The purpose of the National non-Hodgkin lymphoma Audit (NNHLA) is to evaluate the patterns of care and outcomes for people diagnosed with non-Hodgkin lymphoma (NHL) in England and Wales, and to support services to improve the quality of their care. More details of the audit aims and scope can be found on our web page.
The NNHLA is part of the National Cancer Audit Collaborating Centre (NATCAN), the home of ten national cancer audits in England and Wales. This national centre of excellence was established to strengthen cancer services by evaluating the process of diagnosis and treatment, and outcomes in multiple cancer sites.
It should be noted that these provider-specific results are affected by varying levels of data completeness and quality and random variation (i.e., the “role of chance”). At this stage, the audit has not implemented HQIP’s formal “outlier process” (i.e., a formal process to assess the performance of healthcare providers with results that are outside the expected range). This is because, although there is sufficient confidence to report the results publicly, it is the first time that provider-specific results are being provided with untested data completeness and quality, and risk adjustment methods are in development. Instead, where results highlight a potential cause for clinical concern, we will contact the providers within one month following publication of the State of the Nation Report, and work with them to explore factors that may explain their results, according to HQIP’s formal guidance. This process is with a view to being able to adopt the formal outlier process in 2025.
These online dashboards are subject to ongoing iterative development and we therefore welcome suggestions and feedback, which can help guide changes made in future releases.
A second phase of development is planned for 2025, during which we will seek feedback more broadly, consulting with a wide range of stakeholders, including PPI representatives, to ensure the dashboards continue to meet the needs of our end users.
The NNHLA quarterly report currently consists of the following online dashboards:
- Performance Indicator dashboard (updated quarterly):
Aim: to present performance indicators responsive to changes over time and to support NHS providers to track their progress and monitor quality improvement.
Intended audience: NHS provider teams in England.
Data source: Rapid Cancer Registration Dataset (RCRD), the Systemic Anti-Cancer Therapy Dataset (SACT), National Cancer Waiting Times Monitoring Dataset (CWT)
Time period: People diagnosed with non-Hodgkin lymphoma between Q3 2021 and Q2 2024 (1st July 2021 – 30th June 2024)
- Data Quality dashboard (updated quarterly):
Aim: to shine a spotlight on areas where improvements in data completeness are needed.
Intended audience: NHS provider teams in England.
Data source: Rapid Cancer Registration Dataset (RCRD), Cancer Outcomes and Services Dataset (COSD)
Time period (cross sectional view): People diagnosed with non-Hodgkin lymphoma between Q3 2023 and Q2 2024 (1st July 2023 – 30th June 2024)
Time period (longitudinal view): People diagnosed with non-Hodgkin lymphoma from Q3 2021 to Q2 2024 (1st July 2021-30th June 2024)
A data issue has been identified by NDRS in the rapid cancer registration data (RCRD) used in the NNHLA January 2025 dashboards, because of a temporary issue with the way HES and death certificate data are used to construct the dataset. This has resulted in around 1% of tumours missing from the dataset across all tumour types. It has had a larger impact on more fatal cancers and older patients and therefore varies between cancer sites. For the NNHLA January 2025 dashboards, it has reduced the number of people included by 0.2% overall. NDRS are working to correct this issue for future releases of RCRD.
Why do we report data completeness/quality?
We aim to shine a spotlight on areas where improvements in data completeness are needed, as this aspect of data quality underpins what we can reliably and robustly report as an audit.
We encourage all provider teams to review their data completeness and make improvements as required. This will increase the number of people diagnosed with NHL that we can include in analyses and increase the range of analyses we can conduct.
The National Disease Registration Service (NDRS) has regional Data Liaison Managers who support NHS teams submitting cancer data to NDRS with advice and support on data improvement initiatives. We encourage trusts to get in touch with this team for support and advice. Contact details can be found here.
How does cancer registration data used for the Quarterly Report differ from that used for the State of the Nation report?
The Quarterly Report makes use of the Rapid Cancer Registration Dataset (RCRD), whereas the State of the Nation report makes use of the complete cancer registration dataset.
The Rapid Cancer Registration Dataset (RCRD) is compiled mainly from Cancer Outcomes and Services Dataset (COSD) records and is made available more quickly than the complete cancer registration dataset.
However, the speed of production of the RCRD means that the range of data items is limited and several standard data items in the complete registration dataset are unavailable.
Therefore, not all performance indicators included in the State of the Nation report can be included in the Quarterly Report.
For any queries relating to the audit, please email [email protected].
Last updated: 14 January 2025, 2:50pm