Following the initiation of the Pathway Improvement Programme in 2025/26, the 2026/27 programme aims to go further, to streamline and integrate all aspects of operational performance and pathway improvement planning into a single, cohesive framework.
By uniting previously separate sections such as operational performance, faster diagnosis, and treatment variation, the programme seeks to optimise cancer pathways from initial referral through to treatment, maintaining a particular emphasis on areas where pathway breaches most frequently occur.
We will focus efforts on providers in the lowest quartile overall against the three CWT standards, and on providers with pathways in the bottom quartile nationally, where these are not already covered by the bottom quartile providers. The programme has been developed to ensure that all performance-related objectives are addressed as a coherent whole and is reflective of the approach set out in the 26/27 operational planning pack.
The programme prioritises nationally mandated pathways, as well as some locally defined priorities and incorporates new elements such as the bowel cancer implementation programme which will focus on the introduction of Colofit. The programme will also continue to incorporate the delivery of Hepatocellular Carcinoma (HCC) Surveillance improvement initiatives, as well as a number of cross cutting workstreams including robotic surgery provision, capacity and demand management modelling support, MDT improvement, workforce and referral management optimisation, CDC utilisation, and the agreement and implementation of an inter-provider transfer (IPT) policy.
Beyond local performance improvement initiatives, the programme will take a wider leadership role, generating and coordinating large programmes of work to shift the dial on performance through transformation.
This takes the form of articulating target operating models (TOM) which are a statement of where the health-care system would like to develop as one and is appropriate in instances where local and structural barriers produce a limit to the performance improvement ambition. Examples include the establishment of a lung collaborative (supported by GIRFT), a skin summit which brings the whole system together across primary and secondary care to tackle each part of the pathway and address seasonal weakness, and a ‘Fit for the Future’ gynaecology plan which entails a root and branch review of the construction of gynae cancer services in Cheshire and Merseyside.
In line with the review of the wider CMCA clinical leadership model, governance processes within the programme priority pathways (Breast, Gynae, Lung, Lower GI, Skin, and Urology) will be reviewed and realigned under the newly established Specialty Boards. This approach will ensure that strong clinical leadership at the heart of operational improvement.
The programme has projects underway across several priority tumour sites.
For further detail on what each project involves, please contact ccf-tr.admin.cmca@nhs.net: