Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the effects of the work of strategic clinical networks has had on (a) cancer outcomes and (b) quality of cancer services since April 2013.

Strategic clinical networks (SCNs) bring together clinicians from across health care settings and the wider health and care system in 12 geographic areas across England. Their role is to make improvements in outcomes for complex patient pathways. They are structured around four core areas: maternity, children and young people; cardiovascular disease (renal, diabetes, cardiac, stroke); cancer; and mental health, dementia and neurological conditions. On cancer outcomes and the quality of cancer services, they have driven improvement in a variety of ways.

In terms of tackling inequalities in health outcomes, SCNs have implemented local cancer general practitioner (GP) awareness campaigns and GP training to improve the detection of cancer. Wessex SCN bowel cancer screening uptake has risen by 5% to 60% in the last three years as a result of bringing together networks of experts to develop and share evidence-based best practice. Elsewhere, North East SCN continues to support improved cancer detection rates through planned care by increasing two week wait referrals through targeted GP cancer pathways awareness campaigns.

They have also sought to improve access to the best treatment and outcomes for patients. For example, East Midlands SCN has spread best practice in upper gastrointestinal cancer services across the locality and streamlined care pathways by developing commissioning specifications. The South West SCN has worked with GPs and acute trusts to implement intensity modulated radiotherapy leading to an increase in patients receiving this more precise form of treatment from 4% in 2012-13 to 30% in 2013-14. The South East Coast SCN has brought together leaders from across the local health system to tackle waiting times. Since they began leading these improvement initiatives, trusts have seen a marked increase in 62 day cancer waiting times performance.

Another important effect has been the improvement of quality standards. In 2013, the Greater Manchester Lancashire and South Cumbria SCN worked with the local health community to tackle low compliance (18.8%) of acute trust haematology cancer multi-disciplinary team standards against national standards. This resulted in a significantly higher level of compliance (67%) achieved by the development of robust clinical guidelines and patient pathways across the network. In addition, the Thames Valley SCN has worked with a wide range of stakeholders to reconfigure urology cancer pathways in order to comply with National Institute for Health and Care Excellence Improving Outcomes Guidance and improve patient experience scores.

Through evaluation to support commissioning decisions, SCNs have often given clinical commissioning groups (CCGs) the tools to evaluate cancer outcomes for local populations to aid better decision making on patient services. West Midlands SCN developed a Cancer Dashboard which benchmarks performance by CCG, and Yorkshire and the Humber SCN commissioned a study of cancer diagnosis related to emergency presentation designed to build an evidence base to support improved diagnostic services.

SCNs have also enabled participation by facilitating the involvement of patients and the public in the design of local healthcare services. The East of England SCN has worked to ensure that patients and carers are well-represented as partners on service improvement forums and steering groups, ensuring a continued focus on patient experience and on the outcomes that are most important to patients.