• NHS England should stop tying cancer funding to 62 day performance, says senior MP 
  • John Baron has also called for a statutory outcomes target, rather than targets based on waiting times
  • NHS England has pledged to release £200m over two years, and says it is on track to meet this target

NHS England has been urged to stop a “perverse” policy of withholding money from a £200m of cancer transformation fund from areas breaching the 62 day target.

John Baron, who stood down as chair of the all party Parliamentary group on cancer last month after nine years, told HSJ it was “perverse in the extreme” to withhold funding from areas failing to meet the waiting time standard.

Mr Baron, who has been lobbying prime minister Theresa May on the matter, also called for NHS bosses to introduce statutory outcomes targets for cancer rather than relying on waiting time targets (see box below).

On the transformation fund, he said money was being withheld from areas, which arguably needed it most and that the policy was failing patients.

The Conservative Basildon and Billericay MP said the policy had also been introduced “retrospectively”. He added: “All the money should be distributed to the front line as quickly as possible… the NHS’s performance is improving, and of course we welcome this, but we are not catching up with the international averages in survival rates.”

The comments follow NHS England publishing updated allocations for the 19 cancer alliances, on its website for cancer transformation funding last week. There was no formal announcement. All the alliances, which cover every health economy in England, have been allocated some funding. But the amounts vary based partly on performance against the waiting time target.

The performance of the cancer alliances against their targets is not yet publicly available. At a system level, the 62 day target performance has been consistently poor for years – it has been breached in all but one month over the last three years.

NHS England’s website says “an element of the funding… is linked to their 62 day performance [which must be hit 85 per cent of the time]… to make sure funding goes to areas that have robust plans for effective use of these funds”.

NHS England has pledged to release £200m over the course of two financial years. Around £80m was released in 2017-18, but NHS England said it is “on track” to meet the two year commitment.

A further £97m has so far been allocated in 2018-19, although £29.7m of this is capital expenditure, which remains “subject to approval”.

A respected cancer policy expert, speaking on condition of anonymity, told HSJ the withholding of funding from areas breaching the 62 day standard was “concerning”, and not in the best interest of patients.

The source said: “We understand the actual proportion of funding a cancer alliance then receives will be ‘tiered’ depending on how close they are to meeting the 62 day wait standard.”

Transformation projects supported by the fund, earmarked to be spent this year and 2017-18, include a digital project to speed up test results in West Yorkshire and Harrogate and the South Tees optical referral project.

The Wessex Cancer Alliance is meanwhile researching the impact of community based pre-surgery fitness programmes and psychological support to improve recovery.

An NHS England spokeswoman said: “Record numbers of people now receive their first treatment for cancer following an urgent GP referral and 7,000 more people survive cancer compared with three years ago. All cancer alliances have received their full allocation for the first half of this year to support improvements in diagnosis and care.”

Call for statutory outcomes based target for cancer

Mr Baron also said the NHS targets’ review, announced in June as part of the long term NHS plan, was “a golden opportunity” to introduce a statutory cancer target based on outcomes – and a focus on early diagnosis – rather than waiting times.

He said: “We [the APPGC] have long called for the greater need for a focus on outcome rather than process targets. We are failing to catch up with international average survival rates.

“We are proud that we have got the one year survival rates into the DNA of the NHS. But there is understandably a natural tendency for frontline NHS organisations to focus on the process targets, because of the money attached to them.

“A focus on one year survival rates would encourage a big push on early diagnosis. The NHS’s relatively poor performance on early diagnosis is one of the main drivers for why we lag against international averages.”