The UK Government’s new National Cancer Plan for England arrives at a moment of rare consensus in health policy.
Many stakeholders within the NHS – and the wider healthcare industry – broadly agree that the current reactive, hospital-centric model is no longer sustainable. The transition to a newer approach will champion prevention, earlier diagnosis, and quicker intervention – reducing the burden of disease before it overwhelms services.
However, workforce shortages remain a fundamental constraint for the NHS, and unless prevention is properly embedded, cancer outcomes for patients will continue to trail those of comparable nations. For years, private medical insurers have focussed on preventative methods that put lifestyle at the core of sickness prevention, whether courtesy of added benefits like gym membership or regular health assessments.
The new cancer plan reflects much of this thinking and, like the NHS Ten Year Plan before it, its ambition is not found wanting. But to deliver improved survival rates by 2029, the clinical, legal, and operational risks facing the NHS must be addressed with equal seriousness.
A bold vision – on paper
The plan sets out a new measurable goal that three-quarters of people diagnosed with cancer will survive at least five years, or live well with the disease.
To achieve this, key elements include: faster diagnosis, expanded screening, more personalised treatment. Some of the ‘big bets’ in the plan revolve around adoption of cutting-edge technologies, such as genomic testing, multi-cancer blood detection, AI-supported diagnostics, and robotic surgery.
There is also continued acknowledgement that around 40% of cancers are preventable, linked to smoking, obesity, alcohol consumption, and environmental factors. This indicates an important shift away from viewing cancer purely as a treatment challenge, but instead recognising it as a public health failure.
The workforce problem no plan can ignore
The most immediate threat to delivery is the continuing workforce crisis facing the NHS, and to a lesser extent, the wider health and care sector. Faster diagnosis depends on radiographers, radiologists, pathologists, endoscopists, and specialist nurses; all of which are currently in critically short supply.
In response to the new plan, The Royal College of Radiologists (opens a new window) highlighted a 30% shortfall in radiologists and 15% in clinical oncologists – the doctors that oversee non-surgical cancer treatments, such as chemotherapy and immunotherapy. Extended scanning hours and new diagnostic centres may expand physical capacity, but without sufficient trained staff they risk increasing pressure on an already burnt-out workforce.
“We’ve always known early diagnosis is cancer’s magic key, but a tailored support plan covering treatment, mental health, and employment support – is a very significant piece of work.” Steve Brine, Former Health Minister “This plan sets a clear roadmap for the NHS to diagnose more cancers earlier, ensure more patients are treated on time and improve survival, so that hundreds of thousands more people live longer, healthier lives with or after cancer over the next decade.” Professor Peter Johnson, NHS National Clinical Director |
Clinical risk and the growing exposure to malpractice
Raised pressures on health services can introduce clinical risk and medical malpractice exposure. Earlier diagnosis targets, faster treatment pathways, and increased throughput can increase the risk of missed findings, delayed diagnoses, communication failures, and clinical error – particularly in under-resourced settings.
Clinicians working at speed, across fragmented pathways, face growing personal and professional liability when systems fail around them. As activity increases without commensurate investment in staffing, training and governance, the risk profile worsens – both for patients and for professionals.
Any system that pushes clinicians to work faster, adopt new technologies and manage greater complexity must also ensure that:
Clinical governance frameworks are strengthened, not stretched
Risk is regularly re-evaluated, particularly as AI and genomics enter routine practice
Professional indemnity and organisational insurance arrangements remain fit for purpose
Learning cultures are prioritised over blame, reducing defensive medicine rather than exacerbating it
Failure to do so risks a vicious cycle: rising errors, growing litigation, defensive practice, workforce attrition, and escalating costs – all of which undermine the very goals the Plan seeks to achieve.
Technology is not a substitute for safety
The National Cancer Plan places heavy emphasis on innovation, from AI-enabled imaging to liquid biopsies. However, these tools can introduce new liability questions: Who is responsible when an algorithm misses a tumour? How are false positives or negatives handled? Are clinicians adequately trained to challenge automated outputs?
Without clear accountability, robust validation, and appropriate insurance frameworks, innovation can increase risk rather than reduce it. Technology enhances care only when it is embedded within safe, well-resourced systems.
Prevention without policy teeth
The plan’s prevention narrative, while welcome, remains cautious. There is limited commitment to the tougher policy levers – such as alcohol pricing, obesity regulation, or sustained public health funding – that would meaningfully reduce future cancer incidence. Preventable cancers not only cost lives; they generate long-tail clinical liability, extended treatment pathways, and rising negligence exposure. Prevention is not just good public health policy – it is risk mitigation for the NHS itself.
Inequality and unmanaged exposure
Cancer outcomes vary sharply by socioeconomic status and geography. Late diagnosis is more common in poorer communities, increasing both mortality and malpractice risk. If screening, diagnostics, and workforce investment fail to reach these areas, inequalities will persist – and claims will follow. Improving national averages should not mask unsafe local systems.
The risk of an unrealised strategy
The National Cancer Plan is thoughtful and welcomed. But without a parallel focus on clinical risk, indemnity, workforce protection, and systemic safety, it risks bold promises being undermined by inconsistent delivery. Prevention is the new cure. But unless risk is actively re-evaluated, mitigated, and insured against, the cost of failure will be measured not only in missed targets, but in harmed patients, demoralised clinicians, and a rising bill for avoidable litigation.
