The National Cancer Plan is Here: Digital-First Care Is Central to Delivery

Last week, the long-awaited National Cancer Plan for England was released — the first dedicated cancer strategy since 2015, timed to coincide with World Cancer Day.

The need for a new approach has never been more urgent. We have witnessed 100,000 more cases of cancer recorded in 2019 than in 2001. Cancer Research UK forecasts half a million new cases annually by 2040. England's cancer survival rates, while improving, continue to lag behind comparable nations. As Lord Darzi's 2024 report confirmed: we are diagnosing too late, treating too slowly, and losing too many people to the disease.

Earlier diagnosis and treatment could change this trajectory. A substantial proportion of cancer cases are preventable. We therefore have much to gain from a shift away from responding to and treating ill health, towards one that actively reduces avoidable risk and strengthens early detection.

The plan sets an ambitious headline target: three in four cancer patients diagnosed from 2035 should be cancer-free or living well after five years. This will be achieved by reducing waiting times, diagnosing more cancers at an early stage, treating rarer cancers in specialist centres, improving access to new treatments and clinical trials, and providing better support for patients during and beyond treatment.

Additional funding includes £200 million for the 21 Cancer Alliances in 2026–27 to address inequalities in cancer diagnoses, and £2.3 billion to fund an expansion in community diagnostics and four additional aseptic production facilities. Collectively, these commitments make the Plan the most substantial strategic commitment to cancer services in a decade.

The plan expects all providers to use the Federated Data Platform or equivalent technology to improve operational performance. A rollout of the Single Patient Record will consolidate imaging, pathology, genomics, and care plans to support real-time multidisciplinary team decision-making.

The NHS App will be transformed into a digital portal for cancer care, where patients will be able to book screening appointments, access prehabilitation programmes and clinical trials, view their patient records and Personalised Cancer Plan, and provide feedback on their care. The App will also present personalised prevention advice drawing on genomic, lifestyle, and wearable data, delivering real-time prompts as risk changes — shifting patients from passive recipients of care to active managers of their cancer risk.

What is most significant is that for the first time, the National Cancer Plan makes a clear national commitment to providing digital-first prehabilitation for all cancer patients as a core component of the cancer pathway, positioned as integral to treatment, recovery, and long-term quality of life.

Prehabilitation is structured exercise, nutrition, and psychological support delivered ahead of surgery or chemotherapy to improve patients' physical and mental fitness. The concept is straightforward: patients who start treatment with higher functional capacity recover better, experience fewer complications, and spend less time in hospital. Yet despite a growing body of evidence, prehabilitation has remained fragmented across the NHS, delivered inconsistently, available to some patients and not others, often dependent on local initiative rather than strategic policy.

The National Cancer Plan changes this. It commits to a universal, digital-first prehabilitation offer by 2028, and an explicit commitment to making prehabilitation a commissioning standard. For the first time, prehabilitation will be part of expected care pathways.

In the words of Wes Streeting, Secretary of State for Health and Social Care:

"For too long, we've treated the tumour and left patients to figure out the rest on their own. That ends now."

This significant step follows the publication of Macmillan Cancer Support's Clinical and Implementation Guidelines for Prehabilitation — based on an evidence base of over 9,000 papers, representing the most comprehensive clinical framework for cancer prehabilitation to date.

The evidence has shown prehabilitation consistently demonstrates reductions in hospital length of stay, improved recovery, reduced surgical and treatment-related complications, and enhanced physical function and quality of life. Higher functional capacity before treatment predicts better recovery after it, correlating directly with fewer postoperative complications and shorter hospital stays.

For the NHS under sustained pressure, prehabilitation offers direct operational benefits. Shorter hospital stays improve bed and elective capacity. Fewer postoperative complications reduce emergency presentations, unplanned readmissions, and the subsequent care burden.

The Plan acknowledges that delivering prehabilitation to all cancer patients requires digital delivery as a necessity for scale — but also recognises that digital delivery alone isn't sufficient. It requires multimodal delivery and partnership with digital health providers capable of delivering prehabilitation at the scale required for NHS rollout.

Prehabilitation depends on behaviour change. Technology can support adherence, but it also requires personalised goal-setting and structured support for ongoing engagement. Evidence from cancer populations shows that human coaching and peer support drive adherence to exercise and nutrition plans. The most effective digital prehabilitation will amplify these relationships, using technology to coordinate and scale human support rather than replace it.

Alvie Health's prehabilitation platform is one example integrated into NHS cancer pathways. Its model is deliberately human–digital hybrid: the digital layer standardises and scales access to support, while built-in human facilitation helps people with lower digital literacy. Equity is monitored in real time, and human health coaching works alongside digital delivery. This is an example of digital infrastructure that enables human support to be deployed more strategically and cost-effectively.

Research demonstrates that digital health interventions consistently benefit more affluent groups while disadvantaging others by age, income, ethnicity, and digital literacy. With the NHS App increasingly positioned as the central point for accessing care, without targeted equity work, digital cancer pathways risk widening rather than reducing disparities.

The Cancer Plan's equality impact assessment acknowledges early diagnosis rates are already lower among ethnic minorities and deprived communities, yet "delivering care closer to where people live" doesn't automatically mean it's accessible to how people live.

For the digital ambitions in the plan to succeed, equity infrastructure must be built alongside technology infrastructure. Evidence shows "digital health navigators" — support staff who help patients engage with technology — significantly improve equity outcomes. Co-designing digital services with diverse patient populations, active support for devices, data and broadband, and providing culturally responsive content are essential components of a universal offer.

The Plan depends on robust digital infrastructure, yet widespread use of legacy systems and fragmented architecture persists. Delivery requires skills and capacity the NHS workforce is currently constrained in providing. It depends on consistency across 21 Cancer Alliances operating within different financial and organisational contexts.

The Tony Blair Institute for Global Change report on the NHS App notes that without prioritising quality and integration capability, the NHS App risks becoming another fragmented service where patient experience depends on location — a particular risk for cancer care, where consistency across Cancer Alliances is essential.

The National Cancer Plan is the most substantive strategic commitment to cancer services in a decade. It commits to more patients surviving through earlier diagnosis, faster treatment, better support, and prehabilitation as standard. These are the right ambitions.

The Plan is only the first step. What matters now is whether we can translate this into practice and deliver a genuine turning point for cancer care in England.