A system-wide plan to transform outcomes and experiences for people living with metastatic cancer.

Why do we need a metastatic cancer strategy?


Our overarching aim is simple but vital: to improve care for all patients living with metastatic cancer. This includes strengthening non-emergency care pathways, improving clinical outcomes, and enhancing the overall experience for patients and service users.

What is metastatic cancer?

Metastatic cancer occurs when cancer spreads from its original (primary) site to other parts of the body. It is often more complex to treat than localised cancer, and care typically focuses on controlling the disease, managing symptoms, and maintaining quality of life rather than achieving a cure.

Prognosis varies widely and depends on several factors, including the type and origin of the cancer, the extent of its spread, and the individual’s overall health. Encouragingly, advances in treatment and supportive care mean that many people with metastatic cancer are living longer than ever before. Innovations such as genomic profiling, targeted therapies, and immunotherapy are continuing to transform outcomes and offer new hope for the future.

How will we deliver this strategy?

Delivering meaningful change is a shared responsibility. This strategy is not owned by a single team or programme, and it will be embedded across all workstreams.

We will aim to take a metastatic perspective in everything we do, from early diagnosis through to treatment, performance, personalised care, research, and workforce development.

Inclusion will be our starting point. When planning programmes of work and setting priorities, we will actively include, rather than exclude, people living with metastatic cancer.

Quick Links

Our strategy

Primary care and early diagnosis

Patient engagement about signs and symptoms

  • Develop patient-facing communication assets around basic understanding of metastatic disease and terminology
  • Adopt and adapt SUR-designed metastatic breast cancer symptoms infographic for all relevant tumour groups

Primary Care education and engagement including:

  • Signs and symptoms of metastatic disease
  • Impact of early diagnosis of metastatic disease on patient outcomes and avoiding emergency admissions
  • Role of primary care in the holistic support of metastatic patients

Treatment and performance

Ensuring metastatic patients are visible in the data

  • Support MDMs to correctly code de novo AND secondary metastatic diagnoses
  • Explore the feasibility, and understand the BI requirements, of building metastatic digital fingerprints from event-level data to create a metastatic patient database

Equity of access to timely clinical decision-making

  • Identify and reduce variation of diagnostic turnaround time for metastatic diagnosis and progression
  • Develop and test multi-speciality oligometastatic MDMs
  • Develop MDM referral guidelines for brain/liver/lung/bone metastases

Personalised care

Applying principles of PSFU to metastatic pathways

  • Ensure education/resource offer to patients/staff around diet, exercise, prehab is inclusive of metastatic patients
  • Develop EOT alternative for patients living with metastatic disease e.g. COT (Continuation of Treatment) clinics
  • Ensure access to psychological support
  • Promote NHS and VCSE health and wellbeing support offers to improve reach to the metastatic population
  • Expand ETIP (Endocrine Therapy Improvement Programme) to all relevant specialty pathways
  • Apply learning from Cancer Improvement Collaborative Project (PC for metastatic colorectal cancer) and WWL innovation project (metastatic patient experience of health care), to the wider system
  • Design metastatic pathways within the existing system-wide PSFU digital tracking system

Genomics

  • Ensure equitable and timely access to testing, as per the National Genomic Test Directory

Equity of timely access back into the cancer system

  • Review and reform the current primary-to-secondary care referral pathway for suspected metastatic symptoms and harness EMIS to provide GPs with accessible digital information
  • Explore feasibility of direct access to secondary care for patients with metastatic symptoms e.g. algorithm-led metastatic symptom hotline/AI solutions
  • Explore existing resources in localities and their role in supporting timely access back into secondary care e.g. NSS pathways/CDC

  • Improve equity of access to clinical trials for patients with metastatic disease

Workforce and education

Metastatic workforce

  • Collaborative working with the Christie to regularly review the metastatic workforce (including named
    keyworkers and psychological support staff), adapting to support new ways of working
  • Build on Christie-led initiatives to increase workforce efficiency e.g. EPROMs/Drug-specific
    clinics/systemwide working
  • Build on alliance-led initiatives to increase workforce efficiency e.g. GPCR pilot/clinical admin navigators

Education needs

  • Scope education needs of patients and staff, building on service user scoping of the
    Personalised Care team
  • Develop resources to support patient, primary care and secondary care metastatic
    education
  • Create training opportunities for staff in communication and psychological support skills

Communication Principles

  • Incorporate metastatic patients and language into communication assets and increase person-centred content featuring metastatic patients, including ‘primer film’ of metastatic patients’ experience
  • Raise awareness of the Cancer Alliance programme of work to improve metastatic cancer care

Work done

  • This piece of work including a link to more information
  • Another project here
  • A third project here if needed

Videos

Here are some useful videos with guidance on how to use them.

News: UK first metastatic strategy transforms cancer care in Greater Manchester

Andy Burnham, the Mayor of Greater Manchester with a microphone speaking at a conference.

December 11th, 2025

A pioneering strategy is set to revolutionise care for thousands of people living with metastatic cancer in Greater Manchester, giving them the support and voice they’ve long deserved. The new strategy – a UK and NHS first – sets out a bold vision to transform care for people living with metastatic disease, ensuring earlier diagnosis, joined-up care and the personalised support they need to live well for longer. […] 

Read the full story: UK first metastatic strategy transforms cancer care in Greater Manchester – Greater Manchester Cancer Alliance