Recommendations

1. Create one seamless cancer pathway
   Patients should experience one cancer pathway regardless of whether they receive care from NHS or independent providers. National referral protocols should remove unnecessary duplication, delays and administrative barriers.
2. Ensure direct referral into NHS urgent suspected cancer pathways
   Where appropriately regulated independent providers identify suspected cancer, clinicians should always be able to refer directly into NHS urgent cancer pathways without requiring patients to restart their journey through primary care. This is in accordance with NHS England guidance.
3. Improve patient choice in cancer diagnostics
   Patients referred for urgent cancer diagnostics should be able to choose from all qualified providers able to meet national standards, improving convenience, reducing waits and making better use of available capacity.
4. Deliver genuine interoperability
   All providers delivering cancer care should have access to shared patient records, diagnostic information and imaging to reduce duplication and improve continuity of care.
5. Remove barriers to joint working
   Cancer multidisciplinary teams, contractual arrangements and escalation pathways should support seamless collaboration between NHS and independent providers throughout the patient journey.
6. Treat independent providers as full partners in cancer research
   Government and NIHR should enable suitably accredited independent providers to participate fully in national clinical research programmes, ensuring patients have equitable access to innovation regardless of where they receive care.