If there is one overriding insight from this review of the National Cancer Programme over the past 20 years it is complexity, not just of the disease and growing treatment options, but the intrinsic complexity of driving change across many different professional groups and organisations, all of them subject to multiple, competing demands from other parts of the health system. Any condition-specific improvement effort needs to be constructed with this complexity in mind, with a realistic grasp of what it takes to generate momentum and support professionals and patients to make lasting change.

I think it is so easy to lose sight of the absolute requirement to be grindingly relentless about delivering improvements in outcomes for patients and those at risk of cancer. It takes decades to bring about lasting change. Any step forward you make, you’ve got to defend rigorously. Then further steps forward have to be made carefully based on what has worked. You cannot afford to slip back. In an inevitably changing political and economic environment, you will slip back easily. If you want to create something that transcends political power, then your ideas and commitment, professional power and patient power are the resources you’ve got.

Peter Selby, Professor of Cancer Medicine, University of Leeds

Previous Next