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Framework for Effective Cancer Management

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The Framework for Effective Cancer Management (FECM) is a guidance tool for cancer teams across NHS Scotland to support earlier and faster cancer diagnosis. It was refreshed in March 2025 and now includes 10 key elements that must be considered when planning cancer services.  

The 10 key elements of the Framework 

  1. Corporate responsibility 

  1. Collective strength 

  1. Patient voice and user experience 

  1. Demand and capacity 

  1. Optimal referral 

  1. Initiating the pathway 

  1. Optimal diagnostics 

  1. Dynamic tracking, escalation and action 

  1. Effective multi-disciplinary team 

  1. Timely treatment 

Image shows the Cancer Management Framework's 10 Key Elements. These are 1. Corporate Responsibility 2. Collective Strength 3. Patient Voice and User Experience 4. Demand and Capacity 5. Optimal Referral 6. Initiating the Pathway 7. Optimal Diagnostics 8. Dynamic Tracking, Escalation and Action 9. Effective multi-disciplinary team 10. Timely Treatment

CfSD’s Cancer Improvement and Earlier Diagnosis Team works with  Health Boards to help embed all 10 elements of the framework.  Only by adopting all components can we improve cancer performance, patient outcomes, and experience.

A toolkit is available to support Health Boards in implementing the framework.. It brings together key documents and guidance, examples of best practice and case studies from across NHS Scotland. Contact information is included to support local engagement and facilitate shared learning.  

The toolkit can be downloaded by clicking the following link: Framework for Effective Cancer Management (FECM) PDF
 
Clicking this link will take you to the Right Decision Service page where the Framework can be viewed online: Framework for Effective Cancer Management (FECM) | Right Decisions (scot.nhs.uk) 

 

Guidance for the management of Urgent Suspicion of Cancer (USC) referrals:

The guidance for the management of Urgent Suspicion of Cancer (USC) referrals, previously called 'Urgent Suspicion of Cancer: national regrading guidance', sets out the key principles of managing urgent suspicion of cancer referrals in NHS Scotland.

Health Boards should work across primary and secondary care teams to ensure these key principles are embedded, processes are in place, and roles and responsibilities are clear. This is to minimise any possible delays for those with a suspicion of cancer.

The guidance has been reviewed and updated in 2026 following clinical engagement and now sits on the Right Decision Service. The new guidance can be accessed by clicking the following link: Guidance for the management of Urgent Suspicion of Cancer (USC) referrals | Right Decisions