Pandemic Plan of the Czech Republic

Objectives

The National Oncology Programme of the Czech Republic 2030 seeks to enable every resident to prevent cancer and, where cancer occurs, to receive the highest possible quality of care and life regardless of location or disease stage. It is a 2022-2030 strategy aligned with the Czech Health 2030 framework and Europe’s Beating Cancer Plan, responding to the continuing cancer burden, population ageing, avoidable risk factors, disrupted screening during the Covid-19 pandemic and growing numbers of people living after cancer treatment.[1][2][3]

• Increase the effectiveness of primary, secondary and tertiary prevention by strengthening health literacy, healthy lifestyles, risk-factor reduction, vaccination, organised screening, early detection and tailored prevention for people with genetic or treatment-related risk.[4][5][6]
• Ensure patient-centred care that maximises quality of life during illness, after cure and at the end of life, including rehabilitation, survivorship follow-up, psychosocial and social support, return-to-work support and accessible palliative care.[7][8][9]
• Build an integrated, equitable and efficient cancer system through multidisciplinary diagnosis and treatment, defined patient pathways, coordinated specialised centres, regional cooperation and improved access across geographical areas.[10][11][12]
• Advance cancer control in line with scientific and technological progress through personalised medicine, genomic diagnostics, innovative treatments, digitalisation, research, clinical trials, quality standards and health-technology assessment.[13][14][15]
• Strengthen the cancer workforce, provider infrastructure and patient involvement, including patient councils, patient-reported outcomes and experiences, and participation by informal carers and patient organisations.[16][17][18]

The framework comprises four strategic objectives, divided into specific objectives and sub-objectives with associated indicators. Its intended outcomes include improved prevention and early-stage diagnosis, reduced inequalities, high-quality multidisciplinary care, longer survival, better quality of life and sustained support for people cured of cancer and their families.[3][19][20]

Implementation

Implementation is organised through successive Action Plans to 2030, translating the strategic framework into prioritised activities, projects, responsibilities, timetables, estimated financial intensity, preferred funding sources, risk management and communication arrangements. The first Action Plan covered 2022-2024; later plans are to build on evaluations and changing needs, trends and innovations.[21][22][23]

• Lead delivery through the Ministry of Health, with the Minister as Contracting Authority and the Deputy Minister for Healthcare as Administrator responsible for practical implementation.[23][24]
• Coordinate implementation through the National Council for the Implementation of the NOPL CR 2030, a permanent expert advisory body involving ministries, regions, providers, insurers, professional and academic organisations, public health bodies and social services.[25]
• Appoint a Coordinator to prepare and evaluate Action Plans, monitor projects, connect activities, manage information flows and support operational delivery, assisted by ad hoc specialist working groups.[25]
• Use the Institute of Health Information and Statistics of the Czech Republic for analytical feedback, indicator assessment, forecasting, strategic planning and health-technology assessment.[25]
• Deliver care through networks of Comprehensive Cancer Centres, highly specialised adult and paediatric haemato-oncology centres, Regional Oncology Groups, regional hospitals, primary care, outpatient specialists, laboratories, rehabilitation, palliative, home-care and social-service providers.[26][27][28]
• Strengthen prevention and early detection through public-health bodies, health insurers, primary care and the National Screening Centre, which provides methodological and technical coordination for organised screening and early-detection programmes.[29][30]
• Engage patients, informal carers, patient organisations, non-governmental organisations, education and research bodies, municipalities, regions, international partners and the public as both target groups and contributors to implementation.[31][3][9]

Service delivery combines centralisation of complex and targeted care with regional networks and shared care. Measures include standardising referrals and clinical guidance, publishing diagnosis-specific pathways, enabling electronic transfer of documentation, supporting multidisciplinary case review, expanding specialist supportive and palliative care, and integrating follow-up with primary care where appropriate.[32][10][11]

Monitoring combines the National Cancer Registry, the National Health Information System, payer and prevention-register data, patient feedback, patient-reported outcome measures and patient-reported experience measures. A National Cancer Information System is planned to monitor cancer-control policy, evaluate health technologies and assess outcomes, with electronic cancer documentation targeted for creation by 2025 and full implementation by 2030.[33][21][22]

Action Plans require evaluation arrangements and are subject to annual assessment, with annual implementation assessments submitted to Ministry of Health management in April of the following year. A final ex-post impact evaluation is scheduled for preparation between July and November 2031, followed by approval submission in December 2031.[34][35]

Key performance measures include vaccination and screening coverage, early-stage diagnosis, follow-up capacity, access to specialised centres, multidisciplinary consultations, regional implementation, workforce development, registry linkage, patient councils and cancer mortality. Explicit targets include 90% human papillomavirus vaccination coverage, 60% colorectal screening coverage, 42 mobile specialised palliative-care providers and patient councils operating in all Comprehensive Cancer Centres.[20][12]

Risk management and communication are embedded in each Action Plan. Risk Registers are updated at least annually, with corrective measures reviewed by the National Council and Ministry of Health management; Communication Plans are updated annually and delivered by the Coordinator with the Ministry of Health Press Department through professional, public and digital channels.[36][37]

Monitoring & Evaluation

The National Oncology Programme of the Czech Republic 2030 (NOPL CR 2030) establishes a monitoring and evaluation architecture combining cancer registries, objective-level indicators, Action Plan reviews, annual reporting, risk management and patient feedback. It uses the National Health Information System, anchored in the National Cancer Registry, to assess cancer burden, policies, technologies and outcomes; a National Cancer Information System is intended to strengthen these functions.[21]

• Monitor prevention and early detection through indicators covering human papillomavirus vaccination, screening coverage, risk-factor prevalence, preventive examinations, early-stage detection and the implementation of new organised screening or early-detection programmes.[5][30][6][38]
• Track cancer outcomes through incidence, mortality, prevalence, stage at diagnosis, treatment coverage in specialised centres, one-, three- and five-year survival, and longer-term survival for selected diagnoses.[39][40][41][42]
• Assess service organisation through multidisciplinary consultations, guideline use, specialised-centre coverage, patient-pathway arrangements, regional implementation plans, infrastructure developments and participation of general practitioners in follow-up care.[43][10][13][44][12]
• Measure survivorship, rehabilitation and supportive care through follow-up coverage, compliance with guidelines, monitoring of recurrence and late effects, rehabilitation completion, social-support continuity and patient-centred quality-of-life outcomes.[45][46][47][48]
• Monitor palliative care through provider availability, hospice capacity, specialist palliative-care admission before death, intensive-care admission in the final 30 days of life and chemotherapy use in the final two weeks of life.[49]
• Use patient-reported outcome measures and patient-reported experience measures, satisfaction surveys, complaints data and patient councils to assess experience, communication, shared decision-making and supportive-care quality.[9][16][33][41]
• Update and validate indicator sets using National Cancer Registry, payer and prevention-register data, with independent verification and annual reporting by the Institute of Health Information and Statistics.[33]
• Require successive Action Plans to specify activities, responsible entities, timetables, financing, risks, communication and evaluation arrangements; use the findings from each plan to shape the subsequent plan.[22]
• Submit annual implementation assessments to Ministry of Health management in April of the following year and, where relevant, follow-up Action Plans in October; conduct the final ex-post impact evaluation in 2031 after the strategy and final Action Plan have ended.[34][35]
• Manage implementation risks through Action Plan risk registers, updated at least annually, using a five-point likelihood and impact scale and escalation arrangements for critical risks.[36]

The framework includes selected 2030 targets, including 90% human papillomavirus vaccination coverage, 60% colorectal screening coverage, 3.3 long-term-care beds per 1,000 inhabitants, 42 mobile specialised palliative-care providers and functioning patient councils in all comprehensive cancer centres.[20]Further targets include 80% reporting of first-treatment multidisciplinary consultations in comprehensive cancer centres, implementation of regional cancer plans in all 14 regions, and a reduction in malignant-tumour mortality from 258 to 240 deaths per 100,000 inhabitants.[12]Several sections nevertheless do not specify complete reporting frequencies, data ownership, evaluation methodologies or enforcement mechanisms for all objective-level indicators.[3][13][21]

Costing & Financing

Implementation is expected to rely on public health insurance, state and European funding instruments, with Action Plans required to estimate financial intensity and identify a preferred funding source for each activity.[14][50][22]The overall financial complexity of implementing NOPL CR 2030 is estimated at approximately 18 billion, although the currency is not specified; Component 6.2 of the National Plan for Strengthening Cancer Prevention and Care offers approximately 10.3 billion Czech korunas and is identified as the dominant implementation funding source.[51]

• Finance cancer diagnosis and treatment predominantly through public health insurance, supplemented by direct or privately insured expenditure by patients and families.[14]
• Use potential national and European sources including the state budget, National Recovery Plan, Integrated Regional Operational Programme 2021-2027, Operational Programme Employment Plus, Operational Programme Jan Amos Komensky, EU4Health, health-insurance prevention funds and regional or national subsidy programmes.[5][48][14][28][51]
• Allocate European Union support previously reported for cancer-care organisation, including 1.9 billion Czech korunas for comprehensive cancer centre quality and standardisation projects in 2007-2013, 980 million Czech korunas for onco-gynaecological care in 2014-2020, and 2.8 billion Czech korunas from REACT-EU for infrastructure and resilience in 2021-2023.[26]
• Address expenditure pressures associated with late-stage diagnosis, innovative medicines, growing survivorship and long-term haemato-oncology treatment; more than 23,000 patients received centre-based innovative medicines in 2021 at a cost exceeding 8.6 billion Czech korunas.[39][43]
• Plan for forecast annual growth of approximately 10% to 12% in adult solid-tumour and haemato-oncology treatment costs in coming years.[43]
• Develop transparent assessments of direct and indirect cancer costs, taking account of population trends, service requirements, cost structures, inflation, personnel costs and social-insurance effects; indirect costs include work incapacity, disability, premature mortality, transport, caregiving, rehabilitation and psychosocial support.[47][14][50]
• Strengthen reimbursement arrangements based on quality and real costs, including timely coverage of the actual costs incurred by specialised centres and cost-based valuation within the diagnosis-related group system.[32][50][52]
• Address identified resource constraints, including insufficient prevention funding and staffing, absence of a medium-term cancer-care investment plan, limited resources for innovative care, and unsustainable funding for research-project staff, data managers and study nurses.[32][4][29][53]

Detailed allocations, unit costs and funding gaps are generally left for follow-up Action Plans and relevant budget chapters.[51]Europe's Beating Cancer Plan is associated with 4 billion euros from EU4Health and other European Union instruments, but the supplied material does not identify this as a dedicated Czech NOPL CR 2030 allocation.[2]