Cancer Alliances already lead the planning and delivery of cancer services and their improvement across their local systems. We recognise it makes sense for Integrated Care Boards (ICBs), when legally and operationally established, to look to the Cancer Alliances to continue to undertake these roles on their behalf from July 2022. The ICS Design Framework has made this clear, stating that Cancer Alliances will continue to: • “use their expertise to lead whole-system planning and delivery of cancer care on behalf of their constituent ICSs, as well as providing clinical leadership and advice on commissioning.” In Oct 2022 work will commence on 5 new cancer clinical audits, creating a portfolio of 10 cancer clinical audits in total. Clinical audits are used to assess the extent of unwarranted variation in services and provide recommendations to tackle this. Cancer Alliances, supported by the NHS Cancer Programme, will focus in implementing priority recommendations from clinical audits to reduce unwarranted variation.