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This document is intended as a resource to be used by commissioners and providers of community services to help create transparent models of funding, through the use of new currencies and better pricing at a local level. New currencies (the units of healthcare for which a provider is funded) and better pricing are key to transforming community services, enabling commissioners to incentivise improvements in quality and value. The use of new currencies with accurate pricing should also lead to more services being available closer to home for patients.

The cancer commissioning guidance announced as part of the Cancer Reform Strategy has been developed to support world-class commissioning of cancer services across the NHS. The guidance sets out, in an easy-to-use format, key issues and questions that commissioners and cancer network teams will want to take into consideration when assessing health needs, reviewing services, developing their contract service specifications and monitoring performance.
The cancer commissioning guidance sits alongside the linked web-based cancer commissioning toolkit which supports commissioners of cancer services by providing a range of benchmarked information and data.

This letter from Teresa Moss, Director of Cancer Modernisation, announces the publication today of the Skin Cancer measures and the revised Gynaecology Cancer measures as part of the revised Manual for Cancer Services 2008

In the first annual report of the Cancer Reform Strategy, Professor Mike Richards, the National Cancer Director, sets out the considerable amount of progress made in implementing the strategy since its publication in December 2007. The report covers the wide range of actions that were set out in the strategy, highlighting areas of particular progress and setting out a range of priorities for the future.

The PA Consulting Group were commissioned to undertake a review of PbR tariffs and how they impact on cancer services, and how they could be best developed to support cancer services. Key findings and priorities within the report were used to inform the Cancer Reform Strategy. A copy of their full report has been made available for information purposes. The Department is currently considering the recommendations in the report.

The PA Consulting Group were commissioned to undertake a review of PbR tariffs and how they impact on cancer services, and how they could be best developed to support cancer services. Key findings and priorities within the report were used to inform the Cancer Reform Strategy. A copy of their full report has been made available for information purposes. The Department is currently considering the recommendations in the report.

In line with the commitments in the Cancer Reform Strategy, the National Cancer Intelligence Network (NCIN) will be launched in June 2008.

The NCIN will coordinate the collection, analysis and publication of comparative national information on diagnosis, treatment and outcomes for types of cancers and types of patient, in a way which is useful to patients, commissioners and service providers and other interested parties
The NCIN will be launched at an event at the London Hilton Metropole, on Wednesday 18 June 2008. This launch event will set out the initial agenda and role for the NCIN. The event will describe and examine proposed changes in cancer data collection, and will focus on the information which NCIN will provide in its first year, 2008-09.

The event will be of particular relevance to a range of people, including:

information specialists in cancer networks, NHS Trusts, PCTs, cancer registries and the private sector
cancer data users in patient and support groups, charities, information departments
commissioners of cancer care
specialists in cancer service improvement
cancer researchers in epidemiology, health service research and informatics

This guidance follows on from the publication of the Government’s obesity strategy Healthy Weight, Healthy Lives: A Cross-Government strategy for England. The guidance provides advice to PCTs and local authorities on how to set child obesity goals as part of the Vital Signs and the National Indicator Set. This will be followed shortly with full guidance on developing local plans

Care Services Minister, Ivan Lewis will today launch a £20m boost to improve palliative care services for the thousands of children with life-limiting or life-threatening conditions.

Letter from National Cancer Director Mike Richards, about the progress made on the strategy for the reform of cancer services in England.
The letter introduces the press notice announcing the membership of a new advisory board of experts who will provide advice and help develop the strategy.
The press notice also gives details of six new working groups who will develop specific work areas and report their findings to the advisory board.

Advice for the NHS on how to organise services for Malignant Pleural Mesothelioma (MPM) patients to improve quality of care across the country.

BACKGROUND: Herceptin (trastuzumab) is a humanized monoclonal antibody that is being tested in the adjuvant setting. Cost implications of using trastuzumab, as administered in the Breast Cancer International Research Group 006 trial, are being calculated. This provides information on the treatment's value for money. METHODS: Standard breast cancer treatment models were set up for different subpopulations according to stage (I, II, III) and menopausal condition (<50 and>50 years). Costs were calculated from the hospital's point of view, using the micro-costing method. Life expectancy data were based on literature. Our comparator was the existing practice. In addition to a sensitivity analysis, a threshold analysis on the prices of trastuzumab and docetaxel was performed to target an acceptable incremental cost-effectiveness ratio. RESULTS: Treatment costs were euro 45,034 (doxorubicin and cyclophosphamide --> docetaxel and trastuzumab) or euro 47,765 (docetaxel, carboplatin and trastuzumab). This was largely (79% and 75%, respectively) attributed to trastuzumab. According to our threshold analysis, an acceptable incremental cost-effectiveness ratio can be reached if health improvements are large enough and/or price discounts are given. CONCLUSIONS: Trastuzumab is a promising but very expensive antibody. With the current pressure on health-care budgets, cost implications of using trastuzumab in adjuvant setting must be calculated before use of the product becomes wide-spread. This provides essential information for price-setting policies and for policy makers considering reimbursement.

Infliximab (Remicade) is a chimeric monoclonal antibody against tumor necrosis factor (TNF)-alpha that has shown efficacy in Crohn disease and rheumatoid arthritis with a disease-modifying activity and rapid onset of action. It is administered intravenously, generally in a schedule with initial infusions at 0, 2, and 6 weeks, followed by administration once every 8 weeks. Infliximab is effective in the treatment of patients with moderately to severely active Crohn disease with an inadequate response to other treatment options or those with fistulizing disease. In combination with methotrexate, infliximab reduced signs and symptoms and delayed disease progression in patients with active, methotrexate-refractory rheumatoid arthritis and in those with early disease. The drug was generally well tolerated. Recrudescence of tuberculosis infection and worsening of heart failure and demyelinating disease are among some of the concerns with anti-TNFalpha therapy, requiring cautious use of these agents in high-risk patients. Current data suggest that infliximab may be cost effective, especially when long-term clinical outcomes and burden of the diseases are taken into account. More robust, prospective pharmacoeconomic studies are required to better ascertain the cost effectiveness of infliximab. Direct head-to-head comparative trials of infliximab with other biological agents are not yet available and would be helpful in determining with greater certainty the place of infliximab in the management of these diseases. Nonetheless, infliximab, like other biological agents, is a valuable treatment option in patients with moderately to severely active Crohn disease (including fistulizing disease) or rheumatoid arthritis (including early disease).