Cancer Reform Strategy - NHS Cancer Screening Programmes

93Chapter 7:Delivering care in the most appropriate settingChapter Summary●●●●●New models of care can bring significant advantages to patients and release resources forother developments;PCTs will wish to ensure that GPs have appropriate and timely access to diagnostic tests.This will reduce delays in diagnosis and should reduce unnecessary referrals to hospital;Some specialised diagnostic tests should be provided at cancer network level;Cancer inpatient care can be streamlined, with benefits for patients and the NHS.Commissioners will wish to give this high priority; andAn End of Life Care Strategy will be published in 2008. In the meantime PCTs will wish toapply lessons learned from the baseline reviews undertaken in 2007/08 to commissioningdecisions for 2008/09.Introduction7.1 Much of the focus in the past decade hasbeen on reducing hospital waits and ensuringthat patients have access to specialists with thenecessary expertise to deliver high quality cancertreatment. To do this, new models of care havebeen widely introduced across the countrythrough:●●●Rapid access clinics in District GeneralHospitals;Multidisciplinary teams, some of which are inDistrict General Hospitals and some in cancercentres; andEnsuring that complex treatments areundertaken by specialist teams.including inpatient care; support following thecompletion of primary treatment; managementof recurrence and late-effects of cancertreatment; and end-of-life care.7.3 Service models need to be developed whichmeet the needs of patients at each step in theircare pathway and which are cost-effective.As acknowledged in the interim report of theNHS Next Stage Review, patients rightly expectthat their services are safe, fair, effective andpersonalised. 457.4 This chapter sets out some of the changesto cancer service models that commissionersshould consider. These are:●Increasing access to diagnostics;7.2 The Cancer Reform Strategy looks morewidely across the care pathway, encompassing:investigation prior to diagnosis; full assessmentand treatment planning once the diagnosis ofcancer is established; primary treatment,●Improving service models for inpatient care,in particular minimising lengths of stay inhospital and preventing unnecessary hospitaladmissions;