The publication of England’s National Cancer Plan marks a deliberate attempt to re-establish cancer as a national strategic priority. And, Ministers have been clear that Denmark’s model of reform has been influential in shaping the Plan, reflecting a wider recognition that they have achieved some of the most sustained improvements in cancer outcomes among comparable health systems in recent history.
In the mid-1990s, both Denmark and the UK were among the weakest performers on cancer survival across high-income countries. Since then, their trajectories have diverged markedly.
Denmark’s long-term approach to cancer reform has delivered substantial improvements which places outcomes much closer to the leading international performers, whilst England’s survival rates remain lower and progress has been slower and more uneven.
Differences are also evident in how quickly patients move through the system. Denmark operates standardised cancer pathways with a national expectation that treatment should begin within around two weeks of diagnosis. Where these standards cannot be met, patients have enforceable rights to transfer to another provider, or even another country, with costs covered by the Danish health system.
In England, cancer waiting times are significantly longer. The long-standing target is for 85% of treatment to begin within around 62 days of an urgent cancer referral – a standard that has been consistently missed since 2015. Delays in diagnosis and treatment remain a major contributor to poorer outcomes, reinforcing the importance of earlier diagnosis and faster access as central priorities of the National Cancer Plan.
Ultimately, Denmark’s success has not been driven by a single plan or reform. Instead, it reflects a long-term, cumulative approach to cancer policy spanning more than two decades. Comparing England’s new Plan with Denmark’s broader cancer strategy highlights important similarities in direction of travel, as well as structural differences that will shape what is achievable in practice.
Different starting points
Denmark placed cancer at the centre of national health policy from 2000 through a series of five consecutive cancer plans, each designed to build on the last. As a result, Denmark has matured cancer care across the country with well-established diagnostic pathways, tightly controlled waiting times, embedded national standards, and routine use of population-level data and registries. Much of Denmark’s policy effort is now focused on refining care, improving quality of life, reducing unwarranted variation, and embedding personalised medicine.
Whilst England’s National Cancer Plan is by no means a first – we have seen a succession of plans and initiatives over the last 25 years but due to competing priorities and political distractions, we haven’t been able to maintain momentum of that period. This means that, by contrast, England starts from a more pressured baseline with persistent challenges around workforce capacity, diagnostic infrastructure, persistently missed waiting time standards, limited access to personalised treatment, and widespread inequalities in outcomes. The Plan therefore has the challenging role of combining recovery with reform: restoring performance while simultaneously trying to modernise the system.
A shared commitment to whole-pathway cancer care
A core similarity between England’s Plan and Denmark’s long-term approach is the focus on a whole-pathway model of care. In Denmark, this shift has unfolded gradually over successive plans, expanding from acute treatment to diagnosis, survivorship, prevention, and end-of-life care.
England’s National Cancer Plan reflects the same philosophy albeit in one singular Plan. Commitments to personalised cancer plans, improved support for people living with and beyond cancer, and a greater role for community-based services mirror approaches that are already embedded in Denmark.
In both systems, improving the experience and quality of life of people with cancer is treated as a core outcome, not an optional add-on to clinical care.
Data, standardisation and personalised medicine
Denmark’s cancer strategy has been characterised by a strong emphasis on standardisation underpinned by data. National clinical registries and quality databases have enabled Denmark to monitor performance, reduce variation and redesign services over time. More recently, this infrastructure has supported the expansion of personalised medicine, including the use of genomics and real-world evidence to tailor treatment.
England’s National Cancer Plan adopts a similar approach. It places data, digital infrastructure, and innovation at the centre of its vision, with ambitions to link datasets across the cancer pathway, expand genomic testing, and accelerate access to advanced therapies and clinical trials.
The difference lies in the stage of development. Whilst England has established some of the strongest cancer data collation, it is still in the process of building the capabilities to collect this data in a timely manner to inform services or run analysis. Similarly, there is a need for great depth of data collation – for example in genomics, there is no collation of turnaround times data available to understand the performance of these vital services. Whereas Denmark is at a stage of extending and deepening an established data-driven model.
Governance, accountability and delivery
Denmark’s long-term approach to cancer has benefited from relatively simple governance arrangements. National political ownership, clear standards, and delivery through regions and municipalities have provided continuity over time. Crucially, each cancer plan has reinforced the expectation that cancer reform is a shared responsibility across sectors, including primary care, hospitals, local government, and patient organisations.
England’s National Cancer Plan operates within a far more complex institutional landscape. The Plan places significant emphasis on strengthening accountability through Cancer Alliances, ICBs, and designated leadership roles at trust level. This reflects the need to coordinate action across multiple organisations with different incentives and pressures.
While both systems recognise the importance of cross-sector collaboration, England’s challenge is less about designing policy and more about sustaining alignment and delivery across a fragmented system and rapidly evolving ecosystem. As we saw with the original establishment of NHSE, and will now see with the merger of DHSC and NHSE, the risk of both distraction from implementation and the transition of knowledge between these organisations could act as a barrier to delivery.
Prevention and early diagnosis
Prevention has been a consistent feature of Denmark’s cancer strategy, supported by population-level interventions and regulation aimed at reducing exposure to known cancer risks. Over time, this has been complemented by strong primary care pathways and rapid access to diagnostics.
England’s Plan similarly emphasises prevention and earlier diagnosis, but with a greater focus on catching up. Expanding screening, increasing diagnostic capacity and targeting underserved populations are central to reducing late-stage diagnosis, which remains a key driver of poorer outcomes.
Again, this difference reflects starting conditions: Denmark is consolidating gains, while England is still closing significant gaps.
What Denmark’s experience implies for England
The comparison between England’s National Cancer Plan and Denmark’s long-term approach suggests that the two are aligned in terms of strategic direction. Both see cancer as a system-wide challenge requiring sustained attention, whole-pathway reform, and the intelligent use of data and innovation.
The key distinction is temporal. Denmark’s achievements are the product of continuity over 25 years, with successive plans reinforcing national priorities and embedding reform. England’s Plan represents an important reset, but its success will depend on whether it becomes the foundation for a sustained programme of cancer reform rather than a one-off intervention.
If England is to replicate Denmark’s trajectory, the most important lesson may not be any individual policy choice, but the need for long-term commitment, institutional memory, and consistent national leadership on cancer.
