Health
The National Cancer Plan promises a bold vision – now to make it a reality – Cancer Research UK
In February 2026, the UK Government published its National Cancer Plan, the first dedicated cancer strategy for England in a decade. With a new administration now responsible for implementing it, we want to make sure the Plan remains a priority and its ambitions are delivered as quickly as possible.
In this final article in our series taking a closer look at the National Cancer Plan, Matt Sample and Naser Turabi argue the key challenge is building a path to implementation that can turn its ambitions into reality, particularly in a health system undergoing significant change.
Across this series of articles, we’ve looked at the ambitions and commitments in England’s long-awaited National Cancer Plan.
We’ve examined plans to boost clinical research and how the research workforce will be key to this. We’ve discussed its ambitions around cancer prevention (where there’s a concerning lack of focus on obesity), and earlier diagnosis, where a balance of emphasis needs to be struck between innovative new solutions versus bolstering tried-and-tested methods. We wrote about the urgent efforts to bring down waiting times, and the dual challenge of doing this alongside the wider actions needed to improve cancer survival.
We’ve also looked at the Plan’s efforts to tackle variation in treatment, and the thorny issue of whether it’s backed by sufficient funding.
Across all these areas, one issue has kept cropping up: delivery.
As others have pointed out, moving from articulating ambitions to delivering them in practice has often been the weak link in how the UK Government operates. We need to ensure that cancer policy is the exception.
Turning challenges into progress
The Plan already sets out some foundations for delivery. While there is a lot of important detail still missing, there is some detail on who’s responsible for what in the Plan, some timelines and commitments to report on progress. Important work is underway across DHSC, NHS England and the wider cancer community to translate the Plan into action. This is all a good start.
However, the Plan faces two big implementation challenges that the Government has yet to fully face up to.
First, important policy choices remain unresolved. Take, for example, tackling variation in treatment access across the NHS. The policy problem is well described in the Plan, but – as we wrote previously – more work is needed to build a national approach that is equal to the challenge.
Second, the Plan hits the health system during a period of disruptive change for the NHS nationally, regionally and locally created by new legislation, changing structures and a new UK government, all within an ever tighter financial environment.
Delivering the Plan requires marshalling funding, focus and action across multiple parts of the healthcare system. However well intentioned, this wider disruption creates a more challenging environment in which to deliver the Plan.
So how could Government address these challenges, create the conditions to successfully implement the National Cancer Plan, and ultimately deliver real progress for people with cancer?
Three elements will be particularly important: a clear delivery roadmap; robust governance; and sufficient funding.
1) A delivery roadmap
The Plan needs a clear delivery roadmap. To see why, the approach taken in Scotland for its 2023 cancer strategy is instructive. Alongside its 10-year strategy, the Scottish Government published a 3-year action plan, which (though lacking detail in places) clearly identified the actions that were going to be progressed in the early period of the overall strategy. Importantly, it was accompanied by a robust monitoring and evaluation framework, setting out clear success metrics across different timelines. Taken together, these plans and frameworks gave the wider community in Scotland a clear understanding of what should be happening, and the impact the strategy is having.
An equivalent framework for England’s Plan needs to set out sequencing, milestones and expected trajectories for progress. Not every commitment can or should be delivered simultaneously, but stakeholders should be able to understand the ‘route to delivery’ for specific actions and scrutinise progress.
2) Robust governance and delivery arrangements
The National Cancer Board, led by new independent co-chair Anita Charlesworth, has a critical role to play as the driving force behind the Plan. It’s critical that it’s set up to hold the wider system to account on delivery.
This means ministers should empower it to co-ordinate and align the different parts of the system, holding each to account for delivering what is in its power, and ensuring that the Plan’s metrics and commitments are effectively integrated into the wider NHS assurance and oversight regime.
Explicit political backing is also a prerequisite for success. The Plan puts a responsibility on ministers to provide national leadership – not just by empowering the National Cancer Board to provide effective governance but also by ensuring that the whole NHS sees improving cancer outcomes as a shared priority.
Given the breadth of the Plan, serious consideration should be given to establishing additional specialist governance for key areas to support the Board. This would capitalise on the enormous goodwill across the cancer community, enabling better input from external experts and better stakeholder alignment.
The national cancer team plays a role that is essential to ensure delivery, and must be resourced in whatever institutional arrangements emerge from current reforms to NHS England: providing national leadership for the cancer system; facilitating engagement with the cancer community; and working with Cancer Alliances to deliver flagship initiatives such the Lung Cancer Screening Programme.
And of course, the Cancer Alliances themselves will also play a vital role, translating national policy priorities into local action. Indeed, their capabilities in bringing local systems together, marshalling clinical expertise and local knowledge will be doubly important, providing stability in a changing system. And beyond directly implementing the NCP, their cancer expertise will be critical to local commissioners as more cancer services are planned and commissioned locally.
So, while it’s positive that the Plan emphasised their future role, that support needs to be sustained, retaining capacity and capability in core Alliance teams and maintaining service development funding so they have the resources they need.
3) A credible funding plan
As we wrote in detail previously, it’s clear that delivering the Plan will need significant extra funding, whether for specific initiatives, or for NHS services that cancer pathways use.
Fully defining what resources are required to deliver the Plan in full will take time – not least for policies where the best approach is still to be worked out.
But what *is* needed now is some clarity on exactly where funding is already secured for the Plan’s actions and where this will come from, and where funding is yet to be identified.
This will help provide confidence to the cancer community and delivery partners that the resources to deliver will be there. But more importantly – with a Spending Review on the horizon – nailing this down would allow the Department of Health and Social Care to robustly set out their stall on what is needed to deliver the Plan’s policy commitments.
Promises kept?
Addressing these three areas would clearly indicate that the Government is on top of delivering the Plan, and how this will be managed, resourced, governed and scrutinised over the next decade. In doing so, it would provide a vital source of stability for the cancer system, at a time when so much about the wider NHS operating model remains in flux.
Clearly, this is a big task for staff at DHSC, NHS England and in the wider NHS cancer system – who, as we’ve already noted, are at the sharp end of major restructures. While much of the focus of the merger of NHS England into DHSC has been cutting the size of those organisations, the Government needs to make sure the new set-up is sufficiently well resourced to effectively deliver its ambitions around cancer.
Ultimately though, the Plan’s vision is a set of promises made to people affected by cancer. Keeping these promises means sustained ministerial attention and clear political accountability.
The appointment of a minister who will be responsible for the National Cancer Plan is a welcome first step, but there are key tests coming up. Will the first progress report, due in early 2027, give a clear view of progress made and problems still to solve? And crucially, will the next Spending Review commit the resources needed?
The Government’s task is no longer to explain what success looks like. It is to demonstrate how it will be achieved – and to keep the promises it’s made to people with cancer.
