Who we are

In the UK, All.Can is a partnership between leading health charities and biopharmaceutical companies with a shared ambition for cancer patients to receive world-class, patient-centred care that is sustainable for the NHS to deliver.

What we do

In pursuit of this ambition, we identify inefficiencies in cancer care, evidence-based, best practice solutions that put the patient first, and collectively advocate for their implementation by Government and NHS system leaders:

  • Put patients at the heart of cancer policy – and make sure that efforts to drive efficiency are always focused on what matters to patients and their families.
  • Invest in data and systems – to help improve efficiency across all aspects of cancer care.
  • Create accountability – by using data to drive changes in relevant national and regional policies and legislative/non-legislative frameworks.
  • Focus political will – to drive the implementation of more efficient practices into cancer planning, policies and practice across the UK, and with the engagement of all relevant stakeholders.
  • Ensure the sustainability of cancer care – define better solutions for sustainable cancer care and improve patient outcomes in the future.

Why we do it

Every two minutes someone in the UK is diagnosed with cancer. 1 Now, half of the UK population born after 1960 can expect to receive a cancer diagnosis in their lifetime ², and the survival rate of people with cancer in the UK has doubled over the last 40 years 3 – the highest it has ever been. 4 This is leading to cancer services facing record-breaking levels of demand 5 as cancer is increasingly seen a long term condition.

A cancer diagnosis is not only life changing for a patient, it is hugely costly to both the NHS and wider economy. At this time of increasing incidence and survival, 6 it is imperative that the NHS is able to deliver more with less whilst always providing the very best care for patients. This is particularly important given that the UK falls behind other comparable countries in terms of cancer spending. 7

Pressures on the system, in terms of demand and capacity, can often lead to money being allocated towards short-term approaches and managing immediate pressures, rather than transforming services and disseminating best practice.

It was therefore highly welcome that the NHS Long Term Plan, published in 2019, signalled the health service’s long-term commitment to improving cancer care for patients. Key milestones relating to early diagnosis, screening and personalised care 8 will all help to improve care pathways and the provision of services, but it is important to ensure that these changes are made in the areas that matter most to patients to ensure that they feel supported throughout their treatment and beyond.

How we do it

In order to support the NHS in improving patient care, All.Can looks to provide proactive and implementable solutions for UK policymakers and NHS leaders to improve NHS efficiency, share learnings from best practice in cancer care and develop a world class cancer service in the UK.

All.Can UK is led by its members, who collectively make up the Working Group. The initiative is currently chaired by The Patients Association and is governed by a Steering Committee that is comprised of Melanoma UK, Blood Cancer UK and the two current funding partners: Bristol Myers Squibb (BMS) and MSD.

All.Can patient survey

All.Can International, conducted a patient survey in more than ten countries, which asked almost 4,000 cancer patients and carers where they identified inefficiencies in their care. We define waste and inefficiency as any aspect of cancer care that is not focused on what matters to patients. The UK was a pilot site for the international survey, the findings of which were presented at the Britain Against Cancer conference, in the UK Parliament, in December 2018.

The UK survey results highlighted that there are opportunities to improve efficiency across the entire care pathway: from screening and diagnosis, through to the treatment and care that patients receive, and follow-up:

  • 2 in 5 responders said they were diagnosed with something different – either initially or on multiple occasions. 9
  • 1 in 5 people with cancer had to wait for more than six months to be diagnosed with cancer. 10
  • 20% of respondents said that they did not need some sort of psychological support during/after their cancer care. Of those who did, half said that it wasn’t available. 11
  • 40% of were not given any information about patient groups, charities, or other organisations who could support them. 12
  • 1 in 8 UK responders had to pay for their cancer care themselves in avoid delays or to access care or treatment that wasn’t available on the NHS. 13

Our current focus

In light of the UK findings of the All.Can survey, the Working Group collaboratively agreed the initiative’s four priorities:

  • To improve patient experience while making cost-savings, the NHS should value the psychological and emotional wellbeing of patients equally to their physical health.
  • To improve cancer outcomes, the NHS should incentivise best practice in early diagnosis and its dissemination.
  • To improve public awareness, the NHS should ensure the provision of accessible information throughout the care pathway by collaborating with PAGs more actively.
  • To ensure there is capacity and skillset within the workforce to meet demand now and in the future, the NHS should work with Health Education England to implement the Cancer Workforce Plan, as well as the NHS People Plan, once published.

Placing the psychological wellbeing of people with cancer on equal footing to physical health

Following the UK results of the All.Can survey, the Working Group decided it would focus on the value of psychological and emotional wellbeing for people with cancer in 2019 and beyond:

  • The link between mental health and cancer is well understood, with around one in four cancer patients requiring expert psychological assessment and intervention as a result of their diagnosis. 14
  • The NHS has taken steps to expand the availability of mental health services in recent years; however, there remains significant unmet need.
  • There is an increasing number of patients who are expected to survive cancer in the coming decades. 15 As a result, there could be a growing burden placed on the health service to provide support to patients.

In order to gain a deeper understanding of inefficiencies in cancer care, All.Can UK is currently developing a report, Placing the psychological wellbeing of people with cancer on equal footing to physical health, which is due to be published in 2020. To inform this report, All.Can UK undertook the following activity:

  • Extensive literature review
  • Oral Evidence Sessions with patient groups
  • Interviewed academic experts in the field of mental health and cancer care
  • Ongoing engagement with Working Group members

The evidence has uncovered barriers that patients face in accessing mental health support and examples of best practice across the NHS and voluntary sector in providing it. Key themes include:

  • A lack of awareness within the NHS oncology workforce about patients’ psychological wellbeing
  • Variation in access to mental health screening for people with cancer
  • A ‘one size-fits-all’ approach to care

The report makes the case for the NHS and the wider oncology community to come together and address the unmet need in service provision for mental health care during the cancer pathway.

If you would like more information on the report and its launch, please email the All.Can Secretariat at All.Can@hanovercomms.com

A Pathway to Sustainable Innovation

All.Can UK held its first expert Working Group meeting in December 2016, which led to the development of the report, Transforming the Cycle in Cancer Care. The report was launched in Parliament on 22nd March 2017. It sets out recommendations for transforming cancer care by identifying and implementing existing best practice throughout the NHS. It shows that improving efficiency is not just about cutting costs, but rather focusing resources on delivering what matters most to patients. An animation and a fact sheet based on the report have been published to support the dissemination of its key messages.

Following the publication of the Transforming the Cycle in Cancer Care report, All.Can UK’s expert working group reconvened to look at how best practice can be identified and disseminated throughout the NHS. Based on the discussions at this meeting, All.Can UK produced its second report, A Pathway to Sustainable Innovation: Best Practice in Cancer Care, launched in June 2018.

The report identifies five common barriers to the adoption of best practice and a number of case studies that have overcome these challenges and demonstrated both improved patient outcomes and a more effective use of NHS resources. The report also includes a business case template that can be used by NHS services in order to adopt best practice processes in their local area. It is hoped that the report’s recommendations, best practice case studies and business case template will provide a blueprint for Cancer Alliances and other NHS organisations to implement transformational change to the way cancer services and care is delivered to patients. 16

References

  1. Available here: https://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk#heading-Zero
  2. Available here: https://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/lifetime-risk#heading-Zero
  3. Available here: https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival
  4. Available here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
  5. Available here: https://www.england.nhs.uk/wp-content/uploads/2019/09/BM1920-operational-performance-report.pdf
  6. Available here: https://www.pfizer.co.uk/sites/g/files/g10060946/f/202001/A-ripple-effect-analysis-of-cancers-wider-impact.pdf
  7. Available here: https://www.pfizer.co.uk/sites/g/files/g10060946/f/202001/A-ripple-effect-analysis-of-cancers-wider-impact.pdf
  8. Available here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
  9. All.Can Patient Survey: UK findings. 
  10. All.Can Patient Survey: UK findings. 
  11. All.Can Patient Survey: UK findings. 
  12. All.Can Patient Survey: UK findings. 
  13. All.Can Patient Survey: UK findings. 
  14. Macmillan Cancer Support - Psychological support sharing good practice briefing [Accessed February 2020] Available here: https://www.macmillan.org.uk/documents/aboutus/health_professionals/macvoice/psychological-support-sharing-good-practice.pdf
  15. Available here: https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/
  16. Bristol Myers Squibb (2018), A Pathway to Sustainable Innovation: Best Practice in Cancer Care. Job Bag: ONCUK1800817-01. Date of preparation: September 2018.

Contact

Emma Palmer, National Policy & Access Manager, Bristol‑Myers Squibb

Emma.Palmer@bms.com

A range of health charities from across the cancer community have inputted into the development of this programme. A full list of our current members can be found below:

 

 

Steering Committee

Rachel Power – Chief Executive

the Patients Association

Melanoma UK

Bristol Myers Squibb

MSD

Funding Partner

Working Group

Anthony Nolan

Blood Cancer UK

Brain Tumour Research

Breast Cancer Now

British Liver Trust

Cancer52

Cancer Research UK

Fight Bladder Cancer

International Brain Tumour Alliance

Kidney Cancer UK

Look Good Feel Better

Melanoma UK

Ovacome

Pancreatic Cancer UK

Penny Brohn

Prostate Cancer UK

Shine Cancer Support

The Brain Tumour Charity

The Patients Association

The Urology Foundation

All.Can UK hosts inaugural Annual General Meeting

In November 2019, All.Can UK hosted its first Annual General Meeting (AGM), which focused on putting in place the appropriate Governance structures for the initiative and aligning on the initiative’s strategy and priorities for 2020.

The meeting was an opportunity to reflect on the initiative’s activity over the course of 2019, which included a webinar on the 2018 report A Pathway to Sustainable Innovation: Best Practice in Cancer Care, a Working Group meeting in May (at which Macmillan Cancer Support presented on their cancer navigator pilot), the initial development of a report on psychological wellbeing in cancer, and attendance at the annual Westminster Health Forum seminar on cancer.

Similarly, the Working Group discussed and agreed the 2020 programme of work. In line with our priorities, All.Can UK’s activity in 2020 will centre on psychological wellbeing in cancer as we look to finalise the report and launch it externally.

Notably, the AGM saw the election of All.Can UK’s Steering Committee, who provide the executive function of the group. The Steering Committee oversees the strategic direction of All.Can UK and ensures it is achieving its stated aims. Nominations ran for the Steering Committee in November, with two members being elected to sit alongside the Chair and All.Can UK’s two Funding Partners (Bristol Myers Squibb and MSD):

  • Blood Cancer UK
  • Melanoma UK

We welcome the new Steering Committee members and look forward to working with them in 2020.

All.Can UK support Westminster Health Forum event on cancer care

In September 2019, Rachel Power, Chair of All.Can UK and Chief Executive of the Patients Association, spoke on behalf of All.Can at the Westminster Health Forum’s 2019 seminar ‘Cancer care in England – access to treatment, improving diagnosis and implementing the NHS Long Term Plan’.

During her speech and subsequent panel appearance, Rachel stressed that the patient voice should be central to service design; indeed, every single decision about a person’s care should be delivered in a way that meets their personal needs. For this reason, improvements to the diagnosis pathway must be led by engagement with patients and an understanding their experiences.

Quality Health also featured and discussed results of All.Can’s patient survey alongside the National Cancer Patient Experience Survey. Importantly, All.Can’s patient survey covered the entire patient pathway, from diagnosis through to the support received by patients during their treatment and beyond. Strikingly, 2 in 5 respondents said their cancer was misdiagnosed either initially or multiple times and 1 in 5 people with cancer had to wait for more than six months to be diagnosed with cancer.[1]

This was a significant opportunity for All.Can UK to raise awareness of the survey’s findings and generate consensus about the need to refocus efforts relating to service design so that they can be improved in the best interests of patients.

[1] All.Can Patient Survey: UK findings.

All.Can UK hosts annual Working Group meeting with Macmillan Cancer Support

In May 2019, a record number of patient groups came together at our annual Working Group meeting to hear from Macmillan Cancer Support and Quality Health on the results of All.Can’s global patient survey.

The meeting was a highly informative and productive, and benefitted from a wide representation of the cancer community. Macmillan Cancer Support provided attendees with information about their ‘Right By You’ programme and the cancer navigation pilot. This presentation was highly timely given the results from All.Can’s recent patient survey and the UK initiative’s focus on psychological wellbeing and the need to ensure patients are supported throughout their care and treatment journey.

Attendees also heard from Quality Health about the interim results from the international All.Can patient survey, the final results of which are due to be published later in the year.

Best practice webinar to discuss A Pathway to Sustainable Innovation

In February 2019, All.Can UK held a webinar on the key findings of the 2018 report, A Pathway to Sustainable Innovation: Best Practice in Cancer Care, which considers how the NHS could deliver efficiency savings by disseminating best practice more widely.

The report identified a number of organisations that have overcome barriers to the adoption of best practice, while demonstrating improved patient outcomes and a more effective use of NHS resources. The webinar focused on a case study by Pancreatic Cancer UK and the University Hospitals Birmingham NHS Foundation Trust, which is a prime example of how care can be enhanced to improve patient experience and reduce running costs over the long-term.[1] The session was an opportunity for attendees to hear from Dr Keith Roberts, a Consultant at University Hospitals Birmingham who was involved in the set-up and implementation of the redesigned pathway, as well as Pancreatic Cancer UK who supported its development.

[1] Bristol Myers Squibb (2018), A Pathway to Sustainable Innovation: Best Practice in Cancer Care. Job Bag: ONCUK1800817-01. Date of preparation: September 2018.

All.Can UK launched UK results of patient survey at a parliamentary event

In December 2018, the UK national initiative was the first of nine countries to release findings from the All.Can patient survey, which sought patients’ and carers’ perspectives on inefficiencies in cancer care. The findings were presented at the Britain Against Cancer conference, hosted by the All-Party Parliamentary Group on Cancer. The event took place at the UK Parliament in London.

Past events

All.Can UK first Working Group meeting

15 December 2016

London, United Kingdom

The first meeting of the Working Group examined how the NHS can deliver the best possible care for cancer patients, by reviewing the resourcing and organisation of cancer services in the UK.

Parliamentary launch

7 April 2017

Parliamentary launch of the Transforming the Cycle in Cancer Care report. The event, hosted by Stuart Andrew MP, provided a chance for attendees to hear from a range of clinical experts and…

All.Can UK second Working Group meeting

5 July 2017

The focus of this meeting was to identify further examples of best practice and share the challenges faced by organisations to deliver them.

All.Can UK webinar

20 February 2018

All.Can UK hosted a webinar to launch its report that looks at how cancer alliances can expand best practice in cancer care across the NHS.

All.Can UK patient survey

  • Download the infographic Can UK patient survey results

A Pathway to Sustainable Innovation: Best Practice in Cancer Care

Breaking the cycle in cancer care

Disclaimer:

All.Can UK was initiated and funded by Bristol-Myers Squibb, who fully fund the programme. It is a multi-stakeholder initiative involving patient, clinical, academic and industry experts as well as policymakers.

All.Can UK is a multi-stakeholder initiative involving patient group and industry experts. In the UK, All.Can is funded by Bristol Myers Squbb (primary sponsor) and MSD (supporting sponsor). Internationally, All.Can is made possible with financial support from Bristol-Myers Squibb (main sponsor), Amgen, MSD and Johnson & Johnson (sponsors) and Varian (contributor).

All.Can is a trademark of The Health Policy Partnership Ltd.