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CANCER IN SCOTLAND: ACTION FOR CHANGE

09. MAKING IT HAPPEN

THIS STRATEGY IDENTIFIES THE WIDE RANGE OF ACTIONS NECESSARY TO PREVENT WHERE POSSIBLE, CANCER FROM HAPPENING, TO DETECT CANCER AND TO IMPROVE TREATMENT AND CARE FOR PEOPLE WITH CANCER IN SCOTLAND.

It builds on the pledges identified in Towards a Healthier Scotland and Our National Health. It will require to be similarly implemented and monitored to ensure that progress is being made to achieve the targets set.

Let there be no doubt that cancer is a priority for NHSScotland as well as for the Scottish Executive. The Executive is determined to maximise every opportunity to reduce the incidence of cancer through prevention programmes. For those people who do develop cancer, we will provide services aimed at early detection and rapid diagnosis. Effective treatment will be available across Scotland with minimal delay. We can and will provide the care people expect from a modern and supportive NHSScotland which is sensitive to patients' and carers' needs and those of our dedicated staff. Our National Health also set out our unequivocal commitment to modernise services and provide patients with the facilities and support they need if they are to benefit from the best care we can deliver.

We are committing record levels of investment to support modernisation and improvements in the services provided by NHSScotland. We have pledged to continue to do so. Targeted investments are being made to secure real and sustainable improvements in cancer services. For example, new imaging equipment to ensure faster, better diagnosis and modernised radiotherapy machines which provide faster, up to date treatments.

But these investments must be matched by the NHS - with programmes of service redesign and improved ways of working so that real and worthwhile benefits for patients are delivered. The cancer MCNs offer great opportunities for improving patient care and outcomes. We must maximise these and set in place operational frameworks which will allow this to happen.

We have made it clear that the Scottish Executive will make the necessary investments. But, we also need to develop a planning process for the future that ensures that decisions are taken where they matter most - locally, to meet the needs of the people served by healthcare services. Healthcare services need also to keep abreast of new opportunities and challenges as they arise. The cornerstones of the new planning process for cancer services will therefore be the MCNs working through the Regional Cancer Advisory Groups whom we expect to draw up realistic and effective workforce, equipment and chemotherapy spending investment plans in agreement with NHS Boards.

There will be three Regional Cancer Advisory Groups:

• West of Scotland for those NHS Boards which look to the Beatson Oncology Centre for specialist services (Argyll & Clyde, Ayrshire & Arran, Lanarkshire, Forth Valley and Greater Glasgow)
• North of Scotland covering those mainland Boards (Highland, Grampian and Tayside) and Island Boards (Western Isles, Orkney and Shetland) which look to Inverness, Aberdeen and Tayside Cancer Centres
• South East Scotland which will cover the NHS Boards which look to the Oncology Centre in Edinburgh (Lothian, Borders, Fife and Dumfries and Galloway)

Further guidance on the structure and functions of Regional Cancer Advisory Groups and their respective tumour specific MCNs will be issued separately. In the meantime, in parallel with the establishment of NHS Boards, arrangements should be made by Health Boards to secure the appointment of a Chairman for each of these Groups who should be either a recognised lead clinician or lead manager drawn from within the regional MCNs.

Managing Implementation

Nationally, the Scottish Cancer Group will remain as the strategic advisory body to Ministers and the Health Department, but it will be restructured and strengthened. The Lead Clinician for Cancer Services will be Chairman of the Group.

The Chief Medical Officer (CMO) will act as Project Director and a Project Manager will be appointed, regularly reporting progress to the CMO and to the Scottish Cancer Group.

The new NHSScotland performance and accountability framework will provide the structure through which routine monitoring will be assessed and reported. Regional Cancer Advisory Groups and NHS Boards will be assessed against the deliverables set out in their annual cancer investment plans. These investment plans will be expected to reflect continuous progress towards achieving the objectives set out here and in Our National Health, such as, achieving real and sustainable improvements in rapid diagnosis and treatment to meet waiting times standards. Prospective audit is the platform on which monitoring will be based and is the key for local (MCN) continuous assessment.

This document sets out the Scottish Executive's strategy for cancer. There is no doubt that it is challenging as there is much still to be done.
There will be a variety of ways in which the objectives can be delivered and in every case this must be achieved using the methods best suited to local needs. Central guidance will not therefore seek to provide detailed prescriptions for implementation but rather objectives, milestones and frameworks against which progress can be measured.

We have indicated that in several areas we intend to seek the input of staff, patients and public on the way forward. This does not exclude comment on all or any other aspects of this strategy. We welcome feedback and comment.

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