NNHLA Quarterly Report July 2021 to September 2023 - published April 2024

The purpose of the National Non-Hodgkin Lymphoma Audit (NNHLA) is to evaluate the patterns of care and outcomes for patients with Non-Hodgkin Lymphoma in England and Wales, and to support services to improve the quality of care for these patients. More details of the audit aims and scope can be found on our webpage.

The NNHLA is part of the National Cancer Audit Collaborating Centre (NATCAN), the home of the 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 patient outcomes in multiple cancer sites.

This is the first quarterly report published by the NNHLA team and provides an overview of the quality of key data items captured in the Rapid Cancer Registration Dataset (RCRD), and the Cancer Outcomes and Services Dataset (COSD), for people diagnosed in NHS trusts with Non-Hodgkin Lymphoma in England between the 1st of July 2021 and the 30th of September 2023.

A high-level summary of patient characteristics is also provided at NHS trust, Cancer Alliance and national level levels and this covers the time period of 1 October 2021 to 30th of September 2023.

This first quarterly report, and the next one published in July, focus on data quality. These first quarterly reports on data quality are intended to highlight to trusts where data submissions to COSD could be improved to enable better reporting on performance indicators in the future. Subsequent quarterly reports will report on performance indicators relevant to Non-Hodgkin Lymphoma.

Click on the button below to download your copy of the Quarterly Report

NNHLA Quarterly Report, July 2021 to September 2023

Why do these reports focus on data completeness/quality?

We have initially focused on data completeness as this aspect of data quality underpins what we can reliably and robustly report as an audit. Going forward, the team will continue development work, in consultation with stakeholders, to determine which performance indicators are appropriate for quarterly reporting.

We encourage all provider teams to review their data completeness and make improvements as this will increase the number of patients we can include in analyses and increase the range of analyses we can conduct. By focusing exclusively on data completeness for this report, we are aiming to shine a spotlight on areas where improvements are needed.

Data sources used in this report

In England, NATCAN receives information from the National Cancer Registration and Analysis Service (NCRAS), part of the National Disease Registration Service (NDRS), NHS England. NDRS collects patient-level data from all NHS acute providers on people with cancer using a range of national data-feeds. This includes the Cancer Registration datasets and the Cancer Outcomes and Services Dataset (COSD). COSD data are submitted to the NDRS on a monthly basis via Multidisciplinary Team electronic data collection systems.

For this quarterly report, the NNHLA utilised data from the Rapid Cancer Registration Dataset
(RCRD).

This is the first time this dataset has been reported on for NNHLA. This dataset is compiled mainly from COSD records and is made available more quickly than the complete cancer registration dataset. However, the speed of production means that the range of data items is limited and several standard data items in the complete registration dataset are unavailable. It also does not have complete coverage of all patients diagnosed with Non-Hodgkin Lymphoma in England during the reporting period. We therefore report data completeness for a few select items from the COSD that are not reported in the RCRD.

RCRD and COSD were received by NATCAN in February 2024. At the time of developing this quarterly report, the RCRD and COSD that were made available to NATCAN spanned different time periods and are therefore reported in separate dashboards.

For the data quality indicators that use RCRD, the period of 1st October 2022 to 30th September 2023 was selected as it covers the most recent complete four quarters of data (Q4 2022 to Q3 2023). Results are reported for this one year period, rather than quarterly, to ensure sufficiently large numbers of records are included to produce reliable estimates at the trust level.

The period of 1st of July 2021 to 30th of June 2022 was selected for reporting COSD data quality as it covers the most recent four quarters of data that are available in this dataset (Q3 2021 to Q2 2022).

The two year period of 1st October 2021 to 30th September 2023 was selected for the reporting of patient characteristics to avoid reporting based on small numbers at the trust level, particularly for categorical variables with multiple subgroup options.

This NNHLA report allocates records to NHS organisations based on the “trust at diagnosis” recorded within the RCRD dataset.

How have we chosen these specific data items to focus on?

The specific data completeness items were chosen in collaboration with the audit’s clinical and methodological experts.

The audit cohort was selected based on ICD-10 codes C82-C86 or C88 (Follicular and Non-follicular lymphoma, Mature T/NK-cell lymphomas, Malignant immunoproliferative diseases, Other and unspecified types of Non-Hodgkin lymphoma) or ICD-10 code C91 in combination with any of the eligible ICD-O-3 codes listed on the ICD codes sheet (Chronic lymphocytic leukaemia of B-cell type). Diagnoses based on death certificate only were excluded.

Ethnicity was chosen as we would like to thoroughly explore inequalities in cancer care which is a priority for NHS England. To enable this, it is important that every patient has ethnicity accurately recorded.

Performance status was chosen as it is important across cancers for assessing the eligibility of patients for different treatments.

For any queries relating to the audit, please email: [email protected]

Last updated: 11 April 2024, 8:13am