28 October 2026
Moondance Cancer Initiative responds to the National Cancer Strategy for Wales
Moondance Cancer Initiative welcomes the development of a new National Cancer Strategy for Wales and the opportunity to contribute to it.
Established in 2019, Moondance Cancer Initiative is a philanthropically funded not-for-profit organisation solely focused on improving cancer outcomes in Wales. Since inception, we have invested more than £6 million in activity across Wales, working alongside NHS colleagues and wider partners to introduce new diagnostics and treatments, improve cancer pathways, strengthen research and support people leading change within cancer services.
Our response is informed by our practical experience of working alongside colleagues and teams in the NHS, supporting change across different parts of the cancer pathway, across organisational boundaries and across Wales. It has given us unique insight into both the opportunities for improving cancer care and the realities of delivering change, including how challenging it can be to turn proven approaches, evidence and clinical ambition into sustained improvement within services already under significant pressure.
Our submission makes six central recommendations:
Provide clear prioritisation around where Wales can make the greatest difference. There is no shortage of ideas, evidence or innovation. The strategy should be clear about where it expects effort and resources to be focused, prioritising the changes most likely to deliver meaningful and sustained improvement in outcomes.
Set strong expectations around collaboration and shared delivery. The future of cancer care will increasingly depend on shared workforce and infrastructure, networked expertise, and regional or national provision. These approaches can improve access and make better use of scarce skills and capacity. Performance measures and organisational expectations should support that direction.
Broaden how success is understood and measured. The Single Cancer Pathway provides an important measure of timeliness, but it is by necessity a blunt measure. If it remains the dominant conversation between Health Boards and Welsh Government, there is a risk that longer-term work to improve cancer outcomes is displaced by immediate operational pressure. The strategy should create accountability not only for current performance, but for demonstrable progress towards the longer-term change it is seeking to deliver.
Ensure there is no further delay in the rollout of lung cancer screening. Lung cancer remains the leading cause of cancer death in Wales, accounting for around one in five cancer deaths. Targeted lung screening offers a significant opportunity to diagnose earlier, improve survival and reduce inequity.
Establish viable routes from evidence and initial implementation into sustainable NHS provision. Our experience supporting new services and approaches has shown that even where there is strong clinical and financial value, finding a sustainable route into NHS provision can remain difficult. As cancer care becomes more specialised, the strategy should be clear how services offering significant benefit can move into sustainable NHS provision and support equitable access.
- Create the conditions the NHS needs to deliver. The strategy should give people across cancer services the confidence, permission, time and space to act. Implementation capacity needs to be recognised as a vital requirement for improvement. Change is most likely to succeed when people delivering services help shape how it works in practice and have the capacity and support to implement it.
The National Cancer Strategy should therefore be designed not only around what Wales wants to achieve, but around what will enable NHS organisations and the people working within them to deliver it.
You can read Moondance Cancer Initiative’s full response below.