PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk

 
PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan
2017 - 2021
A plan for PHE staff
PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

                        i
PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Foreword
Cancer is a leading                                  PHE has over four
public health challenge                              hundred people working
– a condition that in                                on cancer in a diverse
all its forms is likely to                           and complex range
affect one in two of us                              of programmes that
during our lifetime. However, over 40% of            form one of the ten cross-cutting PHE
cancers are thought to be preventable so             Programmes and co-ordinated through the
our work can have a profound effect on               PHE Cancer Board. Our plan provides the
those burdened with this disease by tackling         framework for our work programmes across
inequalities and reducing the impact of the          the organisation and highlights how we will
major risk factors such as smoking, obesity          work in partnership with external bodies that
and alcohol. PHE is a significant contributor        is key to making the delivery a success.
in the system-wide approach cancer across            We have highlighted the extensive range of
England and we recognise that success                activities of our system-wide data collection
will come from strong partnership-working            and analysis for all cancer.
across the health and care sector, with the
voluntary and charitable sector and most of          Dr Jem Rashbass, National Director
all with the public themselves.                      Disease Registration/ PHE Strategic Lead
                                                     for Cancer
This strategy outlines our contribution to
the cancer system and how our activities
integrate with the work of others. We have
made cancer a cross-cutting programme
to bring together the extensive skills and
expertise we have in PHE. This embraces
the design and implementation of national
prevention programmes based on the
best evidence, population screening for
breast, bowel and cervical cancer, cancer
vaccination programmes, public awareness
campaigns, all the national cancer data
collection and analysis, and our support for
the long-term quality of life of those living
with or who have had cancer.

Duncan Selbie, Chief Executive

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Contents
About Public Health England ............................................................................................... i

Foreword ..............................................................................................................................ii

Glossary ..............................................................................................................................iv

Introduction ......................................................................................................................... 1

    PHE activities: ................................................................................................................... 1

    External activities:.............................................................................................................. 1

Cancer work in PHE ............................................................................................................ 3

Governance and accountability .......................................................................................... 5

Section 1: Delivering on the Taskforce
Recommendations .............................................................................................................. 7

    Workstream 1. Lead the national work-stream on cancer prevention and public health......... 7

    Workstream 2. Drive a national ambition to achieve earlier diagnosis ................................... 9

    Workstream 3. Make patient experience as important as safety and clinical effectiveness .. 11

    Workstream 4. Transform our approach to support people living with and beyond cancer .. 13

    Workstream 5. Make the necessary investments required to deliver a modern,
    high-quality service ......................................................................................................... 15

    Workstream 6. Overhaul processes of commissioning, accountability and provision .......... 17

Section 2. Consolidating and accelerating our cancer intelligence function .................... 19

Section 3. Working in collaboration................................................................................... 21

Section 4. Communications and Awareness..................................................................... 23

Section 5. Investing in cancer activity ............................................................................... 25

Appendices ....................................................................................................................... 27

    Appendix 1: PHE Cancer Board Terms of Reference and Membership .............................. 27

    Appendix 2: Related resources ...................................................................................... 29

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Glossary
ACE       Accelerate, Coordinate and Evaluate          NCRAS     National Cancer Registration and
ALB(s)    Arm’s Length Body (Bodies)                              Analysis Service
BCOC      Be Clear On Cancer                           NCRI      National Cancer Research Institute
CAS       Cancer Analysis Service                      NEoLCIN   National End of Life Care Intelligence
CCG       Clinical Commissioning Group                            Network
CDF       Cancer Drugs Fund                            NHSE      NHS England
CNS       Clinical Nurse Specialist                    NHSI      NHS Improvement
COMARE    Committee on Medical Aspects of              NICE      The National Institute for Health and
           Radiation in the Environment                           Care Excellence
COSD      Cancer Outcomes and Services                 NIHR      National Institute for Health Research
           Dataset                                     ODR       (PHE) Office for Data Release
CPES      Cancer Patient Experience Survey             ONS       Office for National Statistics
CPRD      Clinical Practice Research Datalink          PHE       Public Health England
CQC       Care Quality Commission                      PHOF      Public Health Outcomes Framework
CRCE      Centre for Radiation and Chemical and        PMO       Programme Management Office
           Environmental Hazards                       PROMS     Patient Reported Outcome Measures
CRUK      Cancer Research UK                           QA        Quality Assurance
CSQM      Clinical Service Quality Measures            RTD       Routes to Diagnosis
DH        Department of Health                         RTDS      Radiotherapy Dataset
DIDs      Diagnostic Imaging Datasets                  SACT      Systemic Anti-Cancer Treatment
DPH       Directors of Public Health                   STPs      Sustainability and Transformation Plans
EAG       Expert Advisory Group                        UK NSC    UK National Screening Committee
FIT       Faecal Immunochemical Testing                UV        Ultra-Violet
FYFV      Five Year Forward View
HEE       Health Education England
HPV       Human Papillomavirus Infection
HTA       Health Technology Assessment
ICBP      International Cancer Benchmarking
           Partnership
ICTR      Independent Cancer Taskforce Report
IR(ME)R   Ionising Radiation (Medication Expo-
           sure) Regulations
JCVI      Joint Committee of Vaccinations and
           Immunisation
KPIs      Key Performance Indicators
LAs       Local Authorities
LINAC     Linear Accelerator
MDT       Multi- Disciplinary Team
MRC       Medical Research Council
NCIN      National Cancer Intelligence Network

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Introduction
Public Health England (PHE) is a major contributor to the system-wide approach to cancer
in England outlined in the Independent Cancer Taskforce Report ‘Achieving World Class
Cancer Outcomes: a strategy for England 2015-2020’ (published in July 2015). We bring
leadership in prevention, screening, health marketing and cancer data collection, liaison and
analysis and support many other cancer-related areas. We deliver through our national role
in Public Health and our partnership with health and social care in Local Government as well
as our collaborations with NHS England, other Arm’s Length Bodies (ALBs), Third Sector
partners and Academia. We are committed to improving the public’s health and reducing
variation and inequalities across society.

This, our internal plan, outlines our approach to co-ordinating Public Health England’s
cancer work for the next 5 years, set in the national context of the whole cancer system. It
is aligned with the Five Year Forward View (FYFV) and the Independent Cancer Taskforce
Report (ICTR) and is the manifesto that coordinates the work across PHE to deliver on these
cross-organisational strategies as well as our own core work and innovation. It describes
our ambitions and what we will do to maximise our effectiveness while working in
partnership with others to deliver on the recommendations made in Independent Cancer
Taskforce and enhance PHE’s own role in the fight against cancer.

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan
A schematic diagram showing the relationship
between the internal cancer-related activities in
PHE and those in the wider service
                                                                                                        Key:
                                                                                                               Health Protection                Health Improvement                  NHS Service-led

PHE activities:
                                     Prevention of infection           Behavioural Factors; smoking;                                           Systemic Anticancer
          Hazards                                                                                                  Screening                                                   Data for National Statistics
                                        related morbidity              obesity; alcohol, UV exposure                                           Therapy (SACT) Data

 Ionising Radiation (Medical           Immunisation and                                                                                                                             Survivorship and
   Exposures) Regulations            prevention of infection                Health marketing                 Cancer screening QA             Cancer Drugs Fund Audit
                                                                                                                                                                                     Quality of Life
                                        related cancers

 Radiation worker follow-up                                                                                                                   Surveillance of radiation
                                                                           Be Clear on Cancer             Interval cancer surveillance                                         Supporting End of Life Care
                                                                                                                                                       workers

                                                                      Data collection, quality assurance, analysis and intelligence

                               Local delivery through centres and   regions; healthcare public health, health and wellbeing, health protection and specialised commissioning

External activities:
 National Data and Policy:         National Data and Policy:            3rd Sector: CRUK; Mac-             Research: basic; applied;           Commissioners: CDF;                Patients and Public
       ONS and DH                        ONS and DH                      millan; other charities            service; epidemiology                RTDS provision

   Cancer Screening QA             Data for National Statistics            Routes to Diagnosis                 NHS CancerStats               Cancer as a Rare Disease                   PROMS

   Cancer Outcomes and                Radiation Exposure                                                   Phenotypic Data for 100K            Systemic Anticancer
                                                                            ACE Programme                                                                                            Patient Portal
     Services Dataset                 COMARE & IR(ME)R                                                         Genome Project                     Therapy Data

     MDT performance                Data to inform National                CRUK CancerStats                                                  Outcome monitoring and             National Cancer Patient
                                                                                                             Clinical trial follow-up
       monitoring                       Cancer Policy                         and Policy                                                            relapse                       Experience Survey

 National Lung and Prostate          International Cancer                Macmillan Local Cancer             Surveillance for Genetic           RT provision and use;               Online prognostic
       cancer audits               Benchmarking Partnership                 Intelligence tool                 Cancer Syndromes                 Proton Beam Therapy                tools (e.g. PREDICT)

  Service KPIs and Cancer
                                   Access to Diagnostic tests                                                 Tissue bank linkage            Cancer Drugs Fund Audit           Radiation worker follow-up
        Peer Review

                                                                                                            Standardised pathology
         Screening                    Be Clear on Cancer
                                                                                                                  reporting

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Cancer work in PHE
Public Health England has a wealth of                   • Be Clear on Cancer Evaluation with Health
expertise and knowledge in cancer, and is                 Marketing and NCRAS
well-recognised for its unique position in              • Communicating complex messages about
many areas. We spend over £22 million a                   screening to patients, professionals,
year directly on cancer and employ over 400               the media and the public, supported by
people who work directly on cancer-related                Screening, NCRAS, Communications,
work, with many more working in areas that                Specialised Commissioning and our
significantly contribute to our cancer activity.          Regions and Centres
                                                        • Radiation worker follow-up involving Health
PHE cancer-related activity spans the entire              Protection Centre for Radiation, Chemical
patient pathway. From cancer prevention                   and Environmental Hazards (CRCE) and
(which includes our work on obesity, alcohol              NCRAS
& tobacco, UV radiation and radon exposure,             • NCRAS data to support others such as
screening and HPV vaccination), to earlier                specialised commissioning, Public Health
diagnosis (including cancer screening and                 Outcomes Framework, health economics,
health marketing), guiding and supporting the             Knowledge & Intelligence and Health
NHS to commission treatment and services                  Marketing
(specialised commissioning, screening, data             • Local networks for national initiatives and
intelligence and health economics) through                support for Local Authority Public Health
to supporting those living with and beyond                teams through our Centres & Regions, for
cancer and end-of-life care, encompassing                 example tobacco control, alcohol harm
and responding to user needs and patient                  reduction and tackling indoor radon
experience.

                                                        How the plan will be used
In early 2016 cancer was established as
one of the ten PHE Corporate Programmes.
In doing so, we have begun to harness the               Our plan will be used by all areas of PHE
benefits from cross-organisational working and          working on cancer related activities, to set the
identify further opportunity to exploit our com-        direction of travel for a coordinated approach,
bined skills and knowledge. This allows us to           ensuring join up both internally and externally
work synergistically, sharing expertise, creating       over the next 5 years. Each year the PHE
efficiencies and cost savings. To external              Cancer Board will approve a delivery plan
collaborators and partners it shows how we              using the strategy as its guide, adapting
link our diverse cancer work and provides us            where needed to new initiatives, intelligence
with a single voice and common front door.              and policy as this arises. The delivery plan will
                                                        indicate the year on year deliverables and will
Examples of existing internal collaborations            link with other PHE plans and priorities. It will
include:                                                be the responsibility of the PHE Cancer Board
                                                        to ensure the strategy is reflected in business
• The monitoring of cancer screening involving
                                                        planning processes and to decide on the
  National Cancer Registration, Analysis
                                                        annual priorities for each year.
  Service (NCRAS), and Cancer Screening

                                                    3
PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

    Breadth of cancer-related activity in PHE, through all steps
    of the patient pathway:

                                  Behavioural

                                                                               PR
                                  factors

                                                                                 EVE
                                                                                                  Environmental

                                                                                    N
                                                                                                  risks and hazards

                                                                                  TIO
                                  Physical activity          Smoking

                                                                                     N
                                  Diet and obesity            Alcohol

                                 Immunisations
                                 and prevention of infection-related cancers

                                                                                                  Health
                                                                                                  marketing
                                                                                         SIS
                                                                                       GN O
                                                                                   D IA

    Data and
    intelligence
                                                                                Cancer
                                                              T
                                                            EN
                                                       TM
                                                  EA
                                               TR

                                           OR
                                                IP
                                              SH E
                                                AR
                                                                                 screening
                                      R VIV E C
                                   S U L IF
PREVENTION                             F
DIAGNOSIS                           DO
                                 EN
TREATMENT
             P
SURVIVORSHI
       LI FE C ARE
END OF
                                                                               Patient experience

  Mental health                 Health economics

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PHE Cancer Board Plan 2017 - 2021 A plan for PHE staff - Gov.uk
PHE Cancer Board Plan

Governance and accountability
To deliver our ambitions on cancer success-                                  chaired by our Chief Executive, is responsible
fully we need to coordinate our approach both                                for the co-ordination and delivery of our work
internally across PHE departments and Direc-                                 on the cancer taskforce recommendations
torates and externally, aligning with the National                           and reports to the PHE Delivery Board. The
Cancer Transformation Board Implementation                                   Delivery Board requires the PHE Cancer Board
Plan, as well as delivering in collaboration with                            to report monthly on its progress against the
stakeholders and the public.                                                 strategy and delivery plans. The PHE Cancer
                                                                             Board Terms of Reference and Membership
Internally, Cancer is one of PHE’s Corporate                                 can be found in Appendix 1.
Programmes and the PHE Cancer Board,

PHE Cancer Board: Governance, Functions and Membership

 National Cancer                                    PHE Cancer Board                                 PHE Delivery Board
 Transformation Board
                                                    Chaired by PHE CEO and                           Oversight of Cancer as one of
 Oversight of Cancer Taskforce                      includes leads for all PHE cancer                ten corporate programmes
 Recommendations                                    related functions

 Stakeholders
                                                                                                         All PHE Directorates/ functions
 NHSE, CRUK, CQC, HEE,                                                                                   responsible for cancer-related
                                                                                                         activity report to the Cancer
 Macmillan, NICE, NHS Digital
                                                                                                         Board and align activity with
                                                                                                         PHE’s Cancer Internal Strategy

Health &          Data &            Screening &        Specialised                          Health            Health             Health
                                                                             Research
Wellbeing         Intelligence      Immunisation       Commissioning                        Economics         Marketing          Protection

Behaviour         Data              Leadership,        Supporting            Commis-        Assessing         Prevention,        Working with
change            registration,     commis-            NHS                   sioning of     cost-effective    earlier            partners to
and policy        analysis          sioning            commissioning         research;      interventions     diagnosis          reduce the
- tobacco,        and release.      and quality        of services and       collabora-     to prevent,       and raising        hazardous
alcohol harm      Clinical          assurance          care. Cancer          tions with     diagnose and      awareness          effects of
reduction,        Epidemiolo-       of cancer          Programme of          academia,      treat             with multiple      environmen-
childhood         gy, support       screening          Care Board.           NIHR, NCRI                       campaigns          tal factors
obesity,          for research      services                                 charities &                                         and radiation
physical                                                                     others
activity
                 TF 1, 27, 28,
                 64, 90, 91,        TF 5, 10, 11,      TF 37, 51,
TF 2, 3, 4, 48   92, 94             12 13              76, 82                TF 14          TF 95, 96         TF 2, 15

      Local Delivery: Regions & Centres ensure link up to national strategy, lead and enable local delivery and feedback from local level

                                                      Patient engagement & experience

                                                               Communications

                                                                         5
PHE Cancer Board Plan

Externally, the PHE Cancer Board will work             Additionally, we will develop our partnership
with the National Cancer Transformation                working at national, regional and local levels,
Board, which provides the focal point for              building on successful collaborations to
system-wide leadership on the implementation           develop more formal arrangements with the
of the Independent Cancer Taskforce Cancer             Third Sector including CRUK, Macmillan, Teen-
Strategy for England 2015 - 2020, enabling             age Cancer Trust, National Cancer Research
a joined up and coherent approach. PHE                 Institute (NCRI) and many others as well as
leads the prevention work-stream of the                strengthening our activities with academia.
National Cancer Transformation Programme.              More detail about our partnership working can
                                                       be found in section 3.

 External Governance

                                    Five Year
                                  Forward View
                                  CEOs Board

           National Cancer       National Cancer                                        Clinical
           Advisory Group        Transformation                                        Steering
                                      Board                                             Group

                                                                                     Cancer Data
               Regional           NHS Cancer               PHE       HEE
                                                                                     and Analytics
            Cancer Boards         Performance             Cancer    Cancer
                                                                                    Advisory Group
            (sub-groups of        and Delivery            Board     Board
              STP boards)         Group (PDG)

           STP        Cancer
        footprints   Alliances          Individual project groups

The next section will outline the three key             • Develop our internal data and intelligence
areas of our strategy and describe the work               functions to be responsive to user need
we will deliver over the next 4 years.                    and to develop links across PHE
                                                          cancer-related activities
Our plan will:                                          • Strengthen our partnerships, acknowl-
                                                          edging the expertise and challenge that
• Align our work with the Independent Cancer
                                                          partners bring and to scope further
  Taskforce recommendations, showing
                                                          opportunity to work with combined
  where we have a lead or support role and
                                                          strength
  what we are committed to delivering
                                                   6
PHE Cancer Board Plan

Section 1: Delivering on the Taskforce
Recommendations
Workstream 1. Lead the national                                                   commissioning, service provision and decision
work-stream on cancer prevention                                                  making. PHE leads the prevention work-stream
and public health                                                                 of the National Cancer Transformation Board to
                                                                                  better exploit the system resources and
                                                                                  expertise to reduce the incidence of
We can prevent cancer by changing behav-                                          preventable cancers.
iours, influencing policy, by the elimination or
reduction of harm and improving protection.                                       Our ambitions:
PHE’s ‘From Evidence Into Action: Opportuni-
ties to Protect and Improve the Nations’ Health’                                  • To significantly reduce the 40% of
sets out our ambitions to tackle many of the                                        preventable cancers caused by lifestyle,
root causes of preventable cancers. By provid-                                      behavioural, and environmental and
ing the evidence base we can change policy,                                         chemical exposure through increased
and through our national and regional teams                                         public awareness and by providing the
and local centres we support a whole system                                         evidence to influence policy and support
approach, engaging clinicians, commissioners                                        local decision making
and local authority providers to inform

A diagram demonstrating                                                    Department        Chil
PHE’s key areas of work                                                    of Health             dho
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PHE Cancer Board Plan

We will:                                                                          Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

Address obesity as part of a whole systems approach, working with Gov-
ernment, Directors of Public Health and the voluntary sector to increase the      NHSE, Local Authorities,
proportion of children leaving primary schools at a healthy weight (2)            Department of Health (DH)

Work with Government and NHSE to develop and publish a new tobacco
control plan and will lead on the implementation of the plan with partners        NHSE, DH
including NHSE and CRUK to reduce the number of adults smoking to 13%
by 2020 (3)

Following the publication of the Alcohol Evidence Review in December 2016,
PHE will work at a national and local level to promote the findings and support   NHSE, DH, Academia
the implementation of appropriate evidence based policies (4)

Work with the Joint Committee on Vaccination and Immunisation (JCVI) to           Joint Committee on Vaccina-
re-evaluate the effectiveness of the HPV vaccination in boys (5)                  tions and Immunisation (JCVI)

Work with the JCVI and NHSE to take forward the HPV vaccination pilot for
men who have sex with men (5)                                                     JCVI and NHSE

Support the work to monitor the use of cancer-preventative medication
across the population and work with partners to ensure maximal use of these       NHSE
interventions (6,7)

Work with other ALBs, charities and other stakeholders to ensure that lifestyle   NHSE, Care Quality Com-
advice is provided to cancer patients to prevent secondary cancers, increase      mission (CQC), NICE, Third
sustained health lifestyles and reduce recurrence (8)                             Sector

In line with the PHE Liver Disease Framework we will examine the evidence
for a Hepatitis B vaccine and implement the Hepatitis C Improvement Frame-        NHSE
work to protect against and reduce primary liver cancers (8)

Developing the UK National Radon Action Plan and provide leadership and           DH, Local Authorities and
evidence on tackling radon exposure in homes and supporting employers             other government depart-
and regulators to manage radon exposure in workplaces (8)                         ments

PHE will work with the Health Technology Assessment (HTA) to determine the
positive mortality outcome and cost-effectiveness evidence for lung screening     UK National Screening
(13)                                                                              Committee (UK NSC) HTA

We will work with the UK NSC when new data is available to re-assess the
cost effectiveness of ovarian screening (13)                                      UK NSC

Continue to support the prevention of cancer through a wide range of
marketing campaigns beyond Be Clear On Cancer. In addition to encourag-
ing people to stop smoking with health harm advertising and the Stoptober         NHSE, Third Sector, DH,
campaign, we will also have a major focus on increasing physical activity         Local Authorities
and healthier diets for both adults and children through the One You and
Change4Life programmes (15)

                                                        8
PHE Cancer Board Plan

Workstream 2. Drive a national
ambition to achieve earlier diagnosis

The earlier a cancer is detected, the better the                              Our ambitions:
chance of it being treated successfully. Earlier
diagnosis is facilitated through increased                                    • Increase in the number of patients diag-
awareness of symptoms and signs to act                                          nosed at an earlier stage and referred for
on, screening which detects cancers at an                                       treatment sooner
earlier stage and strong links between primary                                • Reduce the inequalities of access to
and secondary care for timely referrals for                                     screening and other detection and diag-
diagnostics and testing. PHE provides system                                    nostic services through targeted service
leadership for early detection through cancer                                   configuration and campaigns
screening, and its health marketing campaigns
support decision making on the design and
provision of front line services through cancer
intelligence.

A diagram demonstrating PHE’s key
areas of work and partnerships
                                                                                  Be Cle
                                                                                        ar o
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                                                                  UK          Roll-
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                                                                          9
PHE Cancer Board Plan

We will:                                                                           Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

We will work with NHSE to roll-out faecal immunochemical testing (FIT) for
bowel cancer screening and drive up uptake by 2020 (10)                            NHSE, UK NSC

We will lead a roll-out of HPV primary testing in cervical screening (11)          NHSE, UK NSC

Examine inequalities in screening programmes and make recommendations
for action to reduce these and improve access and uptake to services               NHSE, UK NSC
(10,11,12,13)

Continue to invest and deliver the Be Clear On Cancer (BCOC) campaigns
with at least two campaigns every year (15)                                        CRUK, Macmillan, NHSE, DH

Continue to develop, pilot and evaluate the BCOC campaigns, looking
to increase efficiencies and exploring opportunities to raise awareness of
multiple symptoms and, therefore, a greater number of cancers, assessing           CRUK, Macmillan, NHSE, DH
their effectiveness and potential for further roll-out as data becomes available
(15)

Continue to build on the BCOC digital and social media presence, including
opportunities to test and evaluate new approaches wherever possible (15)           CRUK, Macmillan, NHSE, DH

Work with NHSE, DH Policy Research Unit, CRUK and Macmillan to evaluate
the Accelerate, Coordinate and Evaluate (ACE) early diagnosis intervention         NHSE, CRUK, Macmillan, DH
programme (21)

We will support NHSE with the 28-day referral pilots by developing the
metrics and providing near real-time data showing the patient pathway and          NHSE
the stage of diagnosis (24)

Building on the Routes to Diagnosis tool will develop an interactive version
and make this publicly available and scope other options for supporting the        CRUK, Macmillan, NHSE
reduction of people diagnosed through A&E (24)

Support the international comparative analysis on cancer care and outcomes
for example through International Cancer Benchmarking Programme (ICBP)             CRUK, Academia
Phase 2 work (Multiple Recommendations)

Deliver the data collection and evaluation of the primary care National Cancer     NHSE, Third Sector, DH,
Diagnosis Audit (39,82)                                                            Local Authorities

                                                        10
PHE Cancer Board Plan

Workstream 3. Make patient                                                                protected and used only for patient benefit at
experience as important as safety                                                         all times. We hope to improve patient
and clinical effectiveness                                                                experience by providing patients with their own
                                                                                          information and by making cancer data and its
                                                                                          meaning more accessible.
Our role is to support the NHS to improve its
services and provision of care, and patient                                               Our ambitions:
and carer experience is the barometer of how
successful the system is performing. How                                                  • Continue to work closely with patient
patients experience the care pathway and to                                                 groups to enable the patient voice through-
what extent they are able to make informed                                                  out our work and provide patients with
decisions are fundamental to their quality of life                                          access to their own data to support their
while living with and beyond cancer and at the                                              decision making and understanding of their
end of life. PHE deeply values its relationship                                             condition
with patients and their families and takes great
care in ensuring their data and information is

A diagram demonstrating PHE’s key
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                                                                   Patient
                                                                                                                                with
                                                                                                                                     cancer

                                                                   experience                                      CRUK
                Atla s o f Va r i a ti o

                                                                   on a par with
                                                                   clinical
                                                                   effectiveness
                                                                                                              NHS Digital

                                                                                                                    Mac
                                                                                                                           milla
                                                                                                                                    n
                            n

                                                                                                         NHS
                                                                                                         England
                                           Ca
                                                nc
                                                     er
                                                          Pat                                        y
                                                                ie nt E                          e
                                                                          xpe ri e n c e S u r v

                                                                                     11
PHE Cancer Board Plan

We will:                                                                          Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

Work to embed the practice of meeting the mental health needs in everyday         NHSE, HEE, Macmillan,
practice through staff training and new patient information materials (48)        CRUK & Academia

Work with NHSE on the National Cancer Patient Experience Survey to
develop new metrics that measure and promote continuous improvement to            NHSE, Macmillan
service provision (54)

Undertake linkage work to understand the links between patient experience
and outcomes (54)                                                                 Macmillan

Develop tools and information to support patients and the public to better
understand how accessing their data can support their care and decision           Third Sector, NHSE and
making (57)                                                                       patient organisations

Roll-out of the National Hereditary Cancer Registry focussing initially on BRCA
testing for women at risk of breast and ovarian cancer (57/90)

Continue to deliver the data and analysis to support the Atlas of Variation and   NHSE
a reduction in the variation of care (78)

Continue close engagement with patients groups, third sector partners and         NHSE, Macmillan, CRUK and
others to ensure that our work is guided and endorsed by patients and meets       other cancer charities, NCRI
their expectations                                                                patient partners.

                                                        12
PHE Cancer Board Plan

Workstream 4. Transform our                                                                   PHE’s National End of Life Care Intelligence
approach to support people living                                                             Network (NEoLCIN) monitors the quality of care
with and beyond cancer                                                                        in end of life services which serves to drive
                                                                                              improvements across all sectors working in
                                                                                              partnership with NHSE, charities and academ-
There are an increasing number of people                                                      ia. The wealth of data collected by the National
living with and beyond cancer who will                                                        Cancer Registration and Analysis Service
experience new challenges post-treatment                                                      (NRCAS) allows us to model survival by stage,
and changing needs which will impact on                                                       compare patient pathways and provide data
their quality of life. This is an area of increasing                                          on the variations in quality of services and
need as treatments and survival rates improve.                                                care.

In addition, while end of life care is more                                                   Our ambitions:
developed, still there are significant unmet
needs; for example over 40% of patients                                                       • A significant increase in the quality of life
who die of cancer do so in hospital, despite                                                    for people living with and beyond cancer
wanting to die at home.                                                                         by ensuring timely collection of patient
                                                                                                outcomes to drive immediate changes in
                                                                                                service provision, decision making and
                                                                                                understanding of their condition
A diagram demonstrating PHE’s key
areas of work and partnerships
                                                                                      Patient Re
                                                                                                  por
                                                                                                      ted
                                                                                       Link                Ou
                                                                                 Data on     peop
                                                                                                   le        tc
                                                                                         sur          wi       o
                                                                                            viv         th
                                                                                               al
                                                                                                                     m

                                                                                                  an       c
                                                                                                                      e

                               PHE
                                                                                                                     M
                                                                                                              lin
                                                                                                       d

                                                                                                                      ea
                                                                                                                 ica
                                                                                                         ou

                                                                                                                        sur
                                                                                                                    l
                                                                                                           tco

                                                                                                                          tria

                                                                                                                           es
                                                                                                              mes

                                                                                                                              ls

           Third sector

           Academia                                          Living with                                                           Academ
                                                                                                                                            ia

                                                             and beyond
                                                                                                               ONS

                                                                                                                      NIHR         Patients
          lan
 Macmil
                                                                                                                               Third s
                                         Rec

                                                                                                                                         ector
                                             ov
                               De

                                                 er
                                ve

                                                  y

                                         p                  ac
                                                       P

                                                                                                       NHS
                                     lo

                                             Q                   ka
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                                                 ua                   ge
                                                      lit
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                    fl                                      yo
                                                                                                       England
                o

                         ife                                     fL
                               ca                                     ife
                                    re                                      M e t r ic

                                                                                         13
PHE Cancer Board Plan

We will:                                                                          Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

Develop data gathering and monitoring systems to report on access to
services for those living with mental illness and or learning disabilities (48)   NHSE

Work with the National Institute of Health Research (NIHR) and research
charities to develop a system to link patients with clinical trials (50)          NIHR, Third Sector

Support the development of a new quality of life metric to drive improvements     NHSE, Third Sector,
across services (64)                                                              Academia

Support the development of Patient Reported Outcome Measures (PROMs)              NHSE, CRUK, Macmillan,
(64)                                                                              Academia

Explore ways to support the work on recovery pathways and follow – up care
with partners (65)                                                                As appropriate

Support development of stratified follow-up pathways of care for other tumour     NHSE, Commissioning
types, ideally including prostate and colorectal and some rarer cancer types      including Specialised
(67)                                                                              Commissioning

Understand the outcomes of treatment – for example 30 day mortality               NHSE, CQC and NHS
following chemotherapy and surgery; work with NHSE and others to establish        Improvement
online monitoring tools for key metrics

Publish 1 year stage survival analysis on an annual basis using near real-time
data (90/1)                                                                       ONS, DH

Reduce unwarranted variation in quality of end of life care by geography, age
and in some instances ethnicity (73)                                              Academia, DH, NHSE

At the local level support NHSE regional teams to ensure that there is
not inequality of access to health and wellbeing guidance and extending           NHSE, DPH, Third Sector
preventative lifestyle advice to people living with and beyond cancer

                                                          14
PHE Cancer Board Plan

Workstream 5. Make the necessary                                                                    Anti-Cancer Therapy Dataset (SACT) and
investments required to deliver a                                                                   Radiotherapy Dataset (RTDS). Furthermore, we
modern, high-quality service                                                                        support NHS England, through the specialised
                                                                                                    commissioning cancer Programme of Care
                                                                                                    board and clinical reference groups, to devel-
Knowing where to invest and the impact of                                                           op evidenced based clinical policies to ensure
the investment is critical to improving services                                                    cancer services improve outcomes and impact
and care for all. PHE’s role is to support                                                          on reducing health inequalities.
NHSE, commissioners and service providers
to understand the prevalence, disparity and                                                         Our ambitions:
standards of cancer services by linking the
datasets we hold in the Cancer Analysis                                                             • Robust and near real-time data, metrics
System (CAS) through data analyses and                                                                and indicators to measure the effectiveness
metrics. This includes Prescription data,                                                             of new initiatives, inform value for money
Diagnostic Imaging Dataset (DIDs) Systemic                                                            commissioning and policy and decision
                                                                                                      making to improve patient outcomes

A diagram demonstrating PHE’s key
areas of work and partnerships
                                                                                                                    Rec
                                                                                                                       urr
                                                                                                                          en
                                                                                                                            ce
                                                                                       Royal      CRUK                         an
                                                                                       Colleges
                                                                                                            Qua                  d
                                                                                                                 lity
                                                                                                                             re

                                                                                                                      m
                                                                                                                               lap

                                                                                                                       et        C
                                                                                                        Ele              r
                                                                                                                                  se

                                                                                                           ctr
                                                                                                                                    an
                                                                                                                         ic

                                                                                                              on
                                                                                                                           s

                                                                                                                                      ce

                                                                                                                ic
                                                                                                                                       fo

                                       PHE
                                                                                                                                        rA
                                                                                                                                         rs
                                                                                                                  pr

                                                                                                                                          ud
                                                                                                                                           urg
                                                                                                                    es

                                                                                                                                             its
                                                                                                                      cr

                                                                                                                                               ery
                                                                                                                        ibi

                                                                                                                                                        Academia
                                                                                                                           ng

                                                                             High quality
                                           Outco m e s b y

                                                                             services
              S u p p o r t ro l
      CQC

                                                                                                                                          Mac
                                                                                                                                                 mill
                                                                                                                                                        an
                                                           pro
                                 l ou

                                                               xi m
                                      ta

                                                                 ty
         NI

                                                              i

                                                                      ce
            CE

                               nd

                                                                           n tr
                                                                                  es
                                                                                                             NHS
                                           m

                                                 ni
                                            o

                                                       to                              Third sector
                                                             rin
                                           C
                                               an
                                                                      go
                                                                           f LI
                                                                                                             England
                                                     ce                         NACS
                                                             rD
                                                                      rug
                                                                            s Fund

                                                                                               15
PHE Cancer Board Plan

We will:                                                                         Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

Develop an algorithmic solution to determine prevalence of recurrence across     Macmillan, academia
all cancers (9)

Publish the number of cancers diagnosed at stage 1 & 2 and via emergency         NHSE
presentation on a quarterly basis each year (24,96)

Develop the software to provide individual patient pathways and make it          NHSE, Third Sector and
publicly available (24,38,41,46,81)                                              others as appropriate

Determine the variation in outcomes for patients dependent on their proximity    Macmillan, CRUK
to cancer centres (27)

Support the development of the pilot metrics for cancer surgery                  CRUK, Royal College of
sub-specialties and make recommendations to the National Cancer                  Surgeons, NHSE, CQC
Transformation Board on next steps (28)

Support NHSE in the roll-out of new Linear Accelerators (LINACs) linked with     NHSE
the Radiotherapy Equipment Register (29)

Work with CQC and providers to drive up SACT completeness in order to
enable a better understanding of drug use and spend to inform The National       CQC, NICE, NHSE
Institute for Health and Care Excellence (NICE) decisions on the future of the
Cancer Drug Fund (35)

Provide the data and undertake with partners the analysis for cancer audits      NHSE, Royal Colleges,
(82)                                                                             CRUK, Academia

Use data on recurrence and relapse to identify and then optimise the care        NHSE, Macmillan, other third
pathways for patients with metastatic cancer (46)                                sector

To support the monitoring, use and equitable access to genetic testing and       NHSE, Specialised Com-
molecular diagnostics (36,37)                                                    missioning and Genomics
                                                                                 England

Provide data and analytical support to promote the use of electronic prescrib-   NHSE, NICE
ing particularly in secondary care (34)

To support the data requirements for radiotherapy service provision – capital
investment planning, service utilisation, new therapies and outcome evalua-      NHSE, CRUK
tion.

To provide the data infrastructure to support the efficient delivery of rarer    NHSE
cancer MDTs (40) including for Paediatric Cancer (43,44,45)

Public health leadership and support for defined clinical cancer policies and    NHSE
service reviews for the cancer Programme of Care board

Explore the potential to build on existing analytical investments and further    All partners
collaborations

                                                          16
PHE Cancer Board Plan

Workstream 6. Overhaul processes                                                                  advice and systems leadership to improve
of commissioning, accountability and                                                              services, outcomes and reduce inequalities
provision                                                                                         at national, regional and centre level for the
                                                                                                  specialist commissioning portfolio of cancer
                                                                                                  services.
Through PHE’s role as chief public health
advisor to NHS England, PHE supports the                                                          Our ambitions:
translation of knowledge and intelligence into
strategic advice and policy for commissioners.                                                    • Provide public health leadership with rep-
The taskforce recommends timely metrics that                                                        resentation on the National Cancer Trans-
will allow rapid feedback and therefore enable                                                      formation Board and cancer Programme of
a more responsive commissioning of local                                                            Care Board
services. PHE will align its analysis outputs to                                                  • Active involvement with the National Cancer
those of the taskforce recommendations and                                                          Transformation Board plans and decision
work with partners to deliver these. Further-                                                       making
more, PHE recognises its responsibility in the                                                    • To develop an understanding of the costs
delivery of the taskforce recommendations                                                           and benefits associated with cancer
and will ensure its structures, governance                                                          programmes
and reporting mechanisms follow suit. We will
ensure robust, evidence based public health

A diagram demonstrating PHE’s key
                                                                               thway cost-effe
areas of work and partnerships
                                                                        ctal pa               ctiv
                                                                    lore                          en
                                                                                                    es
                                                                  Co                                  st
                                                                                                        oo
                                                                                                          l

                             PHE                                                                                            Third
                                                                                                                                    secto
                                                                                                                                            r

                                                                              Commissioning,
                                                                          Accountability                                      Academia

                                                                          & Provision                                          McKinsey
                       Ca
              Data s u p p

                             Ca n c e
                       P ro g

                          nc

                                                                                                                              Department
                             er
                              ra m

                                                                                                                              of Health
                                r Al

                                                                  sh
                                 da
                                   m

                                                                         bo
                                     li a

                                      e

                                                                              ar
                   ort

                                                            C                      d
                                         of
                                          nc

                                                                ar
                                            for

                                                                     e
                                                                                                              NHS
                                             e

                                                na
                                               A

                                                     ly t
                                                 M

                                                            ica                                               England
                                                   D

                                        s
                                                                  l Su
                                                     T

                                            &
                                                qu                        p por
                                                     ali                               t
                                                           ty s
                                                                urve
                                                                     i ll a            nce

                                                                                             17
PHE Cancer Board Plan

We will:                                                                           Working with:

(*) denotes corresponding Cancer Taskforce Recommendation

Work with NHSE to develop and deliver a cancer dashboard of metrics to             NHSE
support the work of CCGs, Providers and Alliances (1)

Work with NHS England colleagues to define the new Cancer Waiting Times            NHSE
data collection service (24,38)

Develop a user-friendly tool to enable Clinical Commissioning Groups (CCGs)
and local commissioners for the first time to estimate costs and benefits at       NHSE, CRUK, Macmillan,
a local level of improving outcomes in colorectal cancer and to make the           Academia, McKinsey
business case for appropriate investment to improve early detection (95)

Provide the data collection, analysis and reporting functions to assist
with the delivery of efficient Multi-Disciplinary Team (MDT) working               NHSE, NICE
(38,39,40,41,46,70)

Provide the data collection, analysis and reporting functions to support           NHSE, NICE
efficient decision making and use of Cancer Prevention Drugs (6)

Provide the data collection, analysis and reporting functions to assist with the
delivery of efficient use of quality surveillance and the use of NICE and other    NHSE, NICE, HEE
clinical guidelines (79)

Provide the analytical support capacity in partnership with the Cancer             NHSE
Vanguard and Alliances (78)

Provide evidence of impact on national specialised commissioning cancer
products through the NHS England Cancer POC Board; and support                     NHSE
approaches to improving cancer services access and outcomes at Centre
and Region level

                                                        18
PHE Cancer Board Plan

Section 2. Consolidating and accelerating
our cancer intelligence function

PHE is responsible for nearly all the data               • Collect, quality assure and curate cancer
collection, reporting and analysis that under-             data from the entire care pathway on
pins the work of the whole cancer system in                all cases of cancer in the population in
England spanning public health, health care,               England
commissioning, evaluation, research and                  • Co-ordinate cancer data collection and
individual patient choice. The National Cancer             analysis across PHE and working with
Registration and Analysis Service collects                 partners in NHSE and other arm’s length
richer, more-timely data on greater number of              bodies
patients than any other country; data quality for        • Undertake and support academically
key data items such as cancer stage.                       robust data analysis on all aspects of the
                                                           cancer system in England including the
Joining up cancer intelligence & new ways                  new Cancer Alliances and Vanguards, and
of working:                                                alignment with non-cancer specific ‘Sustain-
                                                           ability and Transformation Plans’ footprints
                                                         • Provide timely, high-quality data to all those
We have realigned the work between our
                                                           who require it within a robust information
registration and analysis teams with the imple-
                                                           governance framework
mentation of the National Cancer Registration
                                                         • Develop new resources to deliver relevant,
and Analysis Service (NCRAS) which replaces
                                                           timely cancer data and information to
the National Cancer Registration Service
                                                           all users such as the integrated cancer
(NCRS) and the National Cancer Intelligence
                                                           dashboard
Network (NCIN.) By bringing the functions
                                                         • Continue to interrogate the data and
together we now need to focus our ambitions
                                                           evidence and identify new areas of need to
on continuing to provide a near real-time, cost
                                                           inform the next national cancer strategy
effective, comprehensive data collection and
delivering an academically rigorous and stra-
tegically-driven analysis service. We have also          We will:
enriched our collaborative working to support
our capabilities and build capacity and we will          • Ensure that all our data collection, use
continue to explore further opportunities with             and release is fully aligned with the recom-
stakeholders. For more information about our               mendations of the National Data Guardian
work with partners see section 3.                          Review and emerging policy on data collec-
                                                           tion for National Disease Registers
Our ambitions:                                           • Align the work of the National Cancer Regis-
                                                           tration and Analysis Service to the taskforce
• To set the standard for data collection,                 data needs as described in Section1 and
  analysis and release                                     deliver these in the timeframes given

                                                    19
PHE Cancer Board Plan

• In partnership with others, continue to         • Work to establish data collection and re-
  drive-up data quality and completeness for        porting from rarer cancer MDTs and sharing
  all datasets including staging completeness,      data with the 100,000 genome project
  SACT, RTDS, DIDs, Prescription Data
                                                  To improving data access we will:
  and the Cancer Outcomes and Services
  Dataset (COSD)
                                                  • Continue to develop the PHE Office for Data
• Provide data and expertise on the design
                                                    Release (ODR) to manage the delivery of
  and assessment of prevention interventions
                                                    timely data to all those who request it, within
  including cost-effectiveness and return on
                                                    a robust information governance framework
  investment
                                                  • Work with the Ministerial Information
• Work with the Office for National Statistics
                                                    Strategy Group and other partners including
  (ONS) to produce official and national
                                                    the NHS Digital, Clinical Practice Research
  cancer statistics for England
                                                    Datalink (CPRD) and ONS to harmonise
• Provide the timely, relevant and responsive
                                                    data access requests
  evaluation of the Be Clear on Cancer
                                                  • Develop a range of online directories that
  campaigns
                                                    allow users to discover what data we hold,
• Work with NHS England and NICE to pro-
                                                    and the quality and completeness of this
  vide a robust data collection and evaluation
                                                    data
  of chemotherapy treatments and outcomes
                                                  • Develop one or more physical safe haven
  including those medications provided
                                                    facilities to allow secure data access in a
  through the cancer drugs fund
                                                    controlled environment that guarantees
• Support the monitoring of Section 7a-fund-
                                                    patient confidentiality
  ed activities including the roll-out of FIT and
                                                  • Provide online resources of data, informa-
  HPV primary testing
                                                    tion and knowledge to support call users
• Provide data and expertise to support the
                                                    – including a CCG and Alliance dashboard,
  assessment of inequity and variations in
                                                    the Public Health Outcomes Framework
  access, treatments and outcomes
                                                    and Fingertips and Health Economics
• Provide data to support the work of PHE’s
                                                    modelling tool.
  Chief Economist
                                                  • Work with colleagues in NCRI to improve
• Develop relevant metrics and indicators to
                                                    the use of data collected in clinical trials
  monitor cancer pathways and outcomes
  including monitoring the 28-day standard
  and diagnostic capacity fund
• Develop and manage a national directory
  of all Multi-Disciplinary Teams and the lead
  clinician
• Review the role of the PHE Expert Advisory
  Groups (EAGs) and their relationship with
  other cancer clinical reference groups including
  those supporting NCRI, NICE and NHSE
  to improve effective engagement

                                                20
PHE Cancer Board Plan

Section 3. Working in collaboration

Cancer is a system-wide activity and PHE has             • Be Clear on Cancer Campaigns working
a significant role in improving outcomes for               alongside CRUK & NHSE
cancer but it is the system-wide approach that           • Increased capacity of our cancer intelli-
will make the difference. We must be clear on              gence function and enabling increased data
our part in this, while recognising the many               access through posts funded by CRUK,
strengths of our partners, and how we can                  Macmillan, and NCRI
work better together to achieve the change in            • Macmillan investment and expertise sup-
patient outcomes we all want.                              porting the work on recurrence
                                                         • Teenage Cancer Trust investment for data
The teams and functions delivering cancer-re-              linkage and new work on children’s cancer
lated activities already have strong links with
partners including the Third Sector, Academia
                                                         Our ambitions
and other Arm’s Length Bodies (ALBs).

Building on current successes, we aim to                 Going forward, we will look to build our part-
strengthen our partnership working by consol-            nership working with the Third Sector so that
idating existing relationships, and extending            wherever possible we have a whole pathway
our collaborations with other ALBs, charities,           approach which harnesses partners’ expertise
industry and academia to maximise on the                 in areas such as prevention, quality of life and
potential of collaborative working and achieve           reducing inequalities and variation. We will:
our ambitions and those of our partners. We
recognise partnership working as an enabler of           • Apply a strategic approach to future
joint success, bringing added value by working             partnership development, scoping areas of
to organisational strengths and learning from              need and exploring opportunities with our
one another.                                               wide range of stakeholders
                                                         • Expand our working partnership with CRUK
                                                           to deliver an accelerated cancer intelligence
Our work with the Third Sector                             function and innovative ways of working
                                                           through additional capacity
                                                         • Build on our working partnership with
PHE already has a number of collaborations
                                                           Macmillan to ensure our resources and
with third sector partners which bring together
                                                           expertise are used to support activities in
organisational expertise in specific areas of the
                                                           the areas of Living With and Beyond Cancer
cancer patient pathway and/ or knowledge
                                                           and End of Life Care
and focus on specific cancers or skills.
                                                         • To scope other partnership opportunities
                                                           with our other third sector partners including
These include:
                                                           Teenage Cancer Trust, Braintrust UK, NCRI
                                                           and many others

                                                    21
PHE Cancer Board Plan

Our work with academia & clinical                        and national priorities, supporting delivery of
engagement                                               national programmes tailored to local need and
                                                         enabling others to improve health and reduce
                                                         variation.
Academic input to our work is crucial to pro-
ducing high quality, evidence based outputs,
                                                         At the regional level PHE provides overall
and clinical engagement informs the prioriti-
                                                         quality assurance and co-ordination of PHE
sation of our work, seeing that it is focused
                                                         functions, leading our work on the Sustainabil-
on patient care and service improvement.
                                                         ity and Transformation Plans (STPs) and acts
Across PHE we have a strong relationship with
                                                         as public health advisers to NHS England.
academia. For example, the screening team
work with health education institutes and Royal
                                                         The 9 Centres provide a tailored approach,
Colleges to develop education and training
                                                         reflecting geographical differences.
resources for thousands of front line clinicians,
and we work closely with clinicians to help
                                                         Centres work with NHS England, Health
inform our data and intelligence work through
                                                         Education England (HEE) and Directors of
the EAGs.
                                                         Public Health to support the breadth of public
                                                         health functions at the local level. This includes
                                                         representation on clinical senates, quality
We will:
                                                         surveillance groups, and work that supports
• Scope and develop academic partnerships                improvement in outcomes, providing advice
  and research collaborations building on                and evidence on a wide range of cancer-re-
  appointment of Senior Academic Epidemi-                lated areas. This local position enables us to
  ologist to provide challenge and academic              support place-based approaches with local
  rigour to our workforce and outputs                    public health teams. They provide a strategic
• Work with the Farr and emerging MRC                    link for the ‘national to local’ and ‘local to
  health informatics initiative on data analysis         national’ interface working.
  and interpretation
• Work with the Chairs of the SSCRGs to                  Examples of the local role in supporting and
  re-align clinical input as part of our efforts         taking forward cancer-related activities include:
  to ensure our work programme is based on
                                                         • Centres have strengthened their efforts
  user needs
                                                           to improve cancer outcomes locally. They
• Expand our clinical engagement and input
                                                           successfully undertook the redesign and
  with the appointment of clinical leads for
                                                           implementation of their screening and
  domain areas
                                                           immunisation teams in conjunction with
                                                           local NHSE partners. This is helping to
Our work with local partners                               provide more appropriate services to meet
                                                           local needs. They continue to be creative
                                                           by instituting local initiatives aimed to
PHE’s local function is delivered through its
                                                           address challenges in the vulnerable and
Centres and Regions who work as part of
                                                           underserved populations
local health systems, contributing to local

                                                    22
PHE Cancer Board Plan

• Through the STP processes, Centres                        • Health protection function in monitoring
  support local government and NHS to                         radon exposure and advise on chemical
  co-commission preventative services                         and environmental risks
  aimed to improve health outcomes,                         • Screening & Immunisation staff sit under
  reduce demand on the local health and                       NHSE Directors of Commissioning Opera-
  care system, and secure a reduction in                      tions to deliver local screening programmes
  variations in outcomes across and                           which are tailored to address variation and
  between localities.                                         inequalities to ensure maximum coverage
• Centres also work directly within wider                     as well as delivering HPV vaccinations
  partnerships including Academic Health
  Science Networks, CLAHRCs, Clinical
  Networks, Health Education England and,
  Clinical Senates to provide public health
  advice and support

Section 4. Communications and Awareness
One of the keys to our success will be our                  of Informed Choice for Cancer Registration
ability to communicate our intentions and                   highlighted the need for PHE to increase its
actions in an accessible manner to engage                   transparency about how it obtains and uses
and inform staff, partners, stakeholders,                   data and its need to improve awareness of the
patients and the public.                                    role of the cancer registry respectively, in par-
                                                            ticular with the public, cancer patients, carers
Internally, we have raised the profile of our can-          and health professionals. We will work with
cer-related activities with all staff using targeted        CRUK, Macmillan, and many other partners to
internal communications and events, inviting                respond appropriately to the recommendations
staff to give feedback on how we can improve                from both reviews.
their knowledge of our cancer-related work
and to support them in talking to stakeholders              We will increase our presence with health
and partners in their roles. We will ensure all             professionals, cancer patients and carers with
staff have access to the PHE internal cancer                the review of existing materials and taking on
strategy and that the cross dependencies with               new suggestions to improve accessibility to
department and teams plans are considered                   information, the patient’s right to opt-out and
as part of the annual business planning cycle.              the benefits that patient data brings to the
                                                            whole system.
Both the National Data Guardian Review
of Security, Consent and Opt Outs and                       More widely, PHE recognises its role in
Macmillan and Cancer Research UK’s Review                   disseminating evidence and guidance to a

                                                       23
PHE Cancer Board Plan

wide range of stakeholders to support delivery            Patient and public engagement
and service improvements, but until now has
not coordinated its approach to cancer. The               We value the significant input and feedback
establishment of the PHE Cancer Board has                 from the many patients and carers involved
already taken steps to address this with the              with our work and seek to build on these activities
creation of the PHE Cancer Board Gov.UK                   to ensure the patient voice is reflected in all areas
page and dedicated communications support.                of our cancer-related activity. At the current
                                                          time public engagement helps to shape many
To deliver on PHE’s commitments as part of                of our services and campaigns including:
the Cancer Taskforce, particularly in relation
                                                          • The development of screening information
to prevention and data expertise, Cancer is
                                                            materials
one of the PHE communications priorities as
                                                          • Testing our health marketing campaigns to
outlined in our communications business plan.
                                                            maximise impact
                                                          • Informing NCRAS deliverables through
We will use national media, online and digital
                                                            patient representation on the EAGs
channels and direct communications to inform
                                                          • Ensuring the PHE Cancer Data and
stakeholders of our work in relation to cancer
                                                            Outcomes Conference has a distinct
in general and cancer prevention specifically.
                                                            patient and carer presence through patient
Our public facing messages on diagnosis and
                                                            bursaries
prevention will be delivered primarily through
                                                          • Project specific involvement with the many
our Be Clear on Cancer campaigns and
                                                            patient and consumer groups through our
screening communications work.
                                                            third sector partners
Key outputs outlined in the plan reflect the              As we move forward we will seek further
priorities in the PHE cancer strategy for example:        opportunity to engage with patients and the
                                                          public to help inform our work.
• Publication of national and CCG level
  survival statistics
• Increase in primary screening for HPV and
  national roll out of HPV testing in the cervical
  screening programme
• National Be Clear on Cancer campaign on
  respiratory symptoms
• Outputs of data analysis and cancer intelli-
  gence work such as that on SACT

These will be delivered using a variety of
communications channels including print and
online national and regional media and direct
communications via our direct mailing bulletins.
They will be produced and amplified alongside
our partners in the Five Year Forward View and
the National Cancer Transformation Board.

                                                     24
PHE Cancer Board Plan

Section 5. Investing in cancer activity
Annually, PHE invests            Dedicated cancer functions                        Full Year budget (000s)
£22 million directly into
                                 Be Clear on Cancer campaigns                                       £4,390
dedicated cancer
                                 National Cancer Registration and Analysis Service (NCRAS)        £11,551
activities.
                                 HPV-related cancers                                                  £478
                                 Preventing infection amongst people with cancer                      £300
This includes screening
                                 Cancer screening                                                   £6,170
and screening quality
assurance, cancer data           Subtotal                                                         £2 2 , 8 8 9
collection and intelligence,
Be Clear on Cancer,              Crosscutting functions benefitting cancer          Full Year budget (000s)
radiation protection and with
                                 Ionising radiation                                                 £7,000
an additional £38 million
                                 Non-ionising radiation                                               £500
allocated across all our
                                 Chemical hazards                                                   £1,500
Directorates and teams
                                 Hepatitis B and C                                                    £586
who support the delivery of
                                 Health Equity and Place (Inequalities)                             £1,323
our cancer-related activities,
for example Healthcare           Behavioural risk factors
Public Health teams in
                                 Health & Wellbeing (Diet & Obesity/Alcohol/Tobacco Control)        £5,686
our local Centres.
                                 National Child Measurement Programme                                 £205
                                 NHS Health Checks                                                    £648
                                 Physical Activity                                                      £43

                                 Non-cancer marketing

                                 Ageing Well (Early Diagnosis)                                      £5,200
                                 Living Well (Smokefree)                                            £4,000
                                 Living Well (Alcohol)                                                £200

                                 End of Life Care Network                                             £436

                                 Subtotal                                                         £27,327

* Budgets shown for
                                 Centres and Regions *                              Full Year budget (000s)
Centres and Regions
are not dedicated to             Immunisation and Screening                                       £13,804
cancer-related activity, but     Specialist Public Health                                           £4,934
show the total resource for      Health Improvement                                                 £8,245
cross-cutting functions that
impact on cancer                 Sub total                                                        £26,983

                                 Overall total                                                    £77,199

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