Organisation of children’s cancer services in the UK
Children are seen in both primary (GP), emergency care and secondary care (local hospital) when they present with symptoms. Suspicion of cancer leads to referral to one of the UK or Ireland, tertiary specialist children’s cancer centres, known as Principal Treatment Centres, for diagnosing and treating cancer in children and young people 0-16 years.
Suspicion of cancer
When a suspicion of cancer arises in a child (0-16 years) due to the symptoms they are presenting with, they must be referred to children’s cancer services under national guidance across all five countries of the British Isles.
Further information on symptoms which raise the suspicion of cancer, and who to refer to can be found in in the Child Cancer Smart section of our website.
Using Child Cancer Smart guidance and in line with the NICE NG 12 Endorsed Referral guidance for suspected cancer in children and young people, you must consider cancer as a differential diagnosis and pick up the phone to the community paediatrician, the local Paediatric Oncology Shared Care Unit, or the regional Children’s Cancer Principal Treatment Centre (depending on local pathways), if;
- The child has 3 of more persistent symptoms (symptoms that do not improve or go away like other childhood illnesses after 2 weeks)
- The child has presented at any healthcare service with similar symptoms on 3 occasions
- 3 weeks of unexplained symptoms
Referral to the regional cancer centre
There are 20 regional children’s cancer centres in the UK and Ireland, comprising of 22 hospitals
They are responsible for confirming the diagnosis, identifying and commencing relevant clinical trials or standard of care treatment pathways, recording consent, and co-ordinating the care and management of children and young people diagnosed with cancer in their region.
Some regional principal treatment centres (PTCs) have a larger catchment area than others, but the children will be referred to their nearest regional centre if they have a suspected or a definite diagnosis of cancer. Some regional PTCs also host the national referral centre for some very rare types of cancer or specialised treatments, and a child may therefore have both a local PTC and referral to a national service. An example of this is children with Retinoblastoma.
Most PTCs (except for Northern Ireland) operate a hub and spoke model of care so that some treatment can be given in a more local hospital to save the family travel time, and reduce the challenges of coordinating family life at a geographical distance. These local hospitals are specifically designated hospitals called Paediatric Oncology Shared Care Units (POSCUs).
Some elements of care may also be managed by local community care teams, such as yourselves, and include things like central line care, dressings, re-passing NG Tubes, and low dose bolus chemotherapy. All of this is coordinated through PTC and POSCU.
Every child diagnosed with cancer should have a Key Worker who will be their consistent point of contact throughout treatment. Often the Key worker is the Paediatric Oncology Outreach Nurse Specialist (POONS) or a clinical nurse specialist (CNS) in the type of malignancy the CYP has, for example Leukaemia CNS.
Commissioning and service specifications
Across all countries in the British Isles, the NHS (UK) and HSE (Ireland), there are a range of commissioning documents, government policy documents, and service specifications that outline how children’s cancer services should be provided. They often, but not always, include commissioning arrangements, service structure guidance, operational guidance, workforce guidance, standards or targets, key performance indicators, patient pathway guidance, expectations for patient experience, and patient and public involvement. These vary slightly by country, and some are more detailed than others. Some are very specific to children’s cancer, and some are an element of a broader country specific cancer plan.
This Table shows the current available documents.
How the cancer care team are supported nationally and internationally
UK and Ireland
CCLG: The Children & Young People’s Cancer Association
International
- SIOP (Europe): The European Society for Paediatric Oncology
- SIOP International Society of Paediatric Oncology
Page last updated: March 2026