Improving cancer outcomes through value-based commissioning


This project was designed to simplify the considerable task of costing cancer into an achievable process by focusing on costing two high-volume cancer pathways – breast and lung. The key objective was to facilitate the delivery of high-quality cancer care by understanding the costs of the clinically effective pathways in order to inform future commissioning, ensuring services are appropriately funded. This would give a good guide to commissioners on their total funding requirements for cancer and allow them to have an informed discussion with their providers on how they could improve quality and value-for-money cancer care.

The project will give commissioners greater clarity on which HRGs align with the national pathways for lung and breast cancer, and enable consistent coding of activity across London. Commissioners will have a better understanding of current patient pathway flows across London Trusts, and the impact that has on costs. In turn this should inform commissioning of secondary care activity related to best practice care. Roche have benefited from costed pathways being developed to include NICE approved treatments and cancer care being appropriately funded across London.

The project has managed to bring providers and commissioners closer together to help them better understand the true cost of delivering cancer care. A population-based predictive cost model has been developed to cost out the best practice breast cancer care pathway. This has enabled greater clarity on current service specification against the best practice pathway and informed negotiations between commissioners and providers on quality improvements.  The output from the costed pathways project is also being used as part of a pilot to develop best practice tariffs for selected tumours in shadow form from 2012/13 across London.


The objectives of the team were to:

  • understand, through patient level detail, the cost of cancer treatment thereby leading to greater transparency between actual provider costs and the national tariff
  • develop a population-based predictive funding flow model at local or pan-London level that could be used to model prices of future populations based on forecast incidence and mortality rates for different tumour sites
  • develop an agreed process for the commissioning of cancer services, across the entire clinically effective pathway with built-in service specifications for quality monitoring purposes.

Back to the top

QiC Oncology Highly Commended 2012
Cancer commissioning award
Improving cancer outcomes through value-based commissioning
by NHS National Programmes, Roche Products Ltd and North East London Cancer Network

Supported by: