A commitment to improve cancer outcomes in order to “save 5,000 lives a year” is set to be included in the government’s first “mandate” for the NHS Commissioning Board, HSJ has been told.
Inclusion of such an outcome in the mandate would mean commissioning consortia are held to account for improving survival rates and meeting related process targets for their population.
Under the government’s reform proposals the health secretary will set out what the board must deliver in an annual mandate. The first mandate is due to be published later this year, to take effect from April next year.
National clinical director for cancer Sir Mike Richards told HSJ he thought it was very likely the requirement to improve survival rates to the European average would be included. The DH cancer outcomes strategy, published in January, said this would mean “5,000 lives would be saved every year”.
Sir Mike said the inclusion in the mandate of the outcome measure would mean the commissioning board translated it into part of the commissioning outcomes framework – the indicators which will be used to hold commissioning consortia to account.
In the first strong indication of the content of the mandate, he told HSJ: “Having made this as a commitment in the cancer outcomes strategy the secretary of state is likely to want that to be in the mandate.
“The commissioning board would know it has to save those lives – the commissioning board will also be saying to consortia ‘You have agreed to save your share of those lives.’” He said that would push consortia to consider what in practice “needs to be done at a local level”.
Sir Mike said to meet the targets consortia would be likely to work closely with cancer networks, whose funding the government this week confirmed beyond 2013.
He said his team – and other clinical strategy teams – were working on indicators to include in the commissioning framework. One indicator might be the stage the disease had reached when the patient was diagnosed, which would reflect ability to achieve early diagnosis, a key part of the plan to improve outcomes. Another indicator could be the proportion of diagnoses referred as emergencies.
Sir Mike acknowledged these and many other measures in the commissioning outcomes framework would be process measures rather than outcomes.
He said: “The important point is we have really good evidence these are proxy measures for outcomes.”
HSJ understands as many as two thirds of the indicators could be process measures.
Cancer and mental health are the only outcomes strategies published so far, but HSJ understands cardiovascular and liver disease are likely to follow.