To develop a 5 year Cancer Commissioning Strategy. Identifying areas of fragility within cancer services, including those elements of services which have been delegated or not, through implementation of the “NCL Fragile Cancer Services Framework” and through stakeholder engagement setting out the strategic direction, and priorities, for cancer commissioning in NCL. Development of a tariff or alternative funding mechanism, to support the substantive commissioning of surveillance services across NCL. Lynch Syndrome Surveillance Hub Innovative Pilot in place. Funded for a second year with non-recurrent funding to provide additional evidence and undertake engagement to move the pilot into a sustainable position. Ovarian Surveillance Hub Modelling underway to understand resource implications for ovarian surveillance pathway for BRCA1 and 2 ; ROCA testing pathway (nonrecurrent cancer transformation funding) for patients on a waiting list for risk reducing surgery to commence Q1 25/26. Commissioning Route: Business case outlining proposal for sustainable commissioning of these services under development. Earlier Diagnosis Lymphoedema Service Provision NCL system wide service spec. developed for embedding into NCL provider contracts in 25/26. Support will be provided during 25/26 to RFL Trust and Charity to develop and implement lymphoedema offer for Barnet. Commissioning Route: Acute Trust provision within tariff; Community provision via community core offer. Move4You Programme Will require legacy planning to mitigate risks of service not being re-commissioned. Further information regarding prehab and rehabilitation programme to follow. Psychosocial Support Services Develop service specification to be embedded into future contracts. Support providers to develop necessary business cases for acute and community providers for sustainable delivery of psychosocial support services and delivery of the Cancer Alliance integrated psychosocial pathway. Personalised Care Breast Hormone Pathway Consistent pathway for NCL developed. Prioritises option for patient selfadmin or in a primary care setting with secondary care keeping clinical responsibility. Commissioning Route: Although the pathway addresses current inequity, limited 5 year savings have been identified, impeding system ability to move from secondary to primary care setting. Alternative options being explored. Telederm Develop NCL clinical pathway, service spec, clinical and operational guidelines; Implement pathway - NMUH, UCLH, RFL, WH. Breast Pain Clinical pathway, service spec, clinical and operational guidelines to be documented; Implement pathway - NMUH, UCLH, RFL, WH. Commissioning Route: Commissioned via current tariff. Anticipate a national tariff for image acquisition and reporting. Acute Diagnostic and Treatment 14 | Cancer Commissioning Strategy Framework Cancer Commissioning Strategy Framework | 15 Appendices Appendix 1 NCL High-Level Cancer Commissioning Intentions for 2025-2026 - Implementation Plan Appendix 2 Developing a Methodological Framework to Facilitate a Strategic Review of Fragile Cancer Services Appendix 3 Fragile Services Framework Appendix 4 Tumour Specific ERG Cancer Fragility Risk Checklist Appendix 5 Commissioning Tools, Templates and Resources Directory 14-17 18-19 20-21 22-23 Cancer Commissioning Strategy 24 Cancer Commissioning Intentions* High-Level Indications for 2025-26 *Please see Appendix 1 for a more detailed Implementation Plan
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