Our strategy 2025 and beyond

Deliver safe, high-quality care and outstanding operational and financial performance

We have a consistent record of excellent top-level performance across all aspects of care delivery and patient experience. This includes results from national inpatient and outpatient surveys and national accreditation for safety and quality. This reflects the skills and commitment of our staff. 

2.1 Quality, experience and standards

Everything we do at CCC is directed at achieving the best quality care and outcomes for our patients. As an organisation we are committed to improving quality, delivering safe, effective and personal care, within a culture of learning and continuous improvement.

We continue to offer safe, high-quality care and good patient experience, with patients consistently rating the Trust as providing excellent care. In the 2023 National Patient Experience Survey we were rated one of the best hospitals in England for inpatient care for the fourth year running. 

We have successfully adopted the Patient Safety Incident Response Framework (PSIRF). In partnership with our patients, their families and friends, carers and our colleagues we are always striving to provide excellent, person-centred cancer care. We aim to build our network of patient safety partners to ensure that we continue to learn from incidents. 

Our vision to provide improved outcomes and patient experience alongside the best cancer treatment and care is supported by the following four themes that make up our commitment to patients. We will continue to work to deliver our patient experience commitments: 

• We will listen, hear, learn and act.
• We will communicate clearly in ways that patients and carers can understand, and we will demonstrate that hearing is happening.
• We will act upon feedback, involvement and engagement to demonstrate that what matters to patients and carers matters to us.
• We will give patients a leading voice and support each other to develop innovative ways to obtain feedback, involve and engage with patients and carers.

We also have four quality ambitions, and we will continue to deliver our work to support them. We will be guided in this by NHS Improving Patient Care Together (NHS IMPACT) – the new, single, shared NHS improvement approach:

• To widely share learning, success and excellence to improve patient safety culture and staff experience.
• To use digital real-time data and system-wide collaboration to drive outstanding care.
• To discover and implement new knowledge to achieve the best outcomes for patients.
• To promote and reward continuous quality improvement initiatives to build safer systems and improve patient experience.

In 2024 we introduced CCCARE (the Clatterbridge Cancer Centre Accreditation for the Recognition of Excellence) in our inpatient areas. It provides a framework for measuring the quality of care we provide to our inpatients. We will continue to embed and develop the CCCARE model, including though the application of a similar process in non-inpatient care settings.

2.2 Operational performance

While operational targets in cancer are in large part a measure of how the wider system is working outside our Trust, we are committed to maintaining good internal performance. All our cancer services will be delivered in accordance with the agreed Cheshire and Merseyside Cancer Alliance optimal cancer pathways. 

Our services also support the regional delivery of the 28-day Faster Diagnosis Standard and the cancer waiting time standards. To maximise performance, our operational team manage the waiting list daily and continue to monitor the internal nine days to first appointment and 24 days to treatment targets for all patients on a 62-day pathway.

2.3 Developing and improving our services 

Improving services 

We are committed to continually improving our services. We will continue the work we have started as part of our two major clinical transformation programmes – our outpatient transformation and inpatient transformation programmes. 

Our outpatient transformation programme has already improved our clinic utilisation and the way we use technology and digital systems to improve the efficiency of services. Our continuing priorities will include:

• The further development of risk stratified models of outpatient follow-up, including patient-initiated follow-up (PIFU). This will be supported by our patient portal, which allows patients access to information and clinical teams.
• The opening of additional outpatient capacity in some of the space available in our Paddington building. We will establish the name of the facility as the Clatterbridge Paddington Health Hub to reflect this broadening of services within the building.  

Our inpatient transformation programme will make improvements to services for patients as well as increasing the efficiency and productivity of our inpatient services. The work programme will improve patient flow through CCC-Liverpool and further develop our ambulatory care models to reduce lengths of stay for patients. 

We will also continue our work to improve our other services, for example: 

• We will continue the work we have started to improve how our Clinical Decisions Unit works to ensure that we are supporting urgent cancer care in Cheshire and Merseyside in the best and most efficient way. 
• We will further develop our palliative and end of life care strategy to build upon the significant progress seen in this service over the life of the last strategy. 
• We will work with partners to develop a long-term plan for the National Eye Proton Centre. 

Developing services 

We have a strong track record of taking on and developing new services. Towards the end of our last strategy, we successfully developed a CAR T-cell therapy service for the benefit of patients in Cheshire and Merseyside. We will continue to develop the CAR T-cell therapy service as it becomes a treatment option for more cancer types. We will also explore whether we can work with our local partners to further develop other specialist services. 

Having successfully integrated the two North Mersey haemato-oncology services into CCC, we will explore whether there is potential to further integrate haemato-oncology services within Cheshire and Merseyside, potentially developing a hub-and-spoke model of care for blood cancer across the region. 

We have provided reactive support to help our neighbouring cancer services in North Wales with the challenges that they face at various points over recent years. We will work with the NHS and cancer services in North Wales to propose and develop a more sustainable model for support if this continues to be needed. 

2.4 Patient environments 

CCC-Liverpool was developed as part of a programme of significant investment that also included proposals for the redevelopment of the CCC-Wirral site. The redevelopment of CCC-Wirral was one of the challenges of our last five-year strategy. We have invested significantly in the maintenance and refurbishment of the site but our ability to invest in larger scale redevelopment has been hindered by changes to the way that capital funding works in the NHS. Our ambition to refurbish our Halton chemotherapy delivery unit has been similarly constrained by our limited capital allocation over the last five years. 

The independent Clatterbridge Cancer Charity has identified CCC patient environments as one of its priority fundraising areas. We will continue to work with the Charity to see whether it is able to support our ambition for redevelopment of CCC-Wirral through the development of a new chemotherapy unit. We will continue to invest in all our sites (within the limitations of our capital allocation) while we continue to work to try to deliver our ambitions for more transformational change to the patient environments at CCC-Wirral and Halton. 

2.5 Financial performance 

The healthcare environment remains challenging, with several external factors providing us with both risk and opportunity. We recognise that to deliver our strategy and maintain a balanced financial position we must have a strong commitment to clinical and operational transformation. This includes being as efficient as possible across our services so we can reinvest in patient care. Our approach to sustainability over the coming years will be based on the following programmes.

Productivity improvement programme

We will continue to deliver value for money and live within our funding envelope every year. We will use peer review, benchmarking techniques and service transformation methods to support ongoing improved financial performance and deliver required efficiencies.

Capital programme

We understand that our infrastructure is critical to delivering safe and leading-edge patient care, and that this is supported by an effective capital programme that optimises the use of our limited capital allocation. Where possible we will also bid for additional funding where grant or external opportunities arise that are consistent with our investment plan.

Partner programme

The Clatterbridge Cancer Charity raises money solely to support CCC and deliver improved clinical outcomes. During the life of the last five-year strategy the Charity became independent of CCC and is now overseen by a Board of Trustees. The Charity plans to use this independent status to increase its annual income over the coming years. 

The continued growth of Clatterbridge Private Clinic, a joint venture with the Mater Private since 2012, will continue to support financial sustainability, and allows the Trust to reinvest into front-line care for all our patients.

2.6 Our wider impact

Environmental sustainability 

We published our first ever Green Plan in 2022 and developed a successful sustainability programme over the course of our last strategy. Our Green Plan aims to drive sustainable change across the Trust and prepare us for the transition to delivering net zero carbon healthcare within two decades. We will continue to deliver our sustainability programme, and we will refresh our Green Plan in 2025 in line with new national guidance. We will continue to work with our partners in the emerging UHL Group to ensure that our efforts are coordinated and that we have the greatest possible impact. 

Health inequalities 

During recent years we have developed a clearer perspective on our role as a specialist centre in lessening health inequalities. We will continue to strengthen and deliver our health inequalities and anchor institution programme. We will also work with partners in the emerging UHL Group to ensure that our actions on health inequalities and our work to act as anchor institutions have increased impact. 

Drive better outcomes for cancer patients, working with our partners across our unique network of care

We have a strong track record of collaboration at CCC. Our networked model of care means that we have multiple long-standing partnerships and relationships with our NHS partners in Cheshire and Merseyside and beyond. 

3.1 NHS University Hospitals of Liverpool Group 

We will continue to play an active part in the work of the adult acute and specialist provider trusts in Liverpool come together to fully form the University Hospitals of Liverpool Group.  

We will make proactive preparations for joining the Group and develop detailed proposals for how we think cancer services should operate within it. This will include a proposal for the formation of a single cancer board for the UHL Group, with CCC playing a key role. We will develop proposals for the maintenance of CCC’s specialism and brand within the Group and ensure that these are coherent with the development of the overarching UHL Group brand. 

We will explore whether the formation of the UHL Group presents opportunities for CCC to take a lead in areas beyond non-surgical oncology. We will also explore opportunities to deliver additional services where there are clinical links or similarities with oncology. 

We will strengthen our existing collaborative arrangements with the other adult acute and specialist providers in Liverpool, for example through closer working with cancer surgical teams and through the further development of our interventional radiology service at CCC-Liverpool with colleagues from the Royal Liverpool University Hospital.

3.2 Cheshire and Merseyside Cancer Alliance 

We host the Cheshire and Merseyside Cancer Alliance (CMCA) and our Chief Executive Officer is its Senior Responsible Officer. This arrangement was in place for the duration of our last five-year strategy and has supported the cancer alliance to become one of the most well-regarded alliances nationally. We will ensure that there are clear plans for CCC to continue to host the CMCA and to support its important work as we prepare to join the UHL Group.

We will also continue to engage in joint work with the alliance, such as the critical work that we have started together through the Urgent Cancer Care Board. We will work with the alliance and other partners to continue to enhance urgent cancer pathways across Cheshire and Merseyside. 

3.3 NHS Cheshire and Merseyside 

We will continue to play an active role in Cheshire and Merseyside’s collaborative arrangements. We will continue to engage in the work of the Cheshire and Merseyside Provider Collaborative (formerly CMAST) and we will support the arrangements for provider collaboration as they evolve further. 

Over the last five years we have made a growing contribution to the diagnostic element of the patient pathway as part of our aim to improve cancer outcomes for our region. Working through CMAST, our role in diagnostics extended beyond programme leadership through our direct involvement in CDC delivery – first in partnership with Wirral University Teaching Hospital on the Clatterbridge Health Campus in Wirral, and then through the opening of our own CDC in Liverpool (following our acquisition of the former Rutherford Cancer North West building in Paddington Village).

We will continue to operate the Paddington Community Diagnostic Centre, developing referral pathways and exploring whether the CDC can offer additional diagnostic tests. 

3.4 Other collaborations 

We will continue to play an active role in other key collaborations, including university partners and the two clinical networks of which we are currently a part – the North West Radiotherapy Network and the North West Teenage and Young Adult (TYA) Network. We will also continue to explore and develop other partnerships where this delivers patient and organisational benefit.

Attract, retain and develop a highly skilled, motivated and inclusive workforce to provide the best care

We recognise that our people are our greatest asset. Their dedication, talent, knowledge and experience are at the heart of everything we do and have a big impact on the care that we provide. We want to continue to attract, retain and develop the brightest and best people – locally, nationally and internationally – through our reputation for excellence in patient care, research and education, and our commitment to the health, wellbeing and experience of staff.

4.1 Our People Commitment 

During the life of our last strategy, we developed our People Commitment. The People Commitment outlines our plans to build on our successes and continue to develop an inclusive and compassionate culture where all our staff can thrive. 

Our national NHS staff survey results over the course of the last strategy point to the success of the People Commitment and the work to deliver it. The People Commitment set out our priority areas of work and five broad commitments that served as statements of our ambition to be a great place to work. We will continue our work to deliver and embed these priorities and commitments.

Key priorities

We will continue to: 

• Promote equality, diversity and inclusion for all staff, tackling all forms of discrimination and removing inequality.
• Enhance leadership skills and capacity across all levels of the Trust.
• Recruit the brightest and the best people, with an emphasis on the harder-to-recruit groups such as oncologists, specialist nurses and radiologists.
• Develop new roles and new career pathways that support the sustainable provision of services.
• Provide a comprehensive reward and recognition package to retain and develop a highly skilled and flexible workforce.
• Foster an open, transparent and high-performing culture, where staff feel valued and recognised for their important contribution and feel empowered to raise concerns.
• Promote and maintain the physical and psychological wellbeing of our workforce so we continue to be an employer of choice.
• Achieve excellence in patient care, service delivery and cutting-edge research across the region through our excellence and expertise in education and training.

Our commitments 

• Looking after our people – Our ambition is to create an environment where people are supported and empowered to lead healthy lives and make informed choices that support their wellbeing and enable people to perform at their best.
• Developing our people – Our ambition is to develop compassionate and inclusive leaders and a culture of learning where our staff can grow and reach their full potential.
• Workforce for the future – Our ambition is to create a flexible and adaptive workforce, embed new opportunities across all staff groups and attract and retain the brightest and the best people.
• Our digital workforce – Our ambition is to embed digital workforce solutions and technology to support our people to become digitally enabled and connected.
• Valuing our people – Our ambition is to champion a culture where everyone has a voice that counts and feels welcome, supported and understood.

4.2 Developing our specialist workforce 

Our skilled and committed specialist workforce is key to our excellent patient outcomes and experience. Together, our nurses and allied health professionals (AHPs) make up a significant proportion of our workforce. We will develop and set out our vision for what excellent nursing and AHP care looks like at CCC. This will include how we develop our workforce, foster continuous improvement, and ensure that we deliver person-centred care.

Our education programmes are vital for developing our current and future workforce. The programmes are delivered by a range of different teams within the Trust. We will develop a comprehensive multidisciplinary education strategy to set out in one place our plans to continue to develop our specialist workforce for the future. 

4.3 Joining the UHL Group 

We acknowledge that our decision to come together with the other four providers of adult acute and specialist care in Liverpool in the UHL Group will be a major change for our workforce. We are committed to CCC remaining a great place to work as we join the UHL Group. We acknowledge that this change will affect some staff groups more than others. 

We will work to support our workforce through the transition into the UHL Group. We will work with group partners to develop communication and engagement plans that ensure that staff are informed and involved in changes that affect them. We will work with our partners to ensure that changes take place in accordance with an agreed set of principles and that there is an accompanying multi-year programme of organisational development to support the change.

We will closely monitor staff satisfaction and engagement to ensure that our strong performance of recent years is maintained and improved through our transition to a formal member of the Group. 

Be leaders in cancer research to improve outcomes for patients now and in the future

CCC is one of the UK’s leading cancer centres. We are committed to making ground-breaking research available to patients and helping to enhance understanding of this disease. We are committed to providing the best cancer care to the people we serve, and a strong research capability is essential to deliver this aim. Research studies offer patients a treatment choice and an opportunity to gain access to new therapies. They also improve the capabilities of our workforce and enhance how our staff deliver care.

5.1 A refreshed Research Strategy 

In 2021 we published our Research Strategy, which set out our plans to capitalise on the opportunity of our expansion into Liverpool and the partnerships that we had forged and deliver a step change in research at CCC. The delivery of this strategy progressed well despite a number of challenges, including the lasting impact of the COVID-19 pandemic.

The opening of CCC-Liverpool meant that we were able to expand our early phase trial capacity and include first-in-human and true phase I trials with dose escalations. These developments supported us to: 

• Retain our Cancer Research UK Experimental Cancer Medicine Centre (ECMC) status 
• Become a partner of The Royal Marsden’s National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC), and
• Become a partner in Liverpool’s NIHR Clinical Research Facility (CRF)

The 2021 Research Strategy had a clear focus on getting the infrastructure in place to enable strong research performance. We will refresh our Research Strategy to build on the successes of the previous strategy. The new strategy will set out how we will continue to deliver our vision against our key research priorities. 

5.2 Our key research priorities

While our refreshed Research Strategy remains in development, we anticipate that it will set out our ambitions and actions in several key priority areas.   

Academic, early phase, and complex research

• Focus on early-phase clinical research and complex academic studies.
• Develop and test novel therapies and innovations in medicine.
• Identifying site research groups with strength in research depth and delivery. 
• Establish ‘site research groups’ (SRGs) in areas with strong established or potential research depth and delivery.
• Focus on areas of excellence that conduct high-level fundamental and applied research.
• Foster collaboration between researchers and healthcare professionals for efficient translation from lab to patient care.
• Build robust, impactful studies through specialised expertise within SRGs.
• Identifying areas of clinical need in the region and growth portfolios.
• Align research with regional clinical needs by identifying gaps in treatment options or patient care.
• Develop a growth portfolio of research initiatives that address unmet healthcare needs.
• Ensure research is directly relevant to improving regional healthcare outcomes and quality of life.
• Targeting ‘home grown’ high-volume research.
• Focus on conducting high-volume, locally driven research.
• Leverage local expertise, resources, and patient populations for scalable research.
• Promote training of researchers and clinicians through large-scale studies.
• Continuing to diversify the portfolio with real-world, observational, and translational research.
• Expand the research portfolio with real-world data and observational studies.
• Include translational research to bridge the gap between laboratory discoveries and patient care.

5.3 Research and the UHL Group 

Our refreshed Research Strategy will also set out the opportunities that joining the UHL Group will have for CCC’s research, and cancer research more generally. It will also set out how we will prepare for joining the Group. There is already significant collaboration in place between partners in the Group, for example through the NIHR Liverpool CRF (see above) and the shared biobank, hosted by CCC.

The University of Liverpool has developed a single cancer research strategy and CCC is developing proposals for the development of a single cancer board for the UHL Group. These developments would support the alignment of NHS cancer research into a single point of focus. This will bring a clear opportunity for CCC to take an NHS leadership role for cancer research across the city. 

Deliver digitally transformed services, empowering patients and staff

The government has indicated that its upcoming 10 Year Health Plan will seek to reshape healthcare in the UK through three shifts in care. One of these shifts will be from analogue to digital.

Our Be Digital Strategy 2023 to 2025 set out our digital ambitions and our route to achieving them. The strategy outlined our priorities against four themes:

• Digitally transforming cancer services
• Empowering cancer patients and carers
• Empowering staff, and
• Data-driven cancer research and innovation

The strategy was underpinned by a foundational partnership where the Digital Team set out its commitment to enabling great care across the Trust, and CCC staff commit to make the most of digital tools and engage with how to build and develop them. 

We will continue to deliver against the four themes in the Be Digital Strategy while continuing to work collaboratively with our partners, particularly the trusts that make up the UHL Group. 

6.1 Digitally transforming cancer services

We will work to digitally transform services to deliver high-quality care. Using leading approaches to digital transformation, we will optimise our digital clinical systems to improve how we deliver care. 

By digitally transforming cancer services, we will promote a new, more efficient, joined-up care model across the region. We will know we have succeeded when we have embedded data and digital solutions across our sites and services to improve care, and when we have secured an intuitive set of core clinical digital systems that provide good quality data. 

6.2 Empowering cancer patients and carers

We will implement digital solutions to support people’s choices about how they access care, keep patients and their family and carers connected and in control, and support care at home. 

By empowering patients, we will ensure our service users feel safe and in full control of the care they receive. We will know we have succeeded when patients and their carers are able to manage their appointments and access their clinical information easily, and when we have supported more patients with their care and treatment at home, and people can plan and manage their care effectively through a digital solution. 

6.3 Empowering staff

We will equip staff with the skills and tools to ‘Be Digital’ in the provision of safe, high-quality care across our services, working together to great user-friendly solutions.

By empowering staff, we will provide our workforce with the right equipment and the appropriate digital skills to best support their line of work. We will know we have succeeded when staff are playing an active role in the design, build and delivery of digital solutions, and when staff are confident in how to use their digital tools and systems, and staff say that digital training has been relevant to their role.

6.4 Data-driven cancer research and innovation

We will horizon-scan and harness the power of data to drive planning activities in research and innovation and shape future services. 

By shifting to being a truly data-driven organisation, we will harness data to inform better present and future care delivery through investing in research and innovation. We will know we have succeeded when we have used data and analytics to improve clinical pathways, when we are horizon-scanning and harnessing data science to plan ambitious research and innovation projects, and when we are making data-driven decisions about services, performance and finance. 

6.5 Developing digital within the UHL Group 

There is a significant opportunity to work together on digital developments as part of the UHL Group. There is the opportunity to address, over time, the fragmentation of our different digital systems, enhancing interoperability and supporting more effective information sharing. 

Operating within the UHL Group will allow us to use digital as a key enabler to drive meaningful improvements in all aspects of patient care. Shared digital platforms, such as converged electronic patient records (EPR) and other clinical systems, improve care coordination and patient management, facilitating seamless care transitions and reducing errors. 

We will support the integration of digital systems across the UHL Group, including the introduction of a single EPR, to streamline workflows and support decision-making between back-office operations and front-line workers, improving clinical safety and patient communication. 

Be open to doing things differently, encouraging innovation and exploring opportunities that improve patient care

We will continue the work to foster innovation within CCC as set out in our Innovation Strategy. We will also develop a clear programme to continue to support emergent technology such as artificial intelligence and robotic process automation. In addition to this we will continue to maximise the benefit of our innovative organisational models and continue to innovate within our clinical services. 

7.1 Our Innovation Strategy 

We will continue our work to embed innovation in CCC through the delivery of our Innovation Strategy. The strategy is guided by three strategic themes and is supported through a programme of work dedicated to increasing awareness, education, and developing an innovative mindset.

• We will continue to foster a culture of innovation, by raising awareness of innovation across the Trust and equipping staff with the skills and permission to innovate. 
• We will continue to nurture new innovations, by putting in place supporting processes and governance and helping our staff to secure funding for innovations.  
• We will continue to support adoption of innovation by forming partnerships with academic and commercial organisations and establishing links between different work. 

7.2 Embracing technological innovation

We will embrace cutting-edge technological innovations where they enhance patient care and make our work more efficient. 

• We will continue to explore the potential of artificial intelligence (AI) to support our workforce in ensuring diagnostic accuracy and personalising treatment plans. 
• We will also continue to explore robotic process automation (RPA), which has the potential to automate repetitive and time-consuming administrative tasks, such as appointment scheduling and patient record management. 

By looking to embrace these technological advancements, we aim to provide a more seamless and patient-centred experience for patients, and potentially better outcomes and higher patient satisfaction.

7.3 Innovation in patient care 

We have a history of developing innovative treatments and designing new models of care, such as our innovative and award-winning Clatterbridge in the Community service, which we will continue to develop.

We will continue to encourage and support further innovation in patient care. For example: 

• We will develop new models of specialist ambulatory care across our clinical teams to enhance patient convenience and relieve pressure on our inpatient beds. 
• Following the successful development of the CAR T-cell therapy service, we will work with our partners to explore the feasibility of CAR-T cell manufacturing at CCC. 

7.4 Innovation in the UHL Group 

The area of research, development, innovation and commercialisation has been identified as one of the key opportunities for the emerging UHL Group. There is clear potential to increase Liverpool’s strength in this area by leveraging a larger patient base, driving clinical innovation, and attracting external investment into the city. Through the UHL Group there is potential to accelerate the development of innovative tools and practices by our talented staff and maximise commercial opportunities to optimise patient care. 

We will ensure that our experience of developing and delivering our Innovation Strategy is fed into the development of a wider innovation strategy for the UHL Group. We also play a full part in the development of innovation structures and process for the Group.   

7.5 Maximising our innovative organisation models 

We have two wholly owned subsidiaries and a joint venture as part of the wider CCC group. We will continue to develop and grow these innovative ventures to support the NHS care that we deliver. We will also explore whether there is potential to make use of these innovative models within the UHL Group.

• Our estates and facilities management subsidiary, PropCare, continues to build on its core strengths and explore opportunities to work with NHS partners where this supports the Trust in its delivery of its objectives or makes a positive financial contribution. 
• Clatterbridge Pharmacy Limited (CPL) - trading as PharmaC - is our community pharmacy and logistics subsidiary. CPL has seen considerable expansion in recent years, launching a logistics service on behalf of the Trust and taking over the delivery of the outpatient dispensary services for Liverpool University Hospitals NHS Foundation Trust (LUHFT). CPL will continue to scope future opportunities, including to work with partners elsewhere in Liverpool and beyond in the provision of outpatient pharmacy services. 
• The Clatterbridge Private Clinic is a joint venture between the Trust and the Mater Private. Its continued growth has been important in delivering financial sustainability for the Trust. We will explore the opportunities for our joint venture to continue to grow and to potentially support the UHL Group’s approach to private patient activity. 

7.6 Explore opportunities 

We have a track record of recognising and harnessing opportunities as they present themselves. The biggest example of this in the last five years was the acquisition of the former Rutherford Cancer Centre North West to allow us to rapidly set up the Paddington Community Diagnostic Centre.  

We will explore opportunities as they arise, making the most of this strong position. We will also take opportunities without any commercial gain where these enhance and strengthen our national and international reputation and brand.