The Christie NHS Foundation Trust has shared an update on its neighbourhood oncology programme in a move to a digitally-enabled and neighbourhood-based system of care, sharing a series of milestones for the next 12 months, and the next five years.
Setting out the case for change, the trust notes that by 2040, an estimated six million people will be living with cancer in the UK, in what it calls “a structural shift in demand that cannot be absorbed by existing models of care”. The current approach, it continues, relies on emergency hospital attendances and admissions in an “already overstretched” urgent and emergency care system, creating inequalities in access and often failing to support cancer as a long-term condition.
Following engagement with clinical experts and system partners including the Greater Manchester Cancer Alliance, and neighbourhood teams, the board looks to the neighbourhood oncology programme to transform cancer care delivery, redesigning pathways to be more proactive, and using digital tools to adopt a risk stratified approach. Early intervention will help prevent complications from escalating to a point where they require hospital admission, it suggests, and cancer will be managed as a long-term condition.
For patients, this will mean care closer to home “as standard”, according to The Christie, with faster access to specialist advice, earlier identification of complications, more personalised care supported by digital monitoring, improved experience and quality of life during treatment, and more equitable access. “Recognising cancer as a chronic condition, neighbourhood oncology positions cancer care to fit around patient’s lives, rather than requiring their lives to fit around care,” it states.
The programme’s delivery model is based on three pillars, with the first being systemic anti-cancer therapy delivered at home, enabled by digital identification and referral, the expansion of SACT neighbourhood hubs, and the reconfiguration of the trust’s Christie@Home service. “Currently 1300 patients receive treatment at home with 8500 treatments delivered annually,” the trust explains. “Modelling of our current patient population and available drug regimens has shown this could increase three- or four-fold, with potentially more than 5000 patients receiving SACT@Home each year.”
An ambulatory acute oncology model will also be introduced, with patients continuously connected to the trust using digital tools such as ePROMs and monitoring devices. Supportive oncology will deliver secondary and tertiary prevention, incorporating symptom control, pre- and rehabilitation, psychological and social support, The Christie goes on. Services will be integrated with primary care and community services, as well as the VCSE sector, facilitated through personalised care plans accessible via the NHS App.
Plans for the next 12 months include implementing opt-out digital referral pathways via EPR, expanding the Christie@Home workforce, embedding a pan-Greater Manchester daily virtual acute oncology MDT, developing acute oncology at home pathways, rolling out ePROMs, developing real-time monitoring and escalation systems, and integrating pathways into the NHS App and Christie portal.
Over the next five years, the programme seeks to deliver neighbourhood and home-based care as the default model for cancer treatment, and digitally-enabled and proactive cancer pathways including ePROM-driven surveillance. The trust hopes this will help reduce inequalities and release specialist capacity to allow a focus on complex and tertiary care.
Wider trend: The shift to neighbourhood care
Sir James Mackey, chief executive at NHS England, has outlined next steps on planning and priorities for 2026/27 in an open letter to ICB and trust chief executives. Executives are asked to begin to build out strategic commissioning narratives to focus on what strategic commissioning means for the local system and how it will be developed over the next three years; plans around neighbourhood care; whether changes to financial flows or payment are sought to help with delivery; and what more can be done at the centre to help drive pace of change locally. ICBs should provide a single document via regional teams to summarise the above points by 15 May.
Cheshire and Wirral Partnership NHS Foundation Trust has published its medium term plan, outlining ambitions for the next five years. The trust plans to develop its making data count dashboard, expand patient portal capability, and implement digital tools to improve patient access and system efficiency. For neighbourhoods, the trust anticipates rolling out point of care testing equipment across community teams, completing Accurx and EPR platform integration, and developing electronic prescribing in year one. For years two to five, this extends to full EPR integration across community services, expanded remote monitoring and digital health interventions, predictive analytics for demand management, and AI-enabled care coordination and predictive modelling.
Leicester, Leicestershire and Rutland ICB and Northamptonshire ICB’s latest five-year strategic commissioning plan to 2031 highlights the move from short-term recovery to longer-term transformation, outlining the role of digital and data in areas such as population health, neighbourhood health, and prevention. Under the neighbourhood model, the ICBs commit to increasing access to digital tools to support people, putting in place shared digital records and interoperable systems to enable better integration, and providing a single point of access for service navigation and triage.
