK performs well? It may have its biggest sway on political power yet if it becomes one of the biggest parties in the Senedd as it's presently polling to, & coupled with wins across local elections, this could influence the policy of major parties as they look to win back voters.

Whether that means consolidating core voters through more classic policy positions, or shifting to the right, remains to be seen. Either way, it's a time to be shoring up relationships across parties & preparing for likely change ahead.

Why should you engage Members of the House of Lords?

Whilst the role of the House of Lords is often a topic of debate within the UK’s political apparatus, it remains a key part of Parliament and its legislative processes. Yet a mistake many organisations make when developing their public affairs strategies is focusing all their energy and resource on MPs at the expense of engaging Peers.

In my experience, this is a mistake. Peers make a huge contribution to bringing about positive change and can be incredibly skilful and passionate advocates for worthy causes. Furthermore, as all legislation passes through both the Commons and Lords, engaging with Lords is vital for successful Bill influencing work such as amendments and Private Members Bills.

Many Peers have been appointed to the Lords as a result of their rich expertise and experience in a particular area, such as law, and can bring incredible knowledge and acumen to campaigning issues. Some are also former MPs who are hugely respected by current MPs and have the ear Ministers and other influential stakeholders.

As such creating and maintaining positive, cross-party, relationships with Peers should be within every public affairs strategy. While leading charity campaigns, I have successfully seen an amendment made to a Government Bill through firstly engaging with a passionate Peer, and led work on a Private Members Bill which was driven hugely by a Peer and who skilfully led its passage through the Lords.

If you want to explore how Peers can factor into your influencing work, you are welcome to get in touch!