Calman–Hine report

Report from the Chief Medical Officers (CMOs) of England and Wales setting out the principles underlying good cancer care and the broad structure of services needed to deliver such care. No formal government backing or funding.


Publication of the first Improving Outcomes Guidance

The first in a series of reports summarising what processes of care were most likely to be associated with the best outcomes for individual cancers. Written by expert advisory groups, these were funded by central government money – £10 million for each cancer – from 1997.


Election of the Labour Government

Action to improve the NHS was a key Labour manifesto commitment. This included specific pledges on cancer – £10 million for implementation of breast cancer guidance and commitments on waiting times for breast cancer.


Smoking Kills white paper

The first ever tobacco control strategy set a target to reduce the prevalence of smoking from 28% to 24% by 2010. This was achieved.


Cancer summit at 10 Downing Street (May)

A signifier of the level of political interest in cancer, Tony Blair, then Prime Minister, convened a cancer summit, and subsequently announced a review of cancer services, plus the creation of a National Cancer Action Team ‘to raise the standard of cancer care in all hospitals’.

Appointment of the first National Cancer Director (October)

The creation of this role, and appointment of Professor Mike Richards gave clear leadership on cancer in the NHS in England.

Foundation of the All-Party Parliamentary Group on Cancer

Set up to be the voice in parliament of cancer patients and their families. It campaigns on multiple issues including early diagnosis, cancer workforce and patient experience.


NHS Plan (July)

Promised thousands of new beds, doctors, nurses and improved hospitals and GP premises. NHS organisations would be accountable for new waiting times targets and expected to deliver care to new national standards. Contained a promise of a comprehensive national cancer plan and £570 million over 3 years for improving cancer services.

NHS Cancer Plan (September)

Set out strategies for cancer prevention, screening, diagnosis, treatment and care. Contained detailed plans for implementation over the next 5 years, including milestones and deadlines with dates attached. Established cancer networks as a vehicle for delivering change. Significant funding attached, identified in NHS Plan.


‘National survey: cancer patients’ – the first national survey of cancer patient experience

Pointed to the existence of major delays in accessing cancer treatment, and significant variation in waiting times and patient experience across the country.


Extension of breast screening programme to seven rounds

Fulfilled an NHS Cancer Plan pledge to widen breast screening from age 50–65 to age 50–70 (an additional two rounds).

Introduction of liquid-based cytology for cervical screening

Fulfilled an NHS Cancer Plan pledge to improve and update the cervical screening programme.


National Audit Office (NAO) report: Tackling Cancer in England, Saving more lives

Recognised that the pace of improvement in cancer services had quickened since The NHS Cancer Plan. Raised concerns about delayed diagnosis, highlighted workforce shortages, and called for more action on geographical and social inequality in access to high-quality care.


NAO report: Tackling Cancer, Improving the patient journey (February)

Encouraging progress had been made since 2000 in most aspects of patient experience. However, still too much variation by geography and cancer type.

NAO report: The NHS Cancer Plan, A progress report (March)

Reported that the NHS Cancer Plan is well constructed, well regarded and delivering positive changes. Cancer networks are working well, but can be improved. Plans will be needed to update the NHS Cancer Plan.


Cancer Reform Strategy

Updated the NHS Cancer Plan and acknowledged progress. Despite all this activity there has been a failure to reduce the gap in survival between comparator countries. Included four major new initiatives, on early diagnosis, survivorship, information and equalities. No additional dedicated funding.


New initiatives established

Following the Cancer Reform Strategy, the National Awareness and Early Diagnosis Initiative, National Cancer Survivorship Initiative, National Cancer Intelligence Network and National Cancer Inequalities Initiative were established.


Coalition government elected

Conservative party manifesto promised action on cancer, including a ‘Cancer Drugs Fund’. They were joined in government by the Liberal Democrats.

Bowel cancer screening introduced

The bowel cancer screening programme started, initially using testing of stool samples, but with a government commitment to introducing flexible sigmoidoscopy to the programme.


Cancer Drugs Fund created

Initially worth £200 million per year, this was designed to give patients access to drugs not routinely available on the NHS.

Improving Outcomes: A strategy for cancer

Landed amid plans for NHS reforms, but did not commit additional money to cancer. It promised action on screening and data, and a maintained focus on improving outcomes.


Health and Social Care Act

Fundamental structural reform to the NHS, with the creation of clinical commissioning groups (CCGs). Devolved responsibility for some functions previously held by the Department of Health to new ‘arm’s-length bodies’ such as Health Education England and Public Health England.


National Cancer Action Team

Disbanded and funding for cancer networks reduced.


Five year forward view

Recognised cancer as a priority and promised action on prevention, faster diagnosis and better care. New models of care established, with a shift towards integration of care. Focused on how to make efficiency savings – no extra funding.


NAO – Progress in improving cancer services and outcomes in England (January)

Reviewed progress since 2011. Outcomes continue to improve, but there is too much variability in outcomes and access across the country. ‘Data gaps’ remain, with more action needed to improve cancer data, particularly around stage at diagnosis.

Independent cancer task force report – Achieving World Class Cancer Outcomes: A strategy for cancer 2015–2020

Written independently but adopted in full by NHS England, the 96 recommendations include a focus on prevention and early diagnosis. Called for investment in new infrastructure and the creation of cancer alliances at an estimated cost of £400 million a year.

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