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National Perspective. Kathy Elliott National Lead for Prevention, Early Diagnosis and Inequalities. Cancer Early Detection & Prevention Performance Review Event October 2008. National Cancer Action Team. Cancer Reform Strategy. Preventing cancer

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National perspective

National Perspective

Kathy Elliott

National Lead for Prevention, Early Diagnosis and Inequalities

Cancer Early Detection & Prevention Performance Review Event

October 2008

National Cancer

Action Team

Cancer reform strategy
Cancer Reform Strategy

Preventing cancer

  • Over half of cancers could be prevented by changes to lifestyle

  • Smoking, obesity, alcohol, sun & sun beds, vaccination

    Diagnosing cancer earlier

  • Late diagnosis is the major factor contributing to poor cancer survival rates in England

  • Screening – cervical, breast, bowel

    Reducing cancer inequalities

  • Major inequalities in cancer incidence, access to services and outcomes

National Cancer

Action Team

Initial priorities
Initial Priorities

  • Building links with Cancer Networks and PCTs

    • PCT Strategic Commissioning Plans

    • Cancer mortality reductions

    • Early detection agenda

  • Input to Commissioning Guidance and Darzi alignment

  • Skin cancer – 08/09 procurement decisions

  • National Initiatives – NAEDI and NCEI

National Cancer

Action Team

08 09 cat work programme
08/09 CAT Work programme

Preventing Cancer

  • Study of sun bed use

  • New local & national approaches for skin cancer prevention

  • Dissemination – pilots to assess cancer genetic risks

    Diagnosing Cancer Earlier

  • Support Networks to

    • Review the local indicators to early diagnosis

    • Set out commissioning intentions in PCT Strategic Plans

    • Develop at least one new initiative for implementation locally

    • Use new tools and good practice

      Reducing Cancer Inequalities

  • Equality Impact Assessments

  • Cancer mortality

National Cancer

Action Team

New ways of working
New ways of working

Local priorities

reflecting local

needs & services

Top down

National targets

Local & national


National experts

Short term



effective services

The Importance of Dialogue

National Cancer

Action Team

National awareness and early diagnosis initiative naedi
National Awareness and Early Diagnosis Initiative (NAEDI)

  • Co chairs: Harpal Kumar and Mike Richards

  • 7 work streams

    • Review of evidence base on awareness and early diagnosis

    • Measuring awareness

    • Interventions to promote early presentation by patients

    • Interventions in primary care

    • International benchmarking

    • Prospective research

    • Key messages on individual cancers

  • Launch conference: 21st November 2008

  • Newsletter

Reducing cancer inequalities
Reducing Cancer Inequalities

  • National Cancer Equality Initiative

    • Co chairs: Joanne Rule and Mike Richards

    • Steering group with experts from each of the inequality strands (e.g. race, age, gender, disability, religion, sexual orientation and social deprivation)

  • Working closely with National Awareness and Early Diagnosis Initiative (NAEDI) and with National Cancer Intelligence Network (NCIN)

  • Developing a matrix of local initiatives

    • Please contribute

  • Will then focus on:

    • Spreading good practice where this exists

    • Developing and evaluating new models to reduce inequalities

Cancer networks
Cancer Networks

  • Understanding and communicating local need

    • Joint Needs Assessment (JNAS)

  • Providing leadership for prevention, early detection and inequalities

    • Influencing

      • PCT Strategic Plans

    • Monitoring and assuring quality and outcomes

      • Vital Signs and Local Area Agreements

      • CRS commitments – mortality; inequalities

    • Development

      • Early detection initiatives

    • Network expertise and work plan

      • Good practice – spread of community engagement in early detection

      • Development needs

  • Challenges

National Cancer

Action Team

Diagnosing cancer earlier
Diagnosing Cancer Earlier

Every PCT should have one early diagnosis/ detection initiative.

  • To have reviewed information

    • One year survival rates against international benchmarks

    • Screening uptake, overall and by general practice

    • Referral rates, by general practice

    • Emergency admission

  • In PCT Strategic Commissioning Plan

  • At least one initiative implemented

  • National Awareness and Early Diagnosis Initiative

National Cancer

Action Team

Cancer mortality
Cancer Mortality

  • What local progress has been made towards achieving the cancer mortality target?

  • How does this compare with the England progress, other Networks/ PCTs?

  • What is my local commitment to meet the 2010 standard?

  • ‘Have PCTs agreed challenging goals for reducing cancer mortality in every cancer network area by 2012?’ (CRS)

  • Are these goals in the PCT Strategic Commissioning Plans - and resourced?

  • Do local plans reflect variations between PCT needs and health inequalities?

National Cancer

Action Team

Relative change in cancer mortality by cancer network since 1997
Relative change in cancer mortality by cancer network since 1997



Relative change in mortality rates and the level of change in mortality rates since 1997 (compared to England level) by cancer network.

5 year rolling age-standardised mortality rates (2001-2005) for all cancers for 0-74 years age group; % change in mortality rates since 1997

National Cancer

Action Team

Emerging good practice themes
Emerging Good Practice Themes 1997

  • Priority within local plans, including pledges

  • Leadership commitment and ownership, with clarity on why it matters

    • Reductions in mortality

    • Fair access to services

  • Strong public and patient involvement

  • Relationship management and communications

    • Close working with other networks, with explicit commitments

    • Building a relationship with public health – engagement, influence and work programme

    • Importance of all health professionals understanding their role and implementing their contribution

  • 2 year action plan

National Cancer

Action Team

Kathy Elliott 1997

National Lead for Prevention, Early Diagnosis and Inequalities

National Cancer Action Team

Blackberry and Mobile


[email protected]


0207 972 4816

[email protected]

Note – please use both email addresses

National Cancer

Action Team