From scoping to strategy: building a sustainable cancer workforce for North East London
An end-to-end 18-month programme covering the whole cancer pathway across three acute trusts - from evidence base through to a five-year workforce strategy launched publicly with the Alliance.
North East London Cancer Alliance
End-to-end workforce strategy programme
Three NHS trusts · whole cancer pathway · all professional groups
18 months (November 2024 - April 2026)
A cancer workforce under structural strain - across the whole pathway
North East London Cancer Alliance serves one of the most diverse and deprived populations in England. By 2030 the number of people living with and beyond cancer in North East London is projected to rise by 53% - from 43,000 to nearly 66,000. Yet the cancer workforce was already stretched to its limits.
Vacancy rates in specialist nursing were running at 15% locally against a 12% national average. Histopathology had seven unfilled consultant posts. Nationally, a 10% shortfall in therapeutic radiographers was forecast to worsen, and only 3% of histopathology departments in England had sufficient staff to meet demand. The picture was one of compound structural fragility - not a single shortage but overlapping gaps across diagnostics, oncology, nursing, AHPs, pharmacy and personalised care.
NELCA''s leadership recognised that responding to this piecemeal - through individual trust recruitment drives or short-term project funding - would not be sufficient. What was needed was a comprehensive, evidence-based workforce strategy covering the whole cancer pathway, grounded in honest assessment of both supply constraints and population health demand.
A phased, system-wide programme from evidence to actionable strategy
Health Dynamics designed and led a structured three-phase programme: beginning with the most thorough workforce scoping and mapping exercise NELCA had undertaken, moving into deep dives with the nursing and AHP workforces, and culminating in a comprehensive five-year Cancer Workforce Strategy - complete with workforce risk heat map, scenario modelling and an annually phased action plan.
Throughout the programme, we worked directly alongside NELCA''s clinical and programme leadership, the three acute NHS trusts (Barts Health, BHRUT and Homerton Healthcare), expert reference groups, clinical leads across all tumour sites, ICB colleagues and the broader stakeholder community. Our methodology combined rigorous quantitative analysis of ESR and national workforce data with deep qualitative engagement.
The resulting strategy aligns with NELCA''s own inequalities strategy, its digital and AI strategy, and the North East London ICB''s 2024-2028 People and Culture Strategy - positioning the cancer workforce programme as a system-level endeavour, not a trust-level exercise.
How the programme was delivered
Scoping & Mapping
Nov 2024 - May 2025
134-slide comprehensive workforce scoping and mapping report covering all professional groups, tumour sites and pathway stages. Population health demand analysis, ESR data modelling, stakeholder engagement across PDGs, ERGs, Clinical Boards and Lead Clinicians. Identified key workforce risks across nursing, oncology, histopathology, endoscopy, radiology and radiotherapy.
Deep Dives
Jun - Sep 2025
Structured HEE STAR-framework deep dives into the cancer nursing and AHP workforces, with dedicated workshops across all three trusts. Scenario modelling for sustainable workforce futures. Identified supply, training, attraction and retention pressures by professional group with illustrative STAR bridge outputs.
Workforce Strategy
Sep 2025 - Apr 2026
Full Cancer Workforce Strategy - national and local supply analysis, structural deficit benchmarking against other Cancer Alliances, workforce risk heat map, five-year scenario modelling, recruitment and retention framework, education and training recommendations, digital transformation workforce implications, and an annually phased action plan.
What we delivered
Workforce Scoping & Mapping Report
Comprehensive baseline across the whole cancer pathway - population health demand, performance data, ESR workforce analysis for all three trusts, national benchmarking, specialty-specific risks for every tumour site, and impact assessment of current workforce projects.
Cancer Nursing Deep Dive
Structured workforce development planning for cancer nursing across Barts, BHRUT and Homerton - covering CNS vacancies by tumour group, fixed-term funding risk, age profiles, turnover trends, sickness data and illustrative scenario modelling for a sustainable nursing workforce.
AHP Workforce Deep Dive
In-depth analysis of the Allied Health Professional cancer workforce using the HEE STAR transformation framework - identifying supply, training, attraction and retention gaps across physiotherapy, dietetics, occupational therapy, speech and language therapy, and radiotherapy.
Workforce Risk Heat Map
Priority-ranked visual mapping of all identified workforce risks across professional groups and tumour sites - enabling NELCA to direct investment and intervention to where workforce fragility poses the greatest risk to patient care and pathway performance.
Five-Year Workforce Scenarios
Annual workforce change modelling across five scenarios, incorporating turnover, vacancy fill, digital efficiency gains, new roles, apprenticeships and skills mix change - providing a practical planning tool aligned to NHS Medium-Term Planning requirements.
Cancer Workforce Strategy & Action Plan
The programme''s culminating output - a comprehensive strategy with national policy alignment, structural deficit analysis, service model and digital transformation implications, recruitment and retention recommendations, education and training framework, and an annually phased action plan.
The depth of what we found
Workforce risks identified across the whole pathway
Phase 1 scoping identified overlapping workforce shortages that no single trust could resolve in isolation. Critical shortfalls were documented in: clinical and medical oncology (15% national consultant shortfall projected to worsen to 2029); specialist cancer nursing, with CNS caseloads doubling in some areas over three years; histopathology, with seven unfilled consultant posts and a 21% increase in workload against 2% workforce growth; therapeutic radiography (10% national shortfall, high Band 3-5 turnover of up to 20%); radiotherapy physics (7% scientist shortfall, with 34% of linac engineers due to retire within five years); pharmacy (vacancy rates of 19-21%); and endoscopy, where room closures due to workforce gaps were limiting capacity despite expanded Community Diagnostic Centres.
The deep dives added a human dimension to the data: CNSs describing their role as a "career cul-de-sac" without visible progression; AHPs working in corridor spaces without clinical room access; staff completing advanced practice qualifications with no corresponding role available; small specialist teams absorbing sickness absence with no resilience whatsoever. These systemic pressures were not failures of individual trusts - they were structural features of a workforce that had not been planned at system scale.
Specific to North East London''s population
North East London has a greater concentration of the most deprived areas than any other part of Greater London. The number of people living with cancer is projected to rise by 53% by 2030. Cancer incidence, stage at diagnosis, and patient experience all vary significantly by ethnicity and deprivation - meaning that every vacancy in specialist nursing, personalised care or psycho-social support carries a disproportionate impact on the most vulnerable patients. The workforce strategy explicitly embeds health equity as a core planning principle, linking directly to NELCA''s inequalities strategy.
What changed
System-level foundation
NELCA now has the most comprehensive evidence base for its cancer workforce of any Cancer Alliance in London - spanning all professional groups, all three trusts, and the full pathway from prevention through to end-of-life care.
Decision-ready intelligence
The workforce risk heat map and structural deficit analysis give NELCA''s leadership a clear, prioritised view of where to direct investment - moving the Alliance from reactive gap-filling to proactive workforce planning.
A five-year framework, publicly launched
The scenario modelling and annually phased action plan provide a practical planning tool aligned to NHS Medium-Term Planning requirements, enabling NELCA and its three trusts to plan workforce interventions year by year. The strategy was launched publicly on the NELCA podcast - see below.
Podcast - Launching Our Workforce Strategy
The Cancer Workforce Strategy was launched publicly through a joint episode of the NELCA podcast, featuring Yvonne Beadle (Workforce Programme Manager, North East London Cancer Alliance) in conversation with Matt Morris (Transformation Director, Health Dynamics). The episode covers the ambition of the strategy, the collaborative approach behind it, and what happens next across the three acute trusts.
Working with Alison and Matt at Health Dynamics on the development of our workforce strategy has been a genuinely positive experience. Their expertise and insight guided us seamlessly through the process, resulting in a clear, practical strategy that has been embraced across the system. Alison's flexible and personable approach made collaboration straightforward - she built strong relationships, gathered valuable intelligence and data, and skilfully translated complex, nuanced information into meaningful, actionable outputs. We would not hesitate to work with Alison, Matt, and the wider Health Dynamics team again.
Yvonne Beadle, Workforce Programme Manager, North East London Cancer AllianceServices delivered
Cancer workforce strategy · Workforce scoping & mapping · HEE STAR deep dives · Scenario modelling · Risk heat mapping · Stakeholder engagement · Health inequalities
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