Foreword – Dame Cally Palmer, National Cancer Director

Cancer survival in England is at an all-time high due to the speed and scale of advances in diagnosis and treatment across the NHS. Our work on cancer really matters to people. As we live longer, more of us will develop cancer ourselves, or will have family or friends who are affected by cancer. We want more people to be cured of their cancer or supported to find a way of living their life well with it.

In January 2019, we published our Long Term Plan. It contained two ambitions for cancer, which set the aims for the NHS Cancer Programme:

• by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half to three-quarters of cancer patients
• achieving this will mean that, from 2028, 55,000 more people each year will survive their cancer for at least five years after diagnosis

These are big ambitions – to our knowledge, no country in the world is achieving 75% stage 1 and 2 diagnosis as an all cancer measure. Delivering on these ambitions means developing new and innovative ways to increase earlier diagnosis across the system, creating more capacity and helping people to understand what signs to look out for and encourage them to get checked promptly.

This report provides an overview of the NHS Cancer Programme’s progress towards the delivery of our cancer ambitions, how we are partnering with the research community to make the most up to date treatments available to NHS patients and on the work to improve performance against our newly modernised cancer waiting times standards.

Thanks to the hard work of NHS staff across the country, by March 2024, we have been able to announce that the NHS met its targets to provide at least 75% of people with a definitive diagnosis or ruling out of cancer within 28 days and reduce the number of people waiting longer than 62 days following an urgent suspected cancer referral. The report also describes how we have seen the first significant increase in early diagnosis rates in a decade.

Despite this, there are still challenges and some people are waiting longer for a diagnosis or to start treatment than we want. The achievements we have made to date show us what is possible and give us the best foundation as we move into the next phase of our plan to transform cancer diagnosis and outcomes.

Priorities

In line with Long Term Plan, the NHS Cancer Programme has three priorities:

1. earlier diagnosis
2. improving treatment and personalised care
3. improving performance

Priority 1: early diagnosis

Evidence shows that survival is higher the earlier the stage at which cancer is diagnosed. Diagnosing cancer earlier and so reducing the burden of late-stage cancer is central to improving outcomes.

The 75% ambition in the Long Term Plan was deliberately stretching. Rates of early diagnosis remained stubbornly flat at around 55% between 2013 and the start of our plan in 2019. Getting to 75% means diagnosing around 60,000 more people each year at Stage 1 or 2 as opposed to Stage 3 or 4.

Our plan for early diagnosis

Delivering the ambition means making progress in the stage of diagnosis for all cancers, including rarer and less common cancers. It means identifying innovative new approaches and exploiting new technology, as well as maximising the impact of known interventions. It also requires a particular focus on areas of most disadvantage, where rates of early diagnosis are around 8% lower compared to the most affluent.     

The NHS Cancer Programme is implementing an ambitious and wide-ranging early diagnosis strategy to increase early diagnosis. It focuses on seven priorities: 

• timely presentation – increase public knowledge of the signs and symptoms of cancer and encourage people to act on them
• primary care – support timely and effective referrals from primary care
• targeted interventions – identify and test more risk-based approaches to find cancers in higher risk populations
• screening – modernise and expand cancer screening programmes
• referral pathways – streamline and improve diagnostic pathways to diagnose or discount cancer rapidly
• innovation – accelerate the take up across the NHS of new technologies and tests to support earlier diagnosis
• pipeline interventions – building a pipeline of future interventions to deliver greater impact

How we are delivering on early diagnosis

Timely presentation

People spotting changes in their body, and then acting on them promptly can help us to diagnose cancers at an earlier stage. Our campaigns to alert people to the symptoms of cancers, to take the fear out of contacting their GP, and partnerships with the likes of Stagecoach and Morrisons have contributed to a record three million people having potentially lifesaving cancer checks last year (Nov 2022 – Oct 2023).

Primary care

The proportion of people diagnosed after an urgent GP cancer referral has risen to around 40%, while emergency cancer presentations have fallen. In November 2022 GP teams were given direct access to potentially lifesaving tests, and non-specific symptoms pathways are giving GPs a new referral route where symptoms could indicate several different cancers.

Some people may not have noticed symptoms or may be reluctant to go to their GP. Enabling the wider primary care network to spot signs of cancer and even make referrals will help to find more cancers at an earlier stage. Over 50,000 pharmacy staff have completed training through the ‘Let’s Communicate Cancer’ module. In July 2023, the first small scale pilot of a direct referral route from community pharmacy started in Cornwall, and projects in other alliances are now underway.

Targeted interventions

The Targeted Lung Health Check (TLHC) programme helps to find cancers in those most at risk by offering checks in the local community. Since April 2019 more than 1.5 million people have been invited for a check and over 3,600 lung cancers have been diagnosed – three quarters at stage one or two. The Rapid Cancer Registration Dataset shows that people from disadvantaged areas are now most likely to be diagnosed with lung cancer early. In June 2023, the government announced that TLHCs will become a National Lung Screening Programme by 2028-29.

People with advanced liver fibrosis or cirrhosis are at higher risk of developing Hepatocellular Carcinoma (HCC), a common form of liver cancer. The NHS Cancer programme is working to identify those at risk of liver disease and improve liver surveillance at a local level. The Community Liver Health Checks  pilot is live in 19 locations, has delivered 48,135 fibroscans and referred 3,783 people for liver ultrasound surveillance.

BRCA1 and BRCA2 are genes that everyone has but mutations of the gene can raise your cancer risk. Jewish people are ten times more likely to have the altered gene and in 2023-24 the NHS started offering targeted testing for this community. To date over 20,000 people have requested a BRCA test, and 112 people with the BRCA mutation have been found.

We have also increased the testing of people who have been diagnosed with colorectal and endometrial cancer for Lynch Syndrome, so that their close family members can be given the option of a test and then regular checks.  

Screening

In November 2023, NHS England pledged to eliminate cervical cancer by 2040 by making it as easy as possible for people to get the lifesaving HPV vaccination and increasing cervical screening uptake – in 2022/23 we sent out 4.6 million invitations for cervical screening.

Almost 3 million women were invited for breast screening in 2022/23 and over two million women came forward for their mammogram. In 2023, a £70 million Government investment in the Digital Transformation of Screening was approved. Breast screening will be one of the first programmes to benefit with an ambition to make it easier than ever before for women to book and manage their appointments.

The phased extension of Faecal Immunochemical Test (FIT) kits to over 50s, a national bowel cancer screening campaign aimed to increase the number of people returning a completed bowel cancer screening home testing (FIT kit) and the introduction of a more user friendly test have helped to increase coverage to a record 72% as of March 2023.

Referral pathways

The NHS is investing in new community diagnostic centres to meet growing demand, and has introduced a Faster Diagnosis Standard so people receive a diagnosis within 28 days of an urgent suspected cancer referral or following a screening referral.

To support local systems to deliver the new Faster Diagnosis Standard, the NHS Cancer Programme has produced optimal timed pathways, including for suspected prostate, colorectal, lung, oesophago-gastric, gynaecology and head and neck cancer, which provide a clear guide to the timetable for diagnostic tests which hospitals should meet to deliver a diagnosis within 28 days. New optimal pathways have been published for some faster progressing cancers like pancreatic cancer, which aim to deliver a diagnosis even more quickly.

Innovation

NHS England’s Innovation Open Call is providing financial backing to exciting new technologies to support the early diagnosis of cancer. These include DERM (Skin Analytics) – an AI tool used to diagnose or rule out skin cancers; and Endoscope-I – a smartphone adapter that can turn an iPhone into diagnostic equipment for head and neck cancers.

Cancers can release circulating tumour DNA (ctDNA) into the blood stream early on during their growth. By testing for this ctDNA, it might be possible to identify cancers earlier, as well as providing new ways to guide diagnosis and treatment. Over 140,000 people have taken part in the Galleri trial, a partnership between the NHS and GRAIL. It’s the world’s largest trial of a blood test that has the potential to detect multiple types of cancer.

Pipeline interventions

Achieving the ambitions in the Long Term Plan will require a pipeline of gains in early diagnosis, by identifying opportunities to target more people who are at greater risk of cancer. NHS England is reviewing what further interventions might have the biggest impact. For example, the review of pancreatic cancer has already led to the development of a new programme to support the surveillance of people with a higher inherited risk of the disease.

Impact

The Rapid Cancer Registration Dataset, compiled by the National Disease Registration Service (now part of NHS England), is providing a more effective indicator of real time progress. By December 2023, early diagnosis rates were 2.1% above the 2019-20 pre-pandemic level. There is still a long way to go to reach the 2028 ambition, and it was always expected that the impact from the strategy would increase over time. For now, the fact that early diagnosis rates have increased for the first time in a decade is a strong foundation.

Priority 2: improving treatment and personalised care

Our plan for improving treatment and personalised care

• ensuring that NHS patients get access to the best and latest innovations in cancer treatment
• tackling variation in access to, and outcomes from, treatment
• implementing improvements to the delivery of children’s cancer service
• improving the experience of care and quality of life for people affected by cancer

Delivering innovative treatments

The improvements in survival for people with cancer that we have seen over the last half century have been driven by improvements in treatment. One year survival for patients diagnosed in 2020 was 74.6%, up 9%points from 2005 and five year survival of patients diagnosed in 2016 was 55.7% up 7.8%points since 2005. Ensuring NHS patients get prompt access to the very best treatments remains a priority and will help to ensure that we realise the benefits of earlier diagnosis. 

Enabling patients to receive innovative surgical procedures, such as minimally-invasive surgery or robot-assisted surgery, has helped to reduce recovery times. Over 90% of prostatectomies are now robot-assisted.

The last decade has also seen significant modernisation of radiotherapy services including an expansion of highly targeted Stereotactic Ablative Radiotherapy (SABR) and the establishment of two new proton beam therapy facilities in London and Manchester. More patients are benefiting from hypofractionation, which means their cancer is being treated with larger doses of radiation. This results in fewer visits to hospital which is better for patients and the NHS.

An acceleration in the number of new Systemic Anti-Cancer Therapy (SACT) drugs being approved by NICE and made available to NHS patients has led to increased pressure on SACT services. In summer 2023, NHS England convened a group of patients and experts to recommend national actions to support services.  This has already led to the publication by NICE of a new delivery assessment template for new approvals, and the publication by NHS England of the first future look of new cancer drug assessments to support provider planning.

Since its establishment in 2016, the Cancer Drugs Fund (CDF) has been used extensively to assess the effectiveness of more than 50 new cancer treatments and accelerate access for people with different cancers to new drugs.

Many new treatments have relied on the expansion of our genomic testing capability. The national network of seven NHS Genomic Laboratory Hubs (GLHs) works in partnership with the Genomic tumour advisory boards to interpret this new genomic data and agree complex treatment options. As a result, more people are benefiting from precision medicines like Olaparib, to target cancers with mutations in the BRCA genes. The NHS is also extending ctDNA testing to 10,000 patients with suspected non-small cell lung cancer a year.

The NHS GLHs are also supporting the development of a new generation of cancer vaccines for treatment. The NHS Cancer Programme has established a Cancer Vaccines Launch Pad to identify thousands of NHS patients suitable for personalised cancer vaccine trials – giving them the earliest possible access to this cutting-edge technology.

Tackling variation in care

Variation in access to treatments may reflect differences in local populations and the case-mix of cancers, as well as differences in how Trusts adopt the latest treatments and techniques. Clinical audits hold a mirror up to local systems to highlight these differences. The NHS Cancer Programme is committed to retaining the established clinical audits for lung, colorectal, prostate and oesophago-gastric cancers, and is extending this to five cancers with significant potential to improve outcomes.

In October 2022, the National Cancer Audit Collaborating Centre (NATCAN) was appointed to undertake six new clinical audits covering ovarian, pancreatic and kidney cancer, non-Hodgkin lymphoma and primary and secondary breast cancer. NATCAN has worked with the relevant cancer charities to finalise the scope of the new audits which are due to report initial results in 2024.

The Getting It Right First Time (GIRFT) programme is also using data to improve treatment by creating a safe space in hospitals for clinician-to-clinician discussions about what might lie behind variation. In April 2022, GIRFT programme shared its findings from its first cancer study on lung cancer, which drew on visits to 71 hospitals. As a result, Trusts are starting to implement initiatives to deliver efficiencies and improve patient care, such as one stop clinics and the use of robotics and AI as part of the treatment pathway.

The NHS Cancer Programme has partnered with GIRFT in further studies – into pancreatic cancer and head and neck cancers – which are due to be completed in 2024.

Delivering children’s cancer care

Cancer affects around 3,200 children and young people up to the age of 24 each year. Cancer survival has doubled over the past forty years, and now 86% of children survive for five years or more.

The last five years have also seen significant strides in treatment for young people with cancer including the introduction of CAR-T treatment for children with some forms of leukaemia, and state-of-the-art proton beam therapy centres in London and Manchester. New operational delivery networks have been established to improve the organisation and quality of children’s cancer care.

In 2021, the NHS published the results of its first Under 16 Cancer Patient Experience Survey. The 2022 survey published in November 2023 found that 75% of children said they were looked after very well by healthcare staff; and 89% of parents or carers rated their child’s overall experience as eight or more out of ten.

Improving the experience of care and quality of life for people affected by cancer

Adult cancer patients have consistently reported a positive experience of the care they receive from NHS staff. The National Cancer Patient Experience Survey (CPES) has been running since 2010. In 2022, over 61,000 people responded and, on average, they rated their overall care at 8.88 out of 10. The survey also provided a useful snapshot about the provision of personalised care in cancer: 96.4% of patients who wanted a discussion about their needs or concerns before treatment reported that they had received this, and 93.0% said their care team had helped them to create a care plan.

While they still report a positive experience, for people from ethnic minorities, LGBTIQ+ people and people with some pre-existing conditions it is lower than average. The NHS Cancer Programme has been working with people affected by cancer and NHS staff through its Cancer Experience of Care Improvement Collaborative (CIC) to improve patient experience. Since its inception, the CIC has taken more than 70 project teams through its quality improvement process, which has been co-produced with people who have experience of cancer. Each year focuses on a different theme, with the 2023-24 cohort seeking to improve experience of care in people with a pre-existing health condition. 

Clinical nurse specialists and support workers

The NHS Long Term Plan included a commitment that every person diagnosed with cancer will have access to a clinical nurse specialist (CNS) or other support worker. In CPES 2022, 91.5% of respondents said that they had a main point of contact in their care team, but only 83.6% reported that it was easy to reach them, underlining the importance of growing this workforce.

Mental health support

In 2022, the NHS Cancer Programme set up a Task and Finish Group, with members drawn from cancer charities, to make recommendations to transform the mental health care available to people affected by cancer. The Programme has produced the first consensus statement on what excellent psychosocial care in cancer should look like, and a toolkit of resources to support Cancer Alliances and Integrated Care Systems with its implementation. In 2022-23, Alliances conducted local audits of provision and in 2023-24 implemented local plans to address gaps.

Follow up care

The new approach to follow up care is that everyone should have a clear package of support when they complete their primary treatment. Personalised stratified follow up (PSFU) involves offering people a follow up pathway that is tailored to their needs. It was estimated that, between 2019 and 2024, PSFU pathways would free up at least one million outpatient appointments.

In 2020, the NHS launched its national Cancer Quality of Life Survey. The survey is sent to people with cancer around 18 months after diagnosis. It aims to find out more about the quality of life for people with cancer, where the impacts of cancer are being felt and to signal where efforts to support living with and beyond cancer are most needed. By April 2024 over 215,000 people had responded.

Cancer Alliances and Integrated Care Boards are using data to understand quality of life by cancer type to support bespoke improvements for patients.

Putting patients first

The NHS Cancer Programme is committed to ensuring that every aspect of our work is informed by the experience of people affected by cancer. The insights and experiences of our Cancer Patient and Public Voice Forum have helped to shape the significant progress we have made.

The programme also collaborates closely with cancer charities in every aspect of its work, from early policy development through to implementation. Cancer charities are represented on the National Cancer Board and on many of the programme’s governance and advisory groups.

Priority 3: improving performance

It is important to every person who is referred for checks for cancer that they get a timely and definitive diagnosis – whether cancer is confirmed or excluded. For those people who are diagnosed with cancer, it can be important to start treatment promptly.

In the early phase of the pandemic, there was a sharp reduction in the number of urgent cancer referrals by GPs. While referrals returned to normal levels by September 2020, the legacy was pent up demand for cancer diagnostic and treatment services. Since March 2021, referrals have been at record levels. Twice as many people received checks in April 2023 than in April 2013. While this is exactly what the NHS wants to see, it has also led to sustained pressure on services, meaning some people have had to wait longer than we would want.

The NHS Cancer Programme has led efforts to reduce the backlog created by the pandemic and manage increased demand more effectively.

Our plan for improving performance

The strategy for reducing backlogs and improving performance has three main strands:

• new investment in diagnostic capacity, which is being prioritised for cancer
• focussing attention and support on the trusts facing the most significant challenges
• national action to improve the productivity of cancer pathways facing the biggest challenges

In October 2023, NHSE introduced three new and modernised cancer waiting times standards. These reforms, which have wide support across the clinical and charity community, focus on three priorities:

• Faster Diagnosis Standard: Maximum 28-day wait for diagnosis from urgent GP referral and from NHS cancer screening programmes
• maximum 62-day wait to first treatment from urgent GP referral, NHS cancer screening referral or consultant upgrade
• maximum 31-day wait from decision to treat to any cancer treatment for all cancer patients

The new standards reflect modern cancer care, with a greater focus on definitive diagnosis or treatment instead of process measures such as first appointments. They support equitable access to care by measuring waiting times for all patients, regardless of how they came to be on a waiting list for cancer diagnosis or treatment. They also give clinicians more encouragement and flexibility to adopt remote tests and efficient pathways.

Delivering new diagnostic capacity

The Government has announced capital investment of £2.3bn to increase diagnostic capacity. By 2025, 160 new Community Diagnostic Centres (CDCs) will be located on high streets and in other places close to people’s homes. 106 CDCs are operational as of April 2024, and have provided nearly 2.5 million tests, checks and scans in 2023/24.

One CDC within each system is being earmarked to provide tech-enabled dermoscopy services to support the diagnosis of skin cancer. 

Investment in acute imaging services has modernised and increased the MRI estate, creating additional capacity for over 400,000 scans per year, and contributing to faster diagnosis across multiple urgent suspected cancer pathways. 

Focussing support to improve performance

From July 2022, the trusts with the highest 62-day backlogs were grouped into ‘tiers’ with regular conversations taking place with those in tier 1 and tier 2. The approach has evolved over time to incorporate a wider focus on performance against the 28-day Faster Diagnosis and 62-day Referral to Treatment Standards. These trusts have received focused support from regional performance teams and Cancer Alliances, including additional funding and regular monitoring meetings.

Data shows that the approach worked, with reductions in the backlog being markedly higher in tiered trusts than in those not receiving this additional support. This has supported a significant reduction in the variation in performance across the country with the system with the highest backlog nationally reducing from 100% above the national ambition at the beginning of the year to only 12% above this level at the end of the year. Nearly 85% of Integrated Care Boards are meeting or exceeding their required backlog reduction.

Improving productivity

For lower GI pathways, in line with clinical guidance published in 2022, the NHS Cancer Programme has promoted the use of Faecal Immunochemical Test (FIT) in primary care to reduce unnecessary referrals. This means fewer people will require invasive colonoscopy, and it enables the NHS to focus on patients at greatest risk.

The proportion of colonoscopies taking place without a FIT has decreased from 47% in Q1 2022/23 to 17% in Q4 2023/24. Colon capsule endoscopy – where patients swallow a capsule containing a miniature camera – is also helping to reduce demand for endoscopy. 8,300 patients have benefited so far, and 70% have not needed a colonoscopy.

For skin pathways, the NHS Cancer Programme has been encouraging the adoption of teledermatology, meaning patients do not need to attend an appointment, unless their lesion is of concern. Working with the British Association of Dermatologists, the NHS Cancer Programme has developed a new skin pathway, which by Q1 of 2023-24 was being trialled or had been implemented by 60% of providers and has funded training places for medical photographers, to support skin pathways.

For men with suspected prostate cancer, changes to the diagnostic phase of the pathway are transforming their experience. By giving them an MRI scan first, NHS services are working out who needs a biopsy and significantly reducing the number who have to undergo this procedure unnecessarily. Where men do require biopsy, the NHS Cancer Programme has been training nurses to undertake local anaesthetic transperineal (LATP) biopsy, to support prostate cancer pathways.

Leading change locally

The 20 Cancer Alliances lead the local delivery of NHS-wide priorities for cancer. Cancer Alliances bring together everyone with an interest in cancer across a local system to focus on improving operational performance, early diagnosis, treatment, and care. 

ICBs are responsible for the commissioning of many local health services including routine cancer treatment. In 2024-25, this will extend to more specialised cancer treatments, which until now have been commissioned nationally. This enhanced local leadership will ensure a closer alignment with other local services and help address the health needs of local populations.

The strategy is working

In 2023/24, NHS staff  achieved our ambition to reduce the number of people waiting for diagnosis or treatment to pre-pandemic levels. This is the second consecutive year where the backlog has been lower than the year before and the greatest year on year reduction on record. The NHS also exceeded its March 2024 goal of a 75% Faster Diagnosis Standard. Taken together this suggests that our strategy is working and provides a strong basis for us to continue to improve performance. 

Moving forward the NHS will shift operational focus away from backlog and towards the improvement of performance against the 62 day treatment standard and will increase the Faster Diagnosis Standard to 80% by 2025/26.

Workforce

The delivery of our priorities for cancer depends on our brilliant NHS staff.

The cancer workforce has grown in the past decade. Between 2016 and 2021, the seven priority cancer specialisms in Health Education England’s 2017 Cancer Workforce Plan grew by 3-4% per year. However, further growth is needed to meet the increased pressure on cancer services being driven by growing incidence and the increasing complexity of treatment.

The NHS England Long Term Workforce Plan, published in July 2023, sets out how the NHS will put its staffing on a sustainable footing for the future by:

• training more staff
• better support for existing NHS staff to improve retention
• improving productivity

The plan pledged that an expansion of medical training places would support existing planned growth for cancer and committed that everyone with cancer should have access to a clinical nurse specialist or other support worker.

Making improvements in workforce

• the investment in developing and training the cancer and diagnostics workforce has grown in the last two years from £52m in 2021-22 to £93m in 2023-24
• starting from 2022-23 the NHS created an additional 270 medical training places per year in cancer-related specialisms
• for the first time the NHS has made available training bursaries for nurses who wanted to train to become a cancer CNS or chemotherapy nurse specialist. Nearly 3,500 nurses have benefited to date
• more clinical endoscopists are undertaking gastrointestinal procedures, and reporting radiographers are interpreting clinical images, roles traditionally undertaken by doctors. This improved skills mix empowers clinical staff to work at the top of their licence and keeps them in the NHS for longer, while also freeing up senior medical staff capacity
• apprenticeships are enabling more people to train while continuing in employment including apprenticeships in breast imaging, diagnostic radiography, therapeutic radiography and sonography, and Advanced Clinical Practice
• the NHS has invested over £3.2m since 2022/23 in a National Breast Imaging Academy to promote new professional development opportunities to retain staff in the breast imaging workforce

In addition, in January 2023, the NHS Cancer Programme ran the first “We are the NHS” campaign to encourage more people to apply for university places in therapeutic radiography, which was repeated again in October 2023. From November 2023, NHS England has provided trusts with financial support to undertake the ethical international recruitment of over 60 trained therapy radiographer staff.

Looking forward

Our strategy for cancer remains anchored in the ambitions for early diagnosis and survival set by the NHS Long Term Plan. This consistent purpose has been vital during a period when the NHS has faced unprecedented turbulence as a result of the pandemic and industrial action.

Whilst good progress has been made in the past five years, delivery will need to accelerate to realise our ambitions. This was always part of the plan as more of the interventions, many of which have started off only as ideas or pilots since the publication of the Long Term Plan, begin to be rolled out more widely. Evidence from other jurisdictions suggests that continuity of strategy is important in securing improvements in survival, and the NHS remains committed to the strategy that it set in 2019.

Looking to the next five years, the challenge will be to maintain and accelerate this progress in the face of growing demand and financial challenges. Cancer services will need to play their part in delivering on the NHS’s commitment to maximise productivity and value from day-to-day operations and planned care.

This is likely to mean an increased focus on:

• improving access to primary care and how we triage people at the very start of their cancer pathway, so that we can direct people more efficiently to appropriate care
• targeting resources more effectively at disadvantaged areas where rates of early diagnosis are lower, and at people who are at greater risk of cancer
• harnessing new technology and artificial intelligence to manage increasing demand in areas like mammography and dermatology more efficiently
• exploiting genomic testing and circulating DNA to streamline the diagnosis and treatment of lung and other cancers
• continuing to trial and accelerate the take up in clinical settings of innovations so that NHS patients are among the first to benefit
• working in tandem with the Office for Life Sciences (OLS) cancer mission to ensure the NHS is the best partner for research in diagnostics and treatment, and actively testing and adopting the most cutting-edge technology from around the world

This future vision is already becoming the part of the day-to-day reality in cancer services. Even in the current financial year, we expect to see:

• the completion of the extension of the bowel cancer screening programme to people aged 50, and the first steps towards increasing the sensitivity of the test
• 10,000 people with suspected non-small cell lung cancer receiving genomic testing to speed up their diagnosis and support the identification of the most appropriate treatment
• the first findings from the new clinical audits covering ovarian, pancreatic and kidney cancer, non-Hodgkin lymphoma and primary and secondary breast cancer
• the expansion of targeted lung heath checks to over a third of the country as a stepping stone to becoming a national targeted screening programme by 2028-29
• the first NHS patients recruited through the Cancer Vaccines Launch Pad receiving a personalised cancer vaccine as part of clinical trials

Our ambitions for improving early diagnosis and survival were always something that the whole cancer community could get behind. It is this unity of purpose and collaboration within the cancer community that will give us the best chance to deliver the step change in cancer diagnosis and outcomes that we all want to see.

Publication reference: PRN01330