Pandemic Plan of the Czech Republic

Objectives

The National Oncology Plan of the Czech Republic 2030 aims to ensure that every resident can prevent cancer and, if cancer occurs, receive the highest possible quality of care and quality of life regardless of location or disease stage. It seeks to reduce cancer burden through sustainable prevention, early detection, equitable access, person-centred treatment, survivorship support, palliative care, research, innovation and digitalisation.[1][2][3]The Plan is structured around four strategic objectives: strengthen prevention and prevent cancer; deliver patient-centred care that maximises quality of life during illness, after cure and at the terminal stage; modernise and coordinate the cancer system; and maintain high-quality cancer control in line with medical and technological advances.[4][5]

• Strengthen primary prevention by addressing tobacco use, harmful alcohol consumption, poor diet, inactivity, obesity, infection-related cancers, occupational and environmental exposures, health literacy, vaccination and personalised prevention for groups at elevated risk.[6][7][8]
• Expand early detection through organised breast, cervical and colorectal screening, lung-cancer early detection, preventive examinations, targeted invitations, genetic counselling and risk-based prevention programmes.[9][10][11][12]
• Improve patient-centred care by providing timely rehabilitation, coordinated follow-up, psychosocial, nutritional and social support, shared decision-making, patient information and reintegration into family, community and working life.[13][14][15][16][17]
• Develop lifelong survivorship care, particularly for childhood and young-adult cancer survivors, to detect recurrence, subsequent primary cancers and late treatment effects while supporting transition from paediatric to adult services.[13][18][19][20]
• Ensure accessible general and specialised palliative care, including home care, mobile specialist teams, hospices, hospital consultation services and individualised care plans reflecting patient preferences and family needs.[21][22][23][24]
• Strengthen coordinated, high-quality diagnosis and treatment through comprehensive cancer centres, specialised haemato-oncology and paediatric centres, regional oncology networks, multidisciplinary teams, standardised pathways and evidence-based clinical guidance.[25][26][27][28][29]
• Advance precision oncology through molecular diagnostics, next-generation sequencing, targeted and immune therapies, advanced surgery, radiotherapy, clinical trials, health technology assessment and horizon scanning.[30][31][32][33][34]
• Build workforce capacity, infrastructure, research capability and interoperable health-information systems to sustain cancer control and reduce regional inequalities in access and outcomes.[35][36][37][38][39]

Implementation

Implementation is based on successive, interrelated Action Plans that translate strategic and specific objectives into activities, projects, responsibilities, timetables, estimated financial intensity, funding sources, risk management and communication arrangements.[40][41]The Ministry of Health leads the Plan: the Minister acts as contracting authority, while the Deputy Minister for Healthcare serves as Administrator and appoints a Coordinator for Action Plan preparation, evaluation, project coordination and operational management.[42][43]The National Council for Implementation of the National Oncology Plan of the Czech Republic 2030 provides expert advice and stakeholder coordination, supported by ad hoc working groups and the analytical team of the Institute of Health Information and Statistics of the Czech Republic.[41][43]

• Coordinate delivery across the Ministry of Health, other ministries, regional and local authorities, health insurance companies, healthcare and social-care providers, professional societies, universities, public-health bodies, patient organisations, non-governmental organisations and international partners.[1][44][8][43]
• Deliver prevention through the public health service, the National Institute of Public Health, regional public health offices, general practitioners, occupational health providers, specialist services and the National Screening Centre.[7][8][9]
• Use the National Screening Centre, the National Council for the Implementation and Management of Early Disease Detection Programmes, steering committees and pilot-project working groups to coordinate evidence-based screening, quality assurance, evaluation and full-scale programme rollout.[9][10]
• Organise treatment through comprehensive cancer centres, highly specialised adult and paediatric haemato-oncology centres, regional oncology groups, regional hospitals, laboratories, primary care and contracted provider networks.[26][27][28][29]
• Apply multidisciplinary case review, nationally consistent clinical pathways, referral arrangements, evidence-based recommendations and shared care between specialised services and general practitioners.[14][27][45][46]
• Integrate health and social services for rehabilitation, survivorship, palliative care, vocational support and family assistance, with patient councils and patient representatives involved in planning, monitoring and service improvement.[21][23][16][17]
• Use the National Cancer Registry, National Health Information System and National Cancer Information System to support surveillance, service planning, evaluation, eHealth, telemedicine, interoperable documentation and lawful secondary data use.[46][38][39]
• Monitor implementation through objective-level indicators, annual Action Plan assessments, risk registers, project monitoring and cyclical strategic management.[47][48][5][49]Assessments are submitted to Ministry of Health management, with final ex-post impact evaluation scheduled for the second half of 2031.[47][48]
• Mobilise funding principally through National Recovery Plan Component 6.2, supplemented by national resources, health insurance, the Integrated Regional Operational Programme 2021-2027, Operational Programme Employment Plus, EU4Health and other relevant instruments.[40][41][50]Estimated overall financial requirements are approximately 18 billion, although the currency and Action Plan-level allocations are not specified in the supplied material.[51][50]

Monitoring & Evaluation

The National Oncology Plan of the Czech Republic 2030 uses an indicator-led, cyclical monitoring system to track delivery of its four strategic objectives, Action Plans and overall vision.[48][4][5]Monitoring draws on cancer registry, health-information, provider, payer, screening, service-quality and patient-reported data, with the Institute of Health Information and Statistics providing analytical feedback.[46][38][39][43]

• Assess basic strategic indicators against initial and target values, recognising that results may emerge over time and should not be interpreted rigidly.[48]
• Measure prevention and early-detection performance through vaccination coverage, screening participation, risk-factor indicators, cancer incidence, mortality, stage at diagnosis, five-year relative survival and early-detection programme coverage.[8][9][10][52][4][5]
• Monitor care organisation through multidisciplinary-team activity, specialised-centre coverage, patient pathways, written network agreements, regional inequalities, treatment volumes, staffing, time from diagnosis to treatment and use of innovative or centre-based therapies.[25][26][27][30][38]
• Track survivorship, rehabilitation and supportive care through long-term follow-up programmes, adherence to dispensarisation guidance, care for high-risk groups, rehabilitation outcomes, continuity of social support and psychosocial-support capacity in comprehensive cancer centres.[18][53][21]
• Monitor palliative care through mobile-provider and hospice-bed capacity, specialised palliative-care admission before death, intensive-care admission in the last 30 days of life and chemotherapy use in the final two weeks of life.[24]
• Use patient-reported outcome measures and patient-reported experience measures, patient councils, satisfaction surveys, complaints and accredited patient-experience programmes to assess care quality, accessibility, continuity, shared decision-making and support.[16][17][46][52]
• Evaluate screening programmes through regular quality control, publication of results and, where applicable, time-limited pilots before full implementation; the National Screening Centre provides coordinating and technical support for evaluation.[9][10]
• Maintain and update quality indicators using the National Cancer Registry, hospital information systems and verified National Health Information System data; the Institute of Health Information and Statistics publishes an annual summary report.[46]
• Assess new eHealth tools before introduction against usability, quality, stability, performance, efficiency and sustainability, while the National Cancer Information System is intended to evaluate the plan and health technologies.[54][39]
• Conduct at least annual horizon scanning to estimate costs of major new indications and medicines, and develop methods and data sources for assessing direct and indirect cancer costs.[55]
• Require each Action Plan to identify activities, responsibilities, timetables, financial intensity, funding sources, risks and communication arrangements, creating a practical basis for delivery monitoring and accountability.[40]
• Submit Action Plan implementation evaluations to Ministry of Health management in April of the following year, submit follow-up Action Plans in October, and prepare the final ex-post impact evaluation in the second half of 2031.[47]
• Use risk registers, project monitoring, continuous reporting and indicator-performance feedback to identify corrective actions; update risk registers at least annually and escalate critical risks rated 15–25 to the relevant Coordinator and implementation bodies.[43][49]

Costing & Financing

Implementation is expected to rely principally on National Recovery Plan Component 6.2, alongside public health insurance, state-budget resources, European Union programmes, regional and national subsidy schemes, and other programme-specific sources.[33][41][42][50]The plan requires every Action Plan to estimate financial intensity and identify preferred funding, but most objectives do not have quantified allocations or funding gaps in the supplied material.[40]

• Use Component 6.2 of the National Recovery Plan as the main implementation funding source; it is described as entirely focused on cancer-prevention and care objectives and as offering about 10.3 billion Czech koruna.[41][42][50]
• Estimate overall financial requirements at approximately 18 billion, although the currency, period and detailed distribution are not specified; follow-up Action Plans are intended to define detailed requirements and reflect them in relevant budget chapters.[51][50]
• Draw on the Integrated Regional Operational Programme 2021–2027 for investment projects and the Operational Programme Employment Plus for systemic non-investment activities.[50]
• Use additional potential sources, where relevant, including health insurance companies, the state budget, EU4Health, national and regional subsidy programmes, the Operational Programme Jan Amos Komensky, HORIZON and National Recovery Plan Components 1.1, 1.2, 3.3, 5.1 and 6.1.[21][55][28][38][40]
• Recognise public health insurance as the predominant financing mechanism for oncology care, supplemented by direct or insured spending by patients and families.[33]
• Plan for increasing cost pressures from late diagnosis, demographic ageing, higher cancer prevalence, recurrence, innovative therapies, new drug indications, inflation, personnel costs and long-term treatment needs.[56][57][25][33][55]
• Record that centre-based innovative medicines for more than 23,000 cancer patients cost over 8.6 billion Czech koruna in 2021, with the indicated treatment population increasing by at least 10% annually and projected annual cost growth of 10%–12% for adult solid tumours and haemato-oncology.[25]
• Note historical European support of approximately 1.9 billion Czech koruna for Comprehensive Cancer Centre quality and standardisation projects during 2007–2013, 980 million Czech koruna for onco-gynaecological care during 2014–2020, and 2.8 billion Czech koruna from REACT-EU for specialised infrastructure and resilience during 2021–2023.[26]
• Identify an unquantified research funding gap for salaries and other staff needed for international academic trials and research networks, as hospital resources and sponsor donations are considered insufficient.[58]
• Recognise indirect economic consequences of cancer, including lost work capacity, disability, premature mortality, reduced labour-market participation, patient transport, caregiving, rehabilitation, retraining and psychosocial support.[15]