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With the American Society of Clinical Oncology (ASCO) 2022 coming to an end and being blown away by the development of innovative precision medicines, I couldn’t help but reflect on the challenges ahead for cancer services and the need to address them in order to effectively implement these new treatments.

In their 2022/23 priorities and operational planning guidance, NHS England and NHS Improvement (NHSE/I) have asked systems to “deliver significantly more elective care to tackle the elective backlog, reduce long waits and improve performance against cancer waiting times standards”. This while also entering consultation on plans to replace the current cancer standards with fewer measures and a focus on earlier diagnosis.

The challenges cancer services face in addressing the backlog while also implementing arguably the biggest change in cancer waiting time standards since 2009 cannot be underestimated. In this article we explore this emerging cancer landscape and the role industry can play as a supportive and long-term strategic partner.

The challenge ahead

The COVID-19 pandemic has of course had a hugely negative impact on elective care and those waiting for cancer treatment. Recovering elective services will require a combined effort from systems right across health and social care. NHSE/I have acknowledged that this will involve “transforming delivery of services” to meet an ambitious target of delivering approximately 30% more elective activity by 2024/25.

With the need to address the backlog and a refocus on the ambition that by 2028, 75% of people with cancer will be diagnosed at an early stage (The NHS Long Term Plan), NHSE/I see the simplification of cancer waiting time standards as a key driver to success.

The proposed changes will see a significant change in the standards, with the current nine standards reduced to three:

  • The 28-day faster diagnosis standard (patient informed of a cancer diagnosis, or that cancer has been definitively excluded within four weeks of an urgent GP referral)
  • The existing 62-day wait to first treatment following an urgent GP referral or screening referral
  • The 31-day wait to first treatment following a decision to treat

While the simplification of these standards will be welcomed by many, there is significant challenge presented by replacing the 2-week standard (urgent referral for suspected cancer to first outpatient attendance) with the new 28-day faster diagnosis standard because of the pressure it places on diagnostic capacity. As a result, performance against this standard will likely be targeted at 75% rather than the 95% first proposed by the Independent Cancer Taskforce.

The good news is that Integrated Care Systems present a real opportunity to foster collaboration across health economies with a focus on implementing better pathways and maximising the use of collective resource and capacity. Industry is uniquely placed to facilitate this collaboration but only those that are perceived as providing value will have access.

Impact and opportunity for industry

To help we first need to understand. It’s imperative that industry have an intimate understanding for the environment in which their stakeholders are working to offer real value. Structurally the NHS is going through their biggest change since the Health and Social Care Act of 2012 while at the same time emerging from one of the world’s deadliest pandemics. It will be critical to understand and reflect the new NHS architecture while providing targeted support that aligns with their strategic objectives. For those companies working with cancer services this presents complexity but opportunity.

Companies that have the capabilities to identify and collaborate with the right stakeholders are at a clear advantage. Importantly, those companies that bring to the table offerings that will support the transformation and optimisation of cancer services will present health care systems with an invaluable reason to engage. If done successfully, industry will be seen as an integral part of the solution and long-term strategic partnerships can be cultivated which benefits the NHS and ultimately the patients they care for.

By Andrew Brazier, Senior Consultant. June 2022. Contact:

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