NAoPri State of the Nation Report 2026

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.

This State of the Nation report (SotN) publishes information on the care received by people diagnosed with primary breast cancer during 2021-23 in England and Wales. It is the audit’s first annual assessment of NHS breast services and shares examples of good practice as well as highlighting where care needs to improve.

The SotN report includes performance indicators outlined in the Quality Improvement Plan (QIP). The QIP also sets out the audit scope, care pathway and five quality improvement (QI) goals.

Findings in the SotN report lead to five recommendations highlighting where improvements in care are needed. These recommendations are aligned to the QI goals of the NAoPri.

A Data Dashboard provides results for individual organisations enabling regional and national comparisons to support local QI, in addition to an Action Plan Template to support MDT discussions.

The audit uses information that is routinely collected by the NHS. For people treated within English NHS hospitals, the data are routinely collated, maintained and quality-assured by the National Disease Registration Service (NDRS), which is part of NHS England. For people treated in Wales, the data were provided by the NHS Wales Performance and Improvement, from the Cancer Network Information System Cymru (CaNISC) or Cancer Dataset Form (CDF). A Methodology Document provides information on the data and methods used in this report.

To further support QI activities, the NAoPri publishes quarterly reports of data quality metrics and patient characteristics (England only). From October 2025 these reports will include a subset of performance indicators. These quarterly reports are work in progress and will be further developed in the next 12 months.

A glossary and the summary infographic are also available as downloadable resources.

For more information about the NAoPri, please visit our audit page.