NAO REPORT Foundations and ITCs a 'high risk' to service co-operation

Published: 17/03/2005, Volume II5, No. 5947 Page 8

Foundation trusts present a 'high risk' to implementation of the NHS cancer plan because they may limit effective partnerships, a National Audit Office report has warned.

Changes to the NHS, particularly the introduction of foundation trusts and independent treatment centres, will provide a 'significant challenge' to the 34 local cancer networks responsible for implementing the cancer plan and improving services, a progress report said.

Primary care trusts and cancer network management teams expressed concerns about whether foundation trusts would continue to co-operate and the extent to which they remained accountable to other network members.

They were identified as 'one of the high-risk areas. . . They may limit effective partnership working and the effective implementation of National Institute for Clinical Excellence improving outcomes guidance.' The report added that similar concerns surrounded ITCs.

Greater Manchester and Cheshire cancer network director Toni Mathie said she was concerned foundation trusts could develop strategies that suited them and not the network as a whole.

She said Stockport foundation trust had made a public commitment to work with the network, but if others coming on stream did not it would make things 'very difficult'.

'The important thing is that we have everybody working together - It is a nightmare if you have got organisations that do not engage.

'If they decide not to [work with the network] then I do not know how we are going to implement the cancer plan without them.' Report lead author Tim Fry said:

'The Department of Health needs to ensure that the partnership working is not undermined.' Stephen Humphreys, spokesman for Monitor, the independent regulator for foundation trusts, said:

'The NAO makes two points: that foundation trusts have freedoms which are meant to be used to improve services to patients.

'They also say there is a duty [on foundation trusts] to cooperate. We would like to think the two go hand in hand, but if a network was suggesting a foundation trust wasn't co-operating we would have to make a decision based on the merits of the case.' Commons public accounts committee chair Edward Leigh said: 'The essence of the networks is integration of services and co-operation, but there is a risk that will be diluted by major changes in the NHS, principally the creation of foundation trusts and ITCs.' He said the cancer plan, introduced in September 2000, had improved screening and speeded up access to diagnosis and treatment.

However, only 78 per cent of all patients with cancer urgently referred by their GPs are being treated within two months, against a target of 100 per cent by the end of this year.

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