cancer care

All.Can shares their profound insights into the challenges concerning the need to improve the efficiency of cancer care, focusing on better outcomes for patients

Healthcare budgets are under increasing pressure. We face an urgent question about how we can sustain high-quality healthcare. All.Can is an international multi-stakeholder initiative set up to tackle the challenge of sustainability in cancer care, by addressing one of the main obstacles – the pervasive waste and inefficiency of care systems.

Our approach is simple: focus only on what matters most to patients. There are countless data showing that ignoring patient needs results in inefficient practices, including delays; poor communication; inappropriate, fragmented and duplicated care; insufficient follow-up; negative impact on quality of care and quality of life; and a general disconnect between patient needs and care given.

The World Health Organisation (WHO) estimates that 20% of spending across all healthcare systems is wasted. (1) As cancer is a key component of healthcare and one of the main drivers of expenditure, it is here we can begin to address this urgent problem. And the results can be transformative – the OECD also predicts that countries could gain approximately 2 years’ life expectancy by reducing inefficiencies across healthcare systems. (2) Two years – just through better allocation of resources.

Focusing on patient needs will lead to a better yield from resources used, an improved quality of care for patients and less waste. Our 2017 policy (3) report highlights numerous examples where simple changes, based on observations of patient needs, have had a dramatic impact on costs, waiting times, healthcare professional time, patient satisfaction, stress and anxiety. One manufacturer of imaging tests, for example, noticed that paediatric patients were so nervous before their MRI scan that over three-quarters of them needed to be sedated or to have their scans rescheduled if an anaesthesiologist was not available.

But by decorating the intimidating MRI scanners with fun themes like a pirate ship or space rocket, they turned a scary and unfamiliar process into an adventure. The number of children needing sedation dropped, meaning more could be scanned per day and overall patient satisfaction scores went up by 90%. (4) This is an individual example, but one that could be rolled out globally, with minimal cost, potentially leading to dramatic improvements in patient outcomes.

“People need to go back to the primary source, which is the patients. These are the people at the coalface of their diseases; these are the people who can provide the answers” said Kathy Oliver (Chair and founding co-director of the International Brain Tumour Alliance and All.Can member).

This is not simply an academic exercise. All.Can is using patient insights to inform compelling evidence that can drive real policy change. We are aiming to create practical, targeted policy recommendations for individual countries, that ensure cancer policy is focused on meaningful outcomes for patients above all other considerations, thereby removing unnecessary, problematic or obsolete practices and processes. We are working in partnership with leading organisations such as Quality Health, the International Consortium on Health Outcomes Measurement (ICHOM) and the European CanCer Organisation (ECCO) on four different research projects, to understand where patient care could be improved and how existing inefficiencies can be identified and removed. The aim is to standardise and share efficient and patient-focused practices across all aspects of cancer care.

Finally, All.Can strongly believe that reducing inefficiencies cannot be a simple cost-containment exercise. Focusing only on cutting costs without consideration to patient outcomes may negatively impact the quality of care and undermine long-term sustainability for short-term gain.

Solutions to these problems will invariably involve change, which may at times prove uncomfortable, difficult and even counter-intuitive. Decisions over the removal of certain processes are always difficult, but inefficient, obsolete and unnecessary processes must be removed. The consideration around what to remove and what to keep should come down to one thing and one thing only: whether it positively contributes to patient outcomes.

This is why we need all stakeholders involved in the discussion, to create the trust that we’re all headed in the same direction, improving patient outcomes and ensuring the sustainability of cancer care. We all have a responsibility and a vested interest, in improving the efficiency of cancer care. Join us, work with us, together #WeAllCan.

All.Can is a multi-stakeholder initiative involving patient, clinical, academic and industry experts as well as policymakers. We aim to help define better solutions for sustainable cancer care and improve patient outcomes in the future. The All.Can initiative is made possible with financial support from Bristol-Myers Squibb (lead sponsor), Amgen, MSD and Johnson & Johnson (co-sponsors).


(1) World Health Organisation. Health systems financing: the path to universal coverage. The World Health Report, 2010.

(2) Medeiros J, Schwierz C. Efficiency estimates of health care systems in the EU. European Economy: European Commission Directorate-General for Economic and Financial Affairs, 2015.


(4) Kelley T, Kelley D. Kids Were Terrified of Getting MRIs. Then One Man Figured Out a Better Way. 2013.




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