Cynulliad Cenedlaethol Cymru

Our approach is set out in the Quality Statement for Cancer and in the Cancer Improvement Plan, which was developed by the NHS, as the Welsh Government works with the NHS to ensure services deliver high-quality care in line with expert guidelines and standards. This includes the implementation of technology appraisals from the National Institute for Health and Care Excellence within the 60 days required by the New Treatment Fund.

Health boards also work through the NHS Joint Commissioning Committee to commission services for children and young people. This ensures services are commissioned and overseen to a high standard from specialist centres, including proton beam therapy centres in England.

We also work through the NHS Executive to oversee the quality and delivery of services. The NHS Executive’s cancer network includes subgroups for cancers affecting children and young people, or teenagers and young adults. These subgroups, called cancer site groups, maintain service guidance and nationally agreed pathways to support consistency of service delivery across Wales.

Service concerns and improvement can be addressed through this structure, especially via the peer review process, and issues can be escalated into routine NHS planning and accountability processes.

Regarding detection of cancer, there are clear clinical guidelines in place that are well recognised in general practice. However, this does not mean that it is always clear when a child is presenting that the symptoms may relate to cancer. Assessing common presenting symptoms such as pain, fatigue, fever or swelling requires clinical judgement to be used in the context of understanding the patient history, other possible causes, and due consideration of the relevant clinical guidance. Symptomatic referral guidance for cancer can be found at: Recommendations organised by symptom and findings of primary care investigations | Suspected cancer: recognition and referral | Guidance | NICE