• Non-surgical cancer treatment to be shifted into community settings
  • Cancer network is waiting to hear if it has been granted £6.5m from NHS England
  • Redesigned clinical pathways have so far yielded mixed results

Three London trusts have agreed to redesign their cancer services to try to improve patient care and waiting time performance.

The South East London Accountable Cancer Network, comprising Guy’s and St Thomas’ Foundation Trust, King’s College Hospital FT and Lewisham and Greenwich Trust, has drawn up a memorandum of understanding committing to a level of “cooperation and collaboration… that has not been achieved to date”.

The network has agreed to a programme that involves redesigning clinical care pathways and moving diagnostics and non-surgical treatment into the community.

To implement the changes, the network has submitted a bid for £6.5m to NHS England, requesting:

  • £4.5m for training GPs to spot suspect cancers as early as possible, improving access to diagnostics, and establishing a multidisciplinary clinic for patients with vague but serious symptoms;
  • £1m to work with Macmillan Cancer Support to help patients get emotional support in the community; and
  • £1m to set up community based services for patients in remission.

The network expects to find out this month whether the bid has been successful.

The network was set up in April 2016 after the former London Cancer Alliance split into three smaller cancer networks.

David Cheesman, cancer programme director at GSST, said the network spent its first year redesigning clinical pathways costing £280,000.

Pathways for lung, upper gastrointestinal and urological cancers were redesigned first “because they have the most complicated diagnostic pathways… and present the greatest challenge of achieving cancer waiting times”, Mr Cheesman said.

New pathways for cancer of the head, neck and upper gastrointestinal system were rolled out just before Christmas. The last wave of pathways will be launched at the end of this month for gynaecology, breast and blood cancers.

Although the work is intended to deliver faster cancer care across south east London, the first wave of redesigned pathways appears to have had a mixed impact on how quickly patients are treated, with erratic performance against the 62 day waiting time standard.

Mr Cheesman said a sharp increase in referrals partly explained the ongoing problems with waiting times.

The network is now focused on consolidating specialist thyroid surgery at Guy’s Hospital at the end of April. It is hoped duplication will be eradicated and outcomes will improve.

Thoracic surgery has already been moved to Guy’s and bone marrow transplant surgery has been consolidated at King’s College Hospital.