Contents

1. 1. How has the contracting of NOGCA changed in 2023?
   2. What is NATCAN?
   3. When did NATCAN start and who funds it?
   4. What is NATCAN doing differently?
   5. How are patient data being collected in NATCAN?
   6. How can hospitals ensure that the data analysed by NOGCA in NATCAN is accurate?

How has the contracting of NOGCA changed in 2023?

NOGCA has moved into the National Cancer Audit Collaborating Centre (NATCAN) at the Clinical Effectiveness Unit of the Royal College of Surgeons of England (RCSEng). From 2024, NOGCA will use existing national datasets for its reporting.

NOGCA retains the same core team and now resides within NATCAN.  NATCAN includes three established cancer audits and six newly commissioned cancer audits.

Data for patients diagnosed with oesophago-gastric cancer up to 31 March 2022 should have already been submitted and will be used in the 2023 NOGCA Annual Report. To reduce administrative burden on OG cancer MDTs, reporting from 2024 onwards will utilise existing national datasets.

NOGCA will continue to focus on robust reporting of data for all patients with OG cancer, and incorporate earlier availability of data in reporting outcomes, and a major ongoing emphasis on implementation of quality improvement initiatives.

What is NATCAN?

The National Cancer Audit Collaborating Centre (NATCAN) is a new national centre of excellence which will shine a spotlight on the care and treatment of patients who are diagnosed with cancer in England and Wales. The Healthcare Quality Improvement Partnership (HQIP), on behalf of NHS England and the Welsh Government, has commissioned the development and establishment of NATCAN, which is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). It aims to:

• Provide regular and timely evidence to cancer services of where patterns of care in England and Wales vary;
• Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives;
• Stimulate improvements in cancer detection, treatment and outcomes including survival.

When did NATCAN start and who funds it?

Work on setting up the new centre began on 1 October 2022. NATCAN is funded by NHS England and the Welsh Government, with £5.4m for an initial period of three years.

What is NATCAN doing differently?

• All audits within NATCAN will use linked national routinely collected datasets for its core outputs. This will make the process of producing relevant and robust performance indicators more efficient.
• Rapid cancer registration data, that allow timely (three months following diagnosis) quarterly reporting to providers, will be used alongside annual State of the Nation reports based on “gold-standard” cancer registration datasets (data available at least 18 months after diagnosis).
• Each audit in NATCAN will carry out a quality improvement initiative using the rapid cancer registration data at least once in the first three years. The aim is to “close the audit cycle”, following an approach commonly referred to as the “plan-do-study-act” method. This will be a first at national level for cancer audits.

How are patient data being collected in NATCAN?

In order to reduce burden on hospital staff, the audits in NATCAN do not ‘collect’ clinical data. This is similar to the design of existing audits in prostate and lung cancer, which utilise the nationally mandated flows of data from hospitals to the National Disease Registration Service (NDRS) in NHSE and the Wales Cancer Network in Public Health Wales. Each NATCAN audit will publish a minimum dataset in the Autumn of 2023, comprising relevant data items for each cancer site, which hospitals can check are being completed and submitted to NDRS or the Wales Cancer Network.

NOGCA encourages clinicians to engage with coders and data administrators to ensure data accuracy, especially on staging information provided to NDRS and the Welsh Cancer Network.

Using this approach, NOGCA will receive clinical information for every patient diagnosed with OG cancer in England and Wales. Data from Trust/Health Board data submissions will be linked to selected items from national datasets to provide information on the diagnosis, management and treatment of all patients newly diagnosed with each cancer type. That includes patient and tumour characteristics, diagnostic tests and imaging, hospitals appointments and admissions, procedures, treatments, interventions and outcomes.

How can hospitals ensure that the data analysed by NOGCA in NATCAN is accurate?

For 2024 reporting onwards, NOGCA will use cancer registry data which includes information from multiple data sources submitted by hospitals, one of the main ones in England being the Cancer Outcomes and Services Dataset (COSD). The vast majority of NOGCA data items are COSD items. We therefore ask hospitals to check the data quality of these items entered into COSD or the Wales Cancer Network, particularly staging data. CancerStats2 provides trust-level information about data completeness of key COSD items for hospitals in England.

NOGCA will also be using the rapid cancer registry dataset, much of which comes from COSD. It is important that hospitals regularly upload accurate COSD data to NDRS.

Trusts in England are encouraged to submit all data available on a monthly basis, in line with the COSD reporting timescales. It is expected that the majority of diagnosis and treatment data are submitted within six months of diagnosis. Once the full patient pathway is linked together, the data will be provided to the NOGCA team to analyse. Further information about the COSD and reporting timescales can be found at the following link:

https://digital.nhs.uk/ndrs/data/data-sets/cosd#submission-schedule

For queries regarding data submissions in England, please contact your local contact in the National Cancer Registration and Analysis Service (NCRAS). They can help you to find out more information about your recent COSD submissions.

Please see below the list of regional contacts:

The audit receives data on patients from Wales centrally from the Cancer Network Information System Cymru (CaNISC). These records are linked to the Patient Episode Data Wales (PEDW) to obtain further information on patient care and follow-up (the equivalent of Hospital Episode Statistic data for English patients).

The audit does not collect or analyse data for patients who were diagnosed with oesophago-gastric cancer in Scotland or Northern Ireland. The audit reports only patients from England and Wales. If you are representing a devolved nation and wish to submit data to NOGCA, please contact HQIP who will be able to advise.

We link patient level information to the following external data sources:

• Hospital Episode Statistics (HES)
• Office of National Statistics (ONS)
• National Radiotherapy Dataset (RTDS)
• Systemic Anti-Cancer Therapy (SACT, the chemotherapy dataset)
• Intensive Care National Audit & Research Centre dataset (ICNARC)
• Patient Episode Database for Wales (PEDW)

Please visit our Patient Choices page to view the options available regarding your information.

We use your NHS number to link your information to other secure information sources, such as the National Radiotherapy Dataset. This linked information tells us more about your treatment – for example, if you had an unplanned return to hospital.

The linked information from you and other patients across England and Wales is given to The Royal College of Surgeons (RCS) to analyse and use in the audit reports. The information is anonymised so you cannot be identified.

We may also provide NHS numbers of deceased patients to hospitals so they can check the information they have entered in the audit database is correct.

Improvements in cancer care have been made since the audit began but it is important that this progress continues. For example, survival rates after surgery have improved year on year.

Audits are most effective when information from as many patients as possible is collected. So every patient is valuable to the audit.

The more patients we have information about, the more accurate our results are likely to be.

Only information from your hospital notes is used in the audit. The hospital enters your treatment information and NHS number onto a secure computer database at NHS Digital.

We provide a list of useful external websites of cancer charities and other organisations in the Links section of the website.