The Centre was commissioned for an initial three-year period by the Healthcare Quality Improvement Partnership on behalf of NHS England and the Welsh government. NATCAN’s contract has since been extended for a further two years, enabling the delivery of its ten cancer audits until September 2027.
Peter Johnson, National Clinical Director for Cancer, NHS England
It is based within the Clinical Effectiveness Unit (CEU), an academic partnership between the Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine.
NATCAN brings all national cancer audits together in one place, enabling us to share best practice and clinical excellence as part of the overall strategy of improving healthcare. Each audit has developed explicit quality improvement goals aiming to improve cancer outcomes and the experience of patients.
Ajay Aggarwal, Clinical Director at NATCAN
Which audits are being done?
NATCAN delivers six new cancer audits covering:
- kidney cancer
- non-Hodgkin lymphoma
- ovarian cancer
- pancreatic cancer
- primary and metastatic breast cancer (two separate but closely connected audits)
The first results from these audits were published in 2024 and are updated both annually and quarterly.
The CEU was already the sole provider of national cancer audits in the English and Welsh NHS with audits covering:
- oesophago-gastric cancer (since 2006)
- bowel cancer (since 2010)
- prostate cancer (since 2013)
- breast cancer in older patients (since 2016)
- lung cancer (since 2022)
The National Bowel Cancer Audit and the National Oesophago-Gastric Cancer Audit moved into NATCAN in June 2023. The National Prostate Cancer Audit moved into the centre in July 2023 followed by the National Lung Cancer Audit in October 2023.
Neil Mortensen, Chair of NATCAN Board, President of the Royal College of Surgeons of England (2020 to 2023)
These audits have helped provide a wider understanding of cancer treatments across England and Wales, and improve outcomes for patients. They have also promoted improvement initiatives within NHS cancer services and identified areas of best practice.
What are NATCAN’s guiding principles?
Our guiding principles are:
- Use of routine national data assets to avoid the burden of bespoke data collection by NHS staff
- Timely, public reporting of the process and outcomes of care at both NHS provider and regional level
- Research and development to ensure fair and accurate comparisons are made between providers, and to identify reasons behind any variation in care to guide local and national QI initiatives
NATCAN focuses on the three Rs, ensuring that all our activities are:
- clinically relevant (asking the right questions as a result of close collaboration between clinical and academic experts)
- methodologically robust (using the best epidemiological and statistical approaches to carry out fair comparisons between hospitals)
- technically rigorous (making sure data science is put to the best use, in order to drive quality improvement)
Julie Nossiter, Director of Operations at NATCAN
How do professionals and patients get involved?
NATCAN collaborates closely with professional groups and patient charities. Each audit has established its own PPI Forum, ensuring our work is guided by people with lived experience of cancer, either as a patient or as a family member. We worked closely with our charity partners to recruit members and ensure each forum represents the diversity of patients affected by each cancer type, across stage/type of cancer, treatment received, geographical location, age, gender, and ethnicity.
The audits are committed to engaging widely with charities and experts involved in cancer care, and to delivering for patients and their families, as well as healthcare professionals and the health service.
Everyone involved in cancer treatment knows it is complex. There may be multiple treatment options, including combinations of treatments, for different types of cancer. A patient’s treatment plan needs to take into account the stage of their cancer and how they will respond to treatment.
A key aim for each audit is to ensure the information produced for cancer services recognises these differences, and supports hospitals to focus on specific parts of the care pathway.