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At a meeting of the NCCP Executive Committee in January, the minutes of which were seen by MI through Freedom of Information, it was noted that as a result of changes to the usual finance model, oncology funding has been provided in the base budgets of hospitals, rather than through the NCCP.
“It will not be visible to hospitals that funding is from NCCP, decreasing NCCP leverage,” according to the minutes.
In 2017, the majority of NCCP funding was committed up-front to the designated cancer centres.
Most of the funding in question is for staff and services.
A small amount, €3 million in the HSE National Service Plan for 2017, is reimbursed by the NCCP to the hospitals to cover growth in expenditure on cancer drugs in use prior to 2013.
The reimbursement of new high-cost cancer drugs approved since 2012 is facilitated through a separate system, the Oncology Drug Management System (ODMS).
In terms of cancer funding going into base budgets for 2017, National Director of the NCCP Dr Jerome Coffey admitted to MI recently that some hospitals had queries about their cancer funding, as it was not as “visible” as in previous years.
“The NCCP has monthly meetings with each of the cancer centres, primarily focused on clinical activity and service development,” he explained.
“In addition, it provides written details of budget allocations. Given the very significant increase in cancer incidence projected by the National Cancer Registry, the NCCP is actively planning to scale-up cancer services, primarily in the cancer centres. This approach will serve to increase leverage over time.”
It is envisaged the funding arrangements between the NCCP and hospitals will be strengthened in future years under the National Cancer Strategy 2017-2026.
The relevant recommendation states that: “The central role of the NCCP in ensuring that the National Cancer Strategy 2017-2026 is implemented across the health service will be strengthened, including through the use of Service Level Agreements, and through a direct role in financial allocations to the Hospital Groups under activity-based funding.”