Ahead of the curve

Cancer incidence continues to climb as the population ages and screening improves.

At the same time, the NHS remains under pressure on the constitutional 62-day referral-to-treatment target and on diagnostic waiting times.

Workforce shortages, particularly in radiology, pathology and specialist oncology nursing, constrain throughput.

The NHS Cancer Plan doubles down on three themes:
• Earlier and faster diagnosis, including expansion of Community Diagnostic Centres (CDCs), risk stratification tools and targeted screening
• Reduction in inequalities, with a sharper focus on deprivation, mental health comorbidity, rurality and ethnicity
• Innovation adoption, accelerating uptake of advanced medicines, precision diagnostics and digital tools that improve pathway efficiency.

And it is precisely in these areas that pharma can align most effectively.

They are not abstract ambitions and our work has shown what collaboration can do.
In lung cancer, for example, stage at diagnosis remains highly correlated with deprivation.

Patients with serious mental illness are significantly more likely to present via emergency routes, which is associated with worse outcomes. Reducing that emergency presentation gap is both a clinical and moral imperative.

The UK oncology market is one of the most dynamic in Europe.

Immuno-oncology, targeted therapies, antibody–drug conjugates and personalised medicine approaches are reshaping standards of care across lung, breast, colorectal and haematological malignancies.

At the same time, the NHS is demanding:
• Real-world evidence of value
• Budget impact clarity
• Service redesign support
• Data on inequalities and pathway variation.

In other words, innovation must be embedded in system thinking.

A new therapy that reduces progression-free survival by months is welcome. A therapy that reduces hospital admissions, supports community care, shortens diagnostic odysseys or narrows deprivation gaps is transformative.

The oncology market can offer the NHS three broad assets:
1. Advanced medicines that meaningfully alter survival curves
2. Diagnostic and digital technologies that streamline triage, stratification and monitoring
3. Pathway partnership capability, working with Cancer Alliances and ICBs to make services more resilient and sustainable.
The last of these is increasingly where differentiation lies.

Lung cancer provides a clear lens through which to view the opportunity.

Variation in stage at diagnosis between ICBs remains marked. In some systems, high proportions of patients from deprived backgrounds or with mental health conditions present at Stage III or IV. Rural geographies may see longer travel times to diagnostic hubs.

Understanding that variation allows targeting resource intelligently.

We have engaged in granular analysis of inequalities and pathway variation, so can highlight:
• Which ICBs have disproportionate emergency presentation rates
• Where travel distance may be a barrier to timely diagnosis
• Where variations in treatment rates are across tumour types
• Deprivation-linked stage disparities.

For industry field teams, this is a conversation enabler. Are system leaders aware of the inequality in their population? What initiatives are underway? Where might additional diagnostic or service support make the greatest difference?

By shining a light on variation, for example pockets of inequality in lung cancer stage at diagnosis, companies can approach Cancer Alliances as supportive partners rather than transactional suppliers. This aligns squarely with the Cancer Plan’s emphasis on system-level solutions.

Credibility with clinicians matters. In 2024, HSJ Information convened a national roundtable on non-small cell lung cancer (NSCLC), bringing together chest physicians, oncology leaders and industry stakeholders. The output was a technical white paper and a publication in an indexable journal, with cross-system buy-in and clinical co-authorship.

This model does several things at once:
• Builds rapport with clinicians through serious scientific contribution
• Enables pharma to listen to frontline concerns about budgets and pathway friction
• Embeds industry as a contributor to evidence, not merely a beneficiary of it.

This is where experience pays. Reputable medical publication ensures robustness. Projects developed alongside leading NHS physicians ensure appropriate interpretation of coding, treatment patterns and system context.

The result is work that carries NHS credibility, essential in a climate wary of superficial partnership.

The oncology pipeline is rich, but launches increasingly succeed or fail on local nuance.

Using Specialised Share Data (SSD) and prescription-level insights, our consultancy team can map:
• Stakeholder segmentation across ICBs
• Current treatment patterns and uptake curves
• Inequality rates by geography
• Literature-informed ICB priorities.

For example, in a lung and bladder cancer project, clients received a tailored map of stakeholders, treatment rates and inequality metrics, alongside recommendations on how best to approach upcoming launches in specific systems.

If the South West shows slower uptake or greater travel burden, additional educational or service resource may be warranted.

If Greater Manchester demonstrates strong performance and established pathways, deployment might be recalibrated.

When you are launching, think bespoke. The aim is not generic market access theory but actionable intelligence.

The Cancer Plan places Cancer Alliances at the centre of delivery.

For industry, engagement must be sophisticated, compliant and informed.

Clients need to:
• Identify key Alliance leads and programme directors
• Understand local performance against targets
• Engage in informed, supportive dialogue about pathway sustainability
• Demonstrate where industry has already strengthened resilience, for example enabling quicker patient access or earlier diagnosis in deprived populations.

There are risks in launch of course, in compliance and in terms of ROI. So HSJ Information manages outreach under full ABPI and BHBIA standards, distilling responses from oncologists, programme directors and pharmacy leaders to provide a real-time picture of the NHS cancer landscape.

In a crowded communications environment, compliant intelligence gathering is invaluable.

There is still a lot to do in the Cancer Plan and tech has been widely hedged as the saviour.

We do not know exactly how successful this will be, but there is not really a solution that does not include it.

The problem with the NHS is not clinical excellence but elastic capacity and it is only tech that can fully address this.

For example, the Cancer Plan’s expansion of Community Diagnostic Centres, digital triage and risk-based screening must be matched by:
• AI-enabled imaging interpretation
• Eemote monitoring to reduce outpatient burden
• Precision medicine pathways that avoid futile treatment
• Data transparency to expose unwarranted variation.

Industry’s role here extends beyond molecules.

Digital partnerships, data analytics and pathway redesign can relieve pressure on overstretched MDTs and infusion suites. Advanced medicines that reduce hospitalisation or allow ambulatory care are part of the capacity solution.

But the NHS will increasingly ask: where is the system gain? Where is the inequality reduction? Where is the evidence that this intervention improves flow?

Oncology in the NHS sits at a crossroads.

The policy intent is clear: earlier diagnosis; faster treatment; fewer inequalities and smarter use of technology. The market is vibrant with innovation.

The missing piece, often, is translation, from data to dialogue, from publication to pathway, from molecule to measurable system benefit.

HSJ Information and its consultancy arm operate at that interface.

Through pathway data analysis, prescription insight, academic partnership and engagement tools, we enable companies to understand where need is greatest, where pathways falter and how to engage Cancer Alliances as allies in reform.

For an NHS seeking both capacity and improved outcomes, the opportunity is to co-produce innovation. In oncology, where weeks matter and inequalities cost lives, that partnership could define the next chapter of cancer care.