NAoPri FAQs

The aim of the National Audit of Primary Breast Cancer (NAoPri) is to evaluate the patterns of care and outcomes for people with primary breast cancer in England and Wales, and to support services to improve the quality of care for these patients. It builds on the previous National Audit of Breast Cancer in Older Patients (NABCOP) but is expanded to include all ages and genders. The audit uses routinely collected patient data to provide a comprehensive analysis of breast cancer care.

The National Audit of Primary Breast Cancer (NAoPri) is delivered by the National Cancer Audit Collaborating Centre (NATCAN), part of the Clinical Effectiveness Unit (CEU) at the Royal College of Surgeons of England. The audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England and the Welsh Government.

The project team works with the NAoPri clinical leads, Prof. Kieran Horgan (surgical), Dr. David Dodwell and Dr. Mark Verrill, alongside an Audit Advisory Committee (AAC) and Patient and Public Involvement (PPI) forum. These groups include representatives from professional and patient organisations and help ensure the audit meets the needs of the primary breast cancer community.

Data are drawn from national registries, including the National Disease Registration Service (NDRS) in England and the Wales Cancer Network (WCN).

There are several ways to keep up with our work. You can subscribe to our quarterly newsletter, get in touch at [email protected], or follow us on the following platforms: Bluesky and LinkedIn. 

The audit publishes an annual State of the Nation (SotN) report, which provides information on the care received by people diagnosed with primary breast cancer in England and Wales. It is the audit’s annual assessment of NHS breast services, sharing examples of good practice and highlighting where care needs to improve.

The SotN report includes performance indicators drawn from the Quality Improvement Plan (QIP), which sets out the audit scope, care pathway and five quality improvement (QI) goals. Findings from the report lead to five national recommendations aligned to these QI goals, highlighting where improvements in care are needed.

The SotN report is supported by a dedicated data dashboard, that allows NHS providers and Cancer Alliances to explore their own data and benchmark results.

In addition, clinical reports covering four performance indicators and five data quality metrics are published through an online data dashboard and updated quarterly. Data from the Rapid Cancer Registration Dataset (RCRD) are used to provide NHS trusts, Cancer Alliances and the public with frequent feedback on organisational performance.

The NAoPri dataset includes individuals aged 18 years or older diagnosed with primary breast cancer (ICD-10 diagnosis code: C50 or D05), without evidence of distant metastasis at or within 6 months of diagnosis (stages 0 to 3C) and diagnosed in an NHS hospital within England and Wales. All performance indicators, except immediate breast reconstruction, include both men and women. Immediate breast reconstruction is reported for women only, as it is rarely relevant to male breast cancer treatment.

Yes, the NAoPri is included in the NHS England Quality Accounts list.

The NAoPri Patient and Public State of the Nation Report is published in October. The report was developed in collaboration with the NAoPri patient and public involvement (PPI) forum and aims to make the audit’s results and key findings accessible and understandable to a wider audience.

The [NAoPri Patient Guide] was also produced in collaboration with patient and charity representatives from the NAoPri PPI forum and our clinical leads. It includes useful question prompts to help primary breast cancer patients discuss key elements of their care and treatment with their breast cancer team, supported by their clinical nurse specialist.

For the State of the Nation (SotN) report the indicator definitions are provided in the accompanying methodology supplement which provides detailed information about the audit’s data sources and methods.

For the NAoPri data dashboard, indicator definitions can be found in the “Indicator information” tab for each selected indicator. NHS organisations are also encouraged to review the “Methods” tab for further details on the underlying methodologies. 

The NAoPri reports findings at national (England and Wales), NHS organisation (English NHS trusts and Welsh NHS health boards) and regional Cancer Alliance level. Data are available at each of these levels via the data tables that support the annual State of the Nation publications and the NAoPri data dashboards.

The NAoPri quarterly data dashboard is updated in January, April, July and October. You can also refer to the “Update” tab on the dashboard itself, which displays the date of the next scheduled release. Our annual State of the Nation report is scheduled for publication in September. To receive updates on the latest reports, you can subscribe to the Audit’s newsletter, get in touch at [email protected],  and follow us on Bluesky https://bsky.app/profile/naopri-natcan.bsky.social and LinkedIn https://www.linkedin.com/showcase/naopri-natcan. 

The NAoMe list of Key Data Items submitted via Cancer Outcomes and Services Data set (COSD) is intended to help members of the breast cancer multidisciplinary team (MDT) enter the data items used by the audit to produce the indicators it reports on.

Additionally, the NAoMe guide to collecting COSD data for breast cancer recurrence was designed in collaboration with the National Disease Registration Service (NDRS), with the purpose of facilitating and encouraging the recording of recurrence at multi-disciplinary team (MDT) meetings in the Cancer Outcomes and Services Data set (COSD).

The NAoMe Guide to collecting COSD data was designed with clinicians in mind, in collaboration with the National Disease Registration Service (NDRS) – NHS Digital, with the purpose of facilitating and encouraging the recording of recurrence at multi-disciplinary team (MDT) meetings in the Cancer Outcomes and Services Data set (COSD).