6 | Cancer Commissioning Strategy Framework Cancer Commissioning Strategy Framework | 7 • Utilising analytics and intelligence to assess population needs and service gaps. • Ensuring evidence-based commissioning decisions to improve cancer service delivery. Data-Driven Decision Making • Applying national and local contract and payment models to optimise resource allocation. • Ensuring sustainable financial planning for cancer services. Understanding Financial Mechanisms • Using policies and commissioning levers to design sustainable cancer services. • Implementing innovative service delivery models. Strategic Frameworks and Levers for Change • Ensuring national and regional compliance for effective commissioning. • Aligning cancer services with NHS guidelines and best practices. Driving Quality and Patient Outcomes Cancer commissioning operates within a multi-tiered system, integrating national directives with regional and local strategies: • National Landscape: Policies, frameworks, and funding initiatives set by NHS England, NICE guidelines and national cancer strategies guide service design and expectations. • Regional and Local Landscape: Integrated Care Boards (ICBs), Cancer Alliances, and Local Health Systems tailor national priorities to address regional disparities, workforce capacity and population health needs. • Financial and Contractual Mechanisms: Payment models, tariff structures, and commissioning frameworks determine the funding and sustainability of cancer services. By analysing these landscapes, commissioners can identify service gaps, prioritise investments and implement change effectively. Cancer Commissioning: Key Responsibilities Fragile Services Framework • In order to support a strategic review of fragile cancer services, we have developed a fragile services framework to identify and assess areas of fragility within cancer services. The framework comprises several domains (please see appendix 3 for further detail). • We have constructed a Two-Tier Approach. With clinical and operational teams undertaking a simple high-level assessment (see appendix 4) to identify areas of risk or opportunity. This is followed by a detailed review of identified concerns, supported by relevant quantitative and qualitative data. • Stakeholder collaboration will be key to understanding areas of fragility, identifying opportunities and solutions and prioritising and setting the strategic direction. • The “Fragile Framework” review process will be undertaken annually. The outputs of which will feed into the annual commissioning work-programme. In 2025/26, the key themes will also feed into the NCL Cancer Commissioning Strategy. • The fragile services framework will be embedded into NCL’s Annual Commissioning Cycle. This cyclical process ensures NCL can adapt plans as required to ensure continued high- quality, equitable and sustainable cancer care across NCL. Please see Appendices 2-4 for further detail. PHASE PHASE PHASE PHASE PHASE Undertake an Assessment of Services, Using the Fragile Services Criteria
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