What is Quality Improvement?
The clue is in the name! Quality improvement (QI) means using a variety of tools and methods in a systematic way, in order to improve the quality of care for patients on a constant basis and create better outcomes. QI is central to NATCAN’s mission to reduce variation and improve cancer care across England and Wales. We support NHS organisations through actionable data, meaningful engagement, and practical tools to drive change.
Kate Walker, Senior Methodologist for NATCAN
What role do national cancer audits play?
A priority for each audit in NATCAN is the development of explicit QI goals. The aim is to improve the results of all forms of cancer care, as well as the experience that patients have during diagnosis and treatment. The QI goals are developed in collaboration with a wide range of stakeholders including professional bodies, patient charities and patients themselves.
Where available, national evidence-based standards of care, such as those published by the National Institute of Clinical Excellence (NICE), underpin the improvement goals of each cancer audit. NATCAN and the audit teams review clinical performance against these goals and shine a light on areas where improvements are needed.
How does the audit report results?
Results will be reported back frequently, and as soon after diagnosis as possible, alongside tools and methods which guide the way we evaluate cancer care. That means changes to cancer services, where needed, can be made as quickly and effectively as possible. In addition, the impact of these changes can be measured, and the lessons learnt can be shared, to help reduce costs.
David Cromwell, Director of the CEU
The objective is that we will always be building and refining the way we do things, in order to improve them. NATCAN successfully launched data dashboards in January 2025 to provide quarterly reports on the performance indicators published in the annual State of the Nation reports. These dashboards will support the upcoming QI interventions launching in October/November 2025.
From Data to Action
While measuring how care is delivered is essential, it becomes truly valuable when the data drives local action—empowering frontline teams, including doctors, nurses, and other healthcare professionals, to lead meaningful QI efforts within their own services.
Building the Foundations (2024/25)
Establishing a NATCAN QI Working Group
In September 2025, NATCAN established the QI Working Group led by Professor Ajay Aggarwal — bringing together QI expertise from across the programme, including senior methodologists, clinical leads, the Director of Operations, a project manager and a newly appointed QI Clinical Fellow. This multidisciplinary group serves as a collaborative group to develop learning and support opportunities in delivering QI across the cancer audits.
- Ajay Aggarwal – Clinical Director, NATCAN
- David Cromwell – Director, Clinical Effectiveness Unit
- Julie Nossiter – Director of Operations, NATCAN
- Sudha Sundar – NOCA, Clinical Lead (Surgery)
- Alison Tree – NPCA, Clinical Lead (Oncology)
- Verity Walker – Project Manager, NATCAN
- Sugeeta Sukumar – Quality Improvement Fellow, NATCAN
With external support from:
Clinical Professor of Primary Care, University of Leeds
Clinical Associate Professor of Primary Care, University of Leeds
Associate Professor, Northumbria University
NATCAN Quality Improvement Plans
Each audit developed a QI plan. The initiatives below reflect how NATCAN is working with providers to move from measurement to improvement—supporting local teams to interpret data, plan change, and deliver better outcomes for patients.
NATCAN supports NHS cancer services by providing data to improve care from diagnosis through to long-term outcomes. A 2023 scoping exercise defined the audit pathways and key improvement goals. In 2024, audit teams worked with stakeholders, including people with lived experience, to develop ten performance indicators aligned with these goals and national standards. These indicators will help track progress and better understand variation in cancer care and outcomes.
The QI Plans were published in September 2024* and they outline NATCAN’s shared approach to developing measurable and actionable improvement goals and performance indicators across the cancer audits. These indicators will help track progress and identify factors driving variation in cancer care and outcomes. Developed in collaboration with professional groups, data partners, patient charities and people with lived experience of cancer, the plans detail methods for implementation, reporting, and evaluation.
The Quality Improvement Plans for the audits can be found below:
*The QI goals for the NLCA were published in January 2025.
Summary of the NATCAN QI goals and performance indicatorsBelow is a summary of some of the core QI support activities listed within the QI plans across the audits which have been developed and delivered through NATCAN:
Summary of QI support activities across the audits
| Activity | Description |
| State of the Nation (SotN) Reports | Annual reports allow NHS providers in England and Wales to benchmark performance against national guidelines and peer organisations. |
| Interactive Dashboards | Web-based dashboards enable NHS organisations to compare their performance with others at the national, regional, or local level. |
| Local Action Plan Template | A practical tool for providers to document how they will respond to SotN recommendations and track QI progress locally. |
| Outlier Reporting & Support | Providers with performance indicators falling outside expected thresholds are flagged as potential outliers. NATCAN supports these providers in identifying and addressing areas for improvement. |
| Data Quality Case Studies | Real-world examples of how NHS trusts have improved the quality and completeness of their cancer data submissions. |
| Improvement Case Studies | Examples of how trusts have improved care quality, including learning from both high-performing and underperforming sites. |
| Evidence-Informed Interventions | A curated list of interventions from published literature or developed by NHS providers/Alliances in the NHS aligned to key performance indicators. |
| Target Setting | Where appropriate, NATCAN includes recommended thresholds or targets to guide QI efforts (e.g. % of patients receiving timely treatment). |
| QI Toolkits & Supplementary Materials | Supporting documents and tools to help providers improve care processes and data completeness beyond the core audit reports. |
Key examples of Quality Improvement Support Activities:
Development of bespoke QI Interventions within NATCAN
Launching QI Interventions (Autumn 2025)
Starting in Autumn 2025, each NATCAN audit will launch their QI intervention. Stay tuned for updates on audit-specific plans, focus areas and early impact!
Tool and Resources to Support Local QI
Want to Collaborate?
Interested in local QI support or partnering with NATCAN on improvement initiatives? Contact us.