Progress and pressures, commissioning UK oncology services

Written by Phillip Drew on Thursday 8th February 2018

Philip Drew, a Market Access Consultant at OPEN Access Consulting, has some thought provoking insights following the recent Commissioning Chemotherapy Services Conference.

Cancer services are changing and budget shortages are driving the NHS to consider new ways of delivering care.

We live in a society that enjoys highlighting the errors of our ways and unfortunately the NHS often gets punished for cancer treatment delays and restrictions. At the recent Commissioning Chemotherapy Services Conference the take-home messages were positive (while there is always still room for improvement); more drugs are being funded and better services commissioned resulting in improved pathway productivity and hopefully better short to medium term patient outcomes.

We are now just over the first full year of the National Cancer Programme, and an update from Professor Chris Harrison, National Clinical Director for Cancer at NHS England, showed that 19 Cancer Alliances are now established, with the first wave of funding received. Five have begun to pilot a new quality of life metric whilst another 5 are testing a new 28-day faster diagnosis standard. Dose banding is now fully active and NHS England expect that more than 90% of chemotherapy doses will be prescribed and administered, in accordance with bandings by March 2018.

The NHS also now has access to valuable data on the treatment of cancer patients.  The records held within the systematic anti-cancer therapy (SACT) database are so comprehensive that the challenge is now more about maximising the analytical value than collecting the data. It covers traditional cytotoxic chemotherapy but also biological/endocrine treatments and it is thought that no other country in the world has a prospective national data collection like SACT.

The CDF is also considered to be working better, providing a logical system to speed up access to new cancer therapies whilst ensuring better value for money for taxpayers. The CDF has funded 45 drugs in 80 different cancer indications since July 2016, covering around 15,000 patients. An additional 1,400 patients have accessed promising new treatments via a new managed access agreement. Financial lessons have been learnt and applied from years gone by. From now on, if expenditure exceeds £340m/year, an expenditure control mechanism is applied and each company will rebate its proportional share of overspend to NHS England.

With all these improvements comes increased scrutiny of new products. It seems that demonstrating value in the UK healthcare system is more difficult now than ever before, and it is up to manufacturers’ clinical development and market access teams to ensure evidence requirements are identified early and data gaps filled to ensure marketing authorisation and reimbursement with faster access for healthcare systems and patients.

The conference left me feeling that in a wealth of media criticism, there is so much change going on for the better in oncology. I wonder how quickly we can capitalise on the continual opportunities our unique health system offers. 

To read more about the meeting visit

For further details of OPEN Access Consulting, please get in touch with Philip Drew, Market Access Consultant via email on