My Lords, £42 million has been allocated by the NHS Commissioning Board to support strategic clinical networks in 2013-14. Networks will cover a number of priority conditions and patient groups, including cancer. It is for local health communities and the board to determine the number and size of networks, based on patient flows and clinical relationships, and to deploy their resources appropriately.
My Lords, does the noble Earl accept that cancer networks have done an outstanding job in improving the quality of service and outcomes? Does he agree that there is widespread expectation that the number of cancer networks will be reduced, the staff in many places will be made redundant and the new set-up will not be as effective as the current one? Will he respond to that?
My Lords, I agree that clinical networks are a success story in the NHS. They have raised standards, supported easier and faster access to services and encouraged the spread of best practice. We very much want to see that continue. The final number of strategic clinical networks and the number of clinical staff who support them have not been finalised yet. Those numbers will be determined locally so it is too early to speak with any certainty about final staff numbers. We do not anticipate many compulsory redundancies at all. A number of staff have been deployed to other posts already. The aim of all this is to achieve not only a more effective series of networks but a more efficient system as well. We believe that that will be delivered.
My Lords, I, too, declare an interest, as chief executive of the Breast Cancer Campaign. Does the Minister agree with the charities Cancer Research UK, Macmillan, and Cancer 52—which represents the rare cancer charities—that this is a real issue of concern? The uncertainty is causing a real haemorrhaging of expertise out of the networks that have been such a success in driving up standards in cancer services.
My Lords, I accept that the uncertainty has been unfortunate and, in some cases, damaging. The noble Baroness is right in her broad observations. However, the intent to maintain networks was signalled very early on this summer by the Commissioning Board. The standard operating framework, which will apply to all clinical networks, will be published very shortly. I think that that will provide helpful additional clarity. However, I repeat to the noble Baroness that the aim here is to maintain networks and to ensure that the good work continues and that the expertise which we still have in networks is translated across into the new system.
My Lords, the NHS strategy document The Way Forward stresses that, as regards cancer, the new networks will focus very tightly on what is called domain 1 of NHS outcomes, which is reducing mortality. But surely for all those who have experience of cancer, is not enhancing the quality of life absolutely crucial too, and should not the networks be concentrating on that as well?
Yes, my Lords. While the document to which my noble friend refers does make explicit that the cancer strategic clinical network will be focused around domain 1, which is reducing mortality, nevertheless improvements to patient experience and patient safety underpin all NHS care and those matters will be similarly embedded in the work of all strategic clinical networks.
I absolutely accept that one of the benefits we have seen from the clinical networks is the spread of innovative best practice through the health service, particularly in local areas. That is very much what we wish to preserve. The networks will help local commissioners of NHS care to reduce unwarranted variation in services and encourage innovation. We are determined to see that continue.
We will certainly be monitoring the outcomes in the field of cancer, but I would just like to impress upon the noble Lord that the creation of the clinical support teams—the network support teams—will ensure that the whole service is more efficiently delivered. By having 12 support teams there to underpin all the networks, we will ensure that we have a more cost-effective system.
My Lords, does the Minister agree that our cancer outcomes are not as good as those in some other countries in Europe? What is the reason for that? Does he agree that it would be a very retrograde step if the cancer networks lost expertise which we badly need?
I agree with the noble Baroness, and it is part of the reason why we felt that the recent health service reforms to align clinical decision-making with financial decision-making were so important. The reason why this country lags behind has been clearly set out in a number of documents and, broadly speaking, it is because patients do not present early enough with their symptoms and doctors do not refer early enough to specialist consultants for treatment. There is a lot of work to do there, and I am sure that the noble Baroness will be reassured to know that there will be no let-up in that area.
My Lords, the essence of a cancer network is the web of relationships between individual clinicians. Networks are a source of advice and support and they are there to drive quality improvements locally. The networks will be established to cover patient groups or conditions where improvements to services can be made through an integrated approach. I hope that I have emphasised sufficiently that networks are there to support commissioners in their work.