We will ensure further recovery of services to begin treatment within 62 days of referral for at least 85% of patients on a suspected cancer pathway.

We describe our approach to treating patients with cancer in terms of:

1. What it will feel like for patients
2. Best possible treatment options
3. Right workforce, Right place, Right skills

Aim: We will focus on what cancer care feels like for patients, empowering patients physically, and psychologically, ensuring care is personalised for our population.

Objective: To optimise outcome and experience, reduce treatment burden and improve recovery.

• Treatment will be delivered close to home where possible, with centralisation of services where quality and sustainability require.
• We will ensure that people across Wessex with a cancer diagnosis are able to access symptom support 24/7 in a model which does not compromise equity regardless of the locality of treatment delivery.
• We will make sure people across Wessex, including children, teenagers, and young adults, can access treatment for their cancer equitably.
• Learning from existing oncology Virtual Ward models we will increase application of remote monitoring support for patients to identify when trips to hospital are necessary, and to ensure acute oncology capacity is available when needed.
• As our population’s expectation is of increasing digital access, we will employ personalised technology to help patients best manage their health and wellbeing at home. We will also improve administrative processes to reduce the burden on patients to coordinate their own care and enable a succinct and detailed patient biography to move with the patient.
• Providers of cancer treatment will recognise that, for many of our patients, their cancer care happens alongside treatment for other long-term conditions. Care will be coordinated for the patient and those supporting them.
• Patients will experience inclusive, age appropriate, and culturally sensitive care.
• Initiatives will be developed to reach and engage underserved populations, including people who are unable to use digital communications, people who are experiencing homelessness, those in touch with the criminal justice system and people living with severe mental illness.
• Individual care and treatment plans will be business as usual for care delivery, including effective management of consequences of treatment and late effects. Care planning will be co-created with each patient, planning for end of treatment, during “transition” to follow-up, health-coaching, and support via third sector services for example.
• We will continue to review and describe personalised care and psychological support provided against need and recognised best practice. We will enable commissioning and provision of services to help people to live well beyond their cancer treatment.

Aim: We will provide the best possible treatment options for our whole population.

Objective: We will prioritise development and investment in key enabling tools in planning.

To do this, we will:

• Ensure alignment with best practice guidance, taking account of approved treatments and expand treatment capacity to meet rising demand and reduce waiting times for surgery, radiotherapy, and systemic anti-cancer therapies (SACT).
• Through our Clinical Advisory and Site Specific Groups, and Regional Networks, assure quality, protecting capacity to enable informal peer review of services.
• Work to ensure service development is planned in a data driven way, alongside the Dorset Intelligence and Insight Service (DiiS), HIOW population health analytics service and other agencies, targeting those most in need, to improve individual and population health.
• Work with ICBs to employ predictive modelling tools to build ability to commission sufficient treatment capacity and subsequent supportive care in the right place.
• Ensure system capital planning takes account of projected population health needs including modernisation of radiotherapy infrastructure and expanding robotic surgical service provision.
• Support commissioning colleagues to be aware of developments in treatment (for example, in minimally invasive surgery) of value both to individual patients and in terms of health system resource utilisation.
• Patient experience will be valued with parity alongside clinical outcome and cost effectiveness in prospective planning.
• Make sure that the views of patients, particularly children and young people, help shape services for them and their families.

Objective: We will ensure clear and consistent treatment pathways.

To do this, we will:

• Deliver equitable access for all our population and support commissioners to hold services to account for outcomes including morbidity, mortality, patient experience.
• Ensure the unique needs of children, teenagers and young adults are recognised with age-appropriate services and facilities, ensuring no gaps in care in the 16-18 age group.
• Ensure treatment pathways include all treatment options, including Personalised Stratified Follow Up (PSFU), local authority, acute oncology community services  and access to third sector support.
• Strengthen membership, engagement, and leadership of our Clinical Advisory and Site-Specific Groups (CAG/SSGs) to address unwarranted variation in treatment outcome and experience for patients across Wessex. Through these groups we will support clinical teams to agree best clinical pathways, to use data to identify and address unwarranted variation (taking account of best-practice timed pathways where available) and to seek opportunity for innovation and developments in treatment options for patients.
• Have the courage to redesign and reconfigure services where necessary, aligned with the national Getting It Right First Time (GIRFT) programmes.
• Learn from changes in evidence to capitalise on improvement in diagnostic testing, such as the use of personalised genomic information.
• As part of the wider prehabilitation and rehabilitation implementation, invest in appropriate psychological expertise to support cancer patients and their families to cope with, and live beyond, the potential impact of their treatment, recognising the significant benefit of the right psychological support, provided in the right place.

Objective: We will identify opportunities for enhancing care through innovation and development of digital systems.

To do this, we will:

• Recognise that effective and efficient care needs clear, accessible information at the right time. We will connect digital systems to optimise multi-disciplinary team (MDT) working and to reduce repeat MDT discussion for cases unless clinically necessary. This will include optimisation of digital image sharing, working alongside the Imaging and Pathology Networks.
• Connect patients to a personalised portal through the NHS App, to see test results and understand the support available to them.

Objective: We will adopt a “no-wrong door” approach, to ensure accessible and equitable coordinated support, signposting, advice, and information in a timely and proactive way for people with cancer.

• We will work in partnership across our systems to develop approaches to care using community outreach models and work closely with neighbourhood health  teams. We will centre care around the person. Integrated care is central to personalised care.
• We will support and develop services that have flexibility to work across organisational boundaries, particularly supporting patient care where multi agency approaches are wasteful and confusing for patients and their families.
• We will work in partnership with the Genomic Network, the universities and our CAG/SSGs to ensure emerging developments in medicine increase our personalised approach to treatment pathways, including supporting the rollout of the NHS Cancer Vaccine Launchpad.
• We recognise the importance of understanding frailty in our pathways, and we will embed frailty assessment and support thoughtful discussion with patients and their families ahead of treatment decisions.
• For people in our populations who do not have digital access we will ensure that services and information are equally available.

Aim: To deliver cancer treatments and care / support to our population, we will need the right workforce, in the right place, with the right skills and capabilities to delivery care safely and effectively.

Objective: We will continue to invest in training, development and growth as required, to build a sustainable workforce for the future.

To do this, we will:

• Ensure the right skill and capacity is in place to support patients comprehensively, including for ‘treatable but not curable’ disease. We will support those with long-term side effects, those who experience toxicities from their treatment and those who are under active surveillance where no treatment is given. This will mean working in partnership with patients and their families over many years.
• Build sustainable networked clinical services to attract, retain and develop our workforce. This will also enable us to reduce inequity of access to, and unwarranted
  variation in, service provision.
• Enable and embrace workforce flexibility and mobility across and between systems where opportunity arises.
• Be clear on the skills and capabilities required to safely deliver care, including psychosocial support – driven by data.
• Ensure commissioning and provider planning acknowledges gaps in workforce and takes action to address them.
• Continue to develop and embed the Aspirant Cancer Career and Education Development Programme ACCEND to ensure consistency of standards to support development and retention across the whole of our workforce.
• Support colleagues in primary care and community health care to build on and apply their knowledge about cancer treatments, for example immunotherapy, to better support people to be cared for out of hospital, in line with Lord Darzi’s recent report ‘Independent investigation of the NHS in England’.
• Support nursing and Allied Health Professional clinical services to align with emerging therapies e.g. CAR-T and genomic medicine to ensure the latest scientific developments are accessible for patients and their families.

Objective: We will reduce inequality in access to treatments and best use of all available resources.

To do this, we will:

• Support centralisation of specialised services where necessary and appropriate, to ensure the availability of sustainable specialist care for our population.
• Identify, understand and address unwarranted variation in service provision acknowledging the likely impact of, for example, immuno-oncology service provision and the impact of improving survivorship.
• Identify and provide tools to support clinical teams to plan for fluctuations in service delivery, including new treatments. Planning of Systemic Anti-Cancer Therapy (SACT) chair time, pharmacy capacity and the impact of, for example, reduced radiotherapy fractions or treatment cycles, should be simple, accessible, and useable day to day for teams to optimise use of limited resource.
• Continue to develop prehabilitation services offering the triple benefits of personal empowerment, physical and psychological resilience, and improved long-term health (Aggarwal et al 2024).
• Recognise the value of third sector providers, and support their sustainability, quality, creativity, and accessibility by sustaining strategic partnership arrangements, sharing resources and commissioning services when appropriate.
• Ensure services are designed with environmental protection as an explicit aim, reducing travel where not essential, increasing energy efficiency in high power equipment (e.g. Linear Accelerators) and we will reduce paper use as far as is appropriate.