The development of regional cancer centres – An overall assessment of a four-year follow-up

Based on proposals in A National Cancer Strategy for the Future (SOU 2009:11), the Swedish Government in collaborations with county councils and regions introduced the establishment of regional cancer centres (RCC). The National Board of Health and Welfare was commissioned to submit an overall assessment of the development of RCCs.


In collaboration with county councils and regions, the government has focused longitudinal efforts on establishing regional cancer centres (RCC). Its basis was the challenges faced by society as cancer morbidity increases and as improved treatments mean that those affected by cancer are able to live longer. Great demands are placed on preventative measures and effective use of resources in health and medical care.

Fundamental to the effort has been the official government report, ‘A National Cancer Strategy for the Future’ (SOU 2009:11) and targeted government support driven by ten criteria to be met by the RCCs. The National Board of Health and Welfare has closely followed the develop-ment through its annual assignment of following up and supporting the establishment of RCCs. This report was commissioned by the Government to provide an overall assessment of the RCCs’ establishment.

A successful investment in RCCs

The National Board of Health and Welfare believes that the joint efforts between the government, county councils and regions have been firmly grounded, comprehensive and carefully implemented. One important requirement has been the dialogue and clarity of what is to be achieved and the follow-up of the work conducted.

All RCCs are now fully established after their four-year implementation period. On the whole, they have successfully met all 10 of the of the established criteria – or at least the majority of them. RCC organisation is flexible and efficient, with developed process work.

The National Board of Health and Welfare believes that formulation of methods used to establish the regional cancer centres can serve as a generic model within other areas.

Success factors

A number of success factors characterise the work of the RCCs. One example is how each healthcare region has mutual development plans for cancer care in their particular counties/regions. Sweden currently has a national cancer strategy with six regional cancer plans based on the local development needs. Other significant success factors include

  • patient centering and patient participation,
  • profession-driven development with a solid grounding,
  • an established knowledge management model,
  • increasing nationwide collaboration,
  • new conditions for good, more equal healthcare,
  • high levels of skills at RCCs and in the Confederation of Regional Cancer Centres in Sweden (national collaboration group, CRCC).


Several effects have been felt from the work by the RCCs, for example

  •  patients and their next of kin contribute to the development of cancer care
  • 29 national practice guidelines
  • process work with local discussions for more knowledge-based healthcare
  • a total of 19 national healthcare units for highly specialised care, as of 1 January 2017
  • completed regional-level structuring in several regions.

Some additional examples of development to cancer care that RCCs have contributed to, together with county councils/regions include:

  • more contact nurses in cancer care
  • more patient evaluations in multi-disciplinary conferences (MDC)
  • more individual healthcare plans in the form of “My Care Plan” [Min vårdplan]
  • an online portal for ongoing clinical studies that makes it easier for healthcare professionals and patients to find suitable studies.

Continued challenges

The establishment of RCCs has been a success. Nevertheless RCCs and cancer care continue to face challenges.

The National Board of Health and Welfare has noted that there are exam-ples of certain county councils and hospital and clinic management that are less involved in RCC development. According to the interviews we con-ducted, these are thought to be increasingly fewer and more people express the advantages of RCCs.

One criterion that has been difficult to successfully fulfil has been the provision of skills, as many actors have an individual responsibility for this. Other areas that continue to face challenges include level structuring and preventative measures.

Certain regions have expressed concern about the future of the RCC as this is unclear after 2018. The Government intends to provide support for RCCs, at least during their current term. At the start of the venture, it was stated that support would be given during the implementation period. Since county councils/regions have yet to decide on the full financing of RCCs after 2018, there is an increasing risk that the extent of regional cancer centres will significantly decline once government support is withdrawn.


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Year: 2017
Article number: 2017-10-36
Format: POD
Pages: 145
Language: Engelska
Price (VAT included): 90 kr