The National Cancer Grid

It is a network, not one hospital.

What does it connect?

• The grid is a Government of India initiative.
• It links cancer centres, research institutes, patient groups and charities.
• Its goal is uniform standards of cancer care.
• Members share training, research and treatment guidelines.

Why was a grid needed?

• The 2010 report said patients rushed to Tata Memorial Hospital in Mumbai.
• A network lets knowledge travel to the patient. The patient need not travel to the knowledge.
• The 2023 paper says the aim is uniform, high-quality and affordable care for all patients.

Who benefits, and how?

• A patient at a small hospital gets expert advice from a larger centre.
• A young doctor learns by joining case discussions.
• A hospital pays less when members buy drugs together.
• Under PM-JAY, cancer packages and prices get a joint review.

What is the memory hook?

Think “network, not hospital”. Many members, one standard.

The idea came from the Department of Atomic Energy (DAE).

What did the 2010 report say?

• In July 2010, PTI reported that the DAE had proposed a national cancer grid.
• The aim was uniform standards of care.
• It would also cut the rush of patients to Tata Memorial Hospital, Mumbai.
• The first plan linked Mumbai with Kolkata, Jorhat and Bhopal.

When was it set up?

• The PIB factsheet says the grid was established in 2012.
• So 2010 is the proposal and 2012 is the start.

What is the memory hook?

Think “2010 idea, 2012 start”. The DAE had the idea.

The numbers have grown over the years.

What do the sources give?

• The PIB factsheet gives 287 members.
• It calls the grid the world’s largest cancer network.
• Members treat over 750,000 new patients a year.
• That is over 60% of India’s cancer burden.
• The 2024 Axis release says 300+ cancer centres.
• A 2023 paper says more than 250 centres. A 2023 audit says more than 270.
• That paper says members care for almost two thirds of India’s cancer patients.

Why do two numbers appear?

• The counts come from different years.
• Membership kept growing.
• Quote the number together with its source.

What is the memory hook?

Think “250, 270, 287, 300+”. Later sources give higher counts.

A tumour board is a meeting of cancer specialists about one patient’s case. The Grid runs these meetings by video.

How does a case travel?

• A centre without a full specialist team sends a case summary.
• The summary follows a standard template. It holds clinical details, pathology and radiology findings, and a clear question.
• The details are deidentified, so the patient’s name stays out.
• The host circulates the summary by email before the meeting.
• After the talk, the group agrees a plan. It goes back to the centre by email.

What do the numbers show?

• The Grid began these boards in December 2016.
• One audit covered head and neck cancers up to February 2022.
• It found 208 patients, discussed in 54 sessions.
• A typical session had 4 patients and 19 centres.

Who gains from it?

• Public and private centres took part, in cities and in rural areas.
• Remote centres get expert opinion without sending the patient away.
• Residents and trainees were encouraged to join, so they learn too.

What is the memory hook?

Think “case in, plan out”. Many experts, one video call.

The Grid also bought drugs together. Joint buying gives members more bargaining power.

What was the pilot?

• A price discovery cell was set up in September 2019.
• Procurement ran until October 2020.
• Twenty-three centres took part.
• Forty drugs were shortlisted. They included chemotherapy, targeted therapy and supportive care.

What did it save?

• The pooled demand was worth 15.6 billion rupees at maximum retail prices (MRP).
• The paper reports savings of 13.2 billion rupees against MRP.
• Savings ranged from 23% to 99%. The middle value was 82%.
• Generic drugs saved more than newer patented drugs.

How were contracts signed?

• Vendors went through prequalification, then technical and financial checks.
• Each centre then signed its own agreement with the vendor.
• Vendors promised to supply all centres, wherever they were.
• Negotiated prices stayed valid for two years.

What were the limits?

• Only 23 centres joined the first round.
• The pilot took about a year.
• Three awarded vendors later declined to supply at the pooled price.

What is the memory hook?

Think “23 centres, 40 drugs, median 82%”. Buy together, pay less.

The National Health Authority (NHA) signed an MoU with the grid.

What was agreed?

• The MoU was signed on 23 May 2019.
• It sits under Ayushman Bharat PM-JAY.
• The aim was uniform standards of patient care.
• Both sides would review cancer packages and their prices.
• The grid would also push member hospitals to join PM-JAY.

What is the memory hook?

Think “NHA, PM-JAY, 2019”. Standards and fair prices.

In March 2024, Axis Bank pledged 100 crore rupees to the grid.

What is the money for?

• The partnership runs for five years.
• It builds a National Tumour Biobank.
• It builds a National Cancer Teleconsultation Network.
• It adds cancer-specific electronic medical records.

Why teleconsultation?

• Patients can get expert advice closer to home.
• This saves time and travel cost.

What is the memory hook?

Think “biobank, tele-network, records”. Three Axis projects.

The grid grew out of the DAE’s cancer hospital in Mumbai.

What is Tata Memorial’s role?

• Tata Memorial Hospital (TMH) is part of the Tata Memorial Centre (TMC).
• The DAE ran it, and the 2010 plan called it the “mother” hospital.
• Today TMH coordinates the network.
• The head of TMH serves as convenor of the grid.

Why not the Health Ministry first?

• The first proposal came from the DAE.
• The grid later partnered with health bodies such as the NHA.

What is the memory hook?

Think “DAE, Tata, Mumbai”. The hub is a Mumbai hospital.

Four mix-ups come up often.

What are the traps?

• One hospital or a network? It is a network of many centres.
• Insurer or grid? The grid is not an insurance company. PM-JAY is the scheme.
• 2010 or 2012? 2010 was the proposal. The PIB gives 2012 for the start.
• Which count? 287 is the PIB figure. 300+ is the 2024 Axis figure.
• Saved against what? The pooled-buying saving is measured against MRP, not against past hospital bills.
• Is the Grid a funder? No. It is a network. Axis Bank’s gift and pooled buying are projects inside it.

Misconception: the Grid is a hospital or an insurer that treats patients itself. In fact it links many centres. Each centre treats its own patients.

What is the memory hook?

Think “network, not insurer, two dates”.