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The ever-changing politics of the provision of NHS services means that the emergence of more Foundation Trusts, the future PCT geography, the emergence of the London SHA, and the issues of commissioning, will all impact on the Cancer Network as a funnel/arbiter/commissioner of cancer services. In this context the agreement of all stakeholders of this Network to go forward with the Network as a “governed partnership” is a very strong positive step and indicates the true willingness of the majority of stakeholders to genuinely work together over coming years.

Provider support

Many of the significant improvements that have been made in implementing the NHS cancer plan and therefore improving the quality of services for cancer patients has been through the application of various types of information technology. NLCN has led the way in implementing e-prescribing, videoconferencing and clinical datasets and much of this could not have been achieved without our IM&T; support to Providers. The Provider support function is also carried out through management of the Cancer Services Collaborative Improvement Partnership (CSCIP) and the North London Cancer

Research Network (NLCRN). These, together with Provider support given to ensure achievement of cancer waiting times, represent a significant contribution to Trusts within the North London Cancer Network.

Commissioner support

Cancer Networks do have a significant value added role to play in supporting the commissioning process particularly at the beginning (setting of standards, protocols, and management pathways etc.) and at the end (monitoring, auditing and performance management).

It is recognised patients frequently need services from multiple providers (primary, secondary, and tertiary). These services need to be planned and coordinated. Providers need to cooperate to ensure seamless care and commissioners need to work together since these services span several PCTs.

The North London Cancer Network in a relatively short space of time has established a significantly robust framework of clinical engagement across many tumour sites and statutory organisations. This has

often been done via:

- Greater cohesion amongst the local providers of cancer care.

- Clinical and managerial engagement in planning services across whole care pathways in line with national guidance.

- Improved local needs assessment for all aspects of cancer care (e.g. diagnostics, surgery, radiotherapy, chemotherapy, supportive and palliative care).

- A channel for communication between the Department of Health, London SHAs (now NHS London) and the NHS locally.