Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System
West Yorkshire and Harrogate Cancer Alliance · Network
In term In term in the September 2026 edition: the latest version runs to 8 January 2029.
- Reference
- DARS-NIC-204520-B1V2G
- Current version
- v3.4
- Term of current version
- 9 January 2026 to 8 January 2029
- Start date
- 1 March 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 0
Data controllers
Why the data was released
Objective for processing
Improvements for Cancer patients:
In 2015, the independent Cancer Taskforce set out an ambitious vision for improving services, care and outcomes for everyone with Cancer: fewer people getting Cancer, more people surviving Cancer, more people having a good experience of their treatment and care, whoever they are and wherever they live, and more people being supported to live as well as possible after treatment has finished. In 2019, the NHS Long Term Plan was published and it aims to improve how we diagnose and treat cancer. The plan included cancer care as one of its clinical priorities and aimed to boost cancer survival rates by focusing on early diagnosis. The plan set new targets that, by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise to 75% of cancer patients. Further, an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis.
Cancer Alliances:
Cancer Alliances have a crucial role to play by being the cancer arms of their ICSs and being the leaders for cancer within their ICB and ICS footprint. Their role is to lead the planning and delivery of the Long-Term Plan ambitions for cancer for their populations, to provide system oversight and co-ordination for cancer services and to oversee the delivery of critical programmes of work within that footprint. They do this by:
• Collaborating with partners (ICSs, commissioners and providers) to provide system level oversight and co-ordination to deliver the operational standards for cancer and the Long Term plan ambitions across their cancer system;
• Deploying service development funding in a way that supports their whole population, and which complements baseline investment so that it maximises the impact on improving cancer outcomes;
• Providing clinical leadership for cancer services across their area to ensure the delivery of a consistently high level of service to patients and to drive the rapid adoption of new approaches; and
• Working as part of the NHS Cancer Programme to share best practice and solutions, and to provide peer support to other Alliance teams.
Cancer Alliance boundaries encompass the range of providers that a cancer patient will typically use. This gives them an opportunity to organise services across organisation boundaries – reducing variation and inequalities, and overall benefitting patients
Cancer Wait Times (CWT) system:
The Cancer Wait Times (CWT) system collects and validates the National Cancer Waiting Times Monitoring Data Set (NCWTMDS), allowing performance to be measured against operational Cancer standards. Data is validated and records merged to the same pathway to cover the period from referral to first definitive treatment for Cancer and any additional subsequent treatments.
The CWT system then determines whether the operational standard(s) that apply were met or not for the patient and the accountable provider(s). The CWT system holds NCWTMDS in a series of pre-aggregated static reports. These reports are available monthly and quarterly data (aligned with the National Statistics for Cancer Waiting Times published by NHS England). Users can query the CWT system to generate reports to feedback on the progress towards meeting these targets.
West Yorkshire and Harrogate Cancer Alliance
NHS West Yorkshire Integrated Care Board (ICB) will directly access the Cancer Waiting Times System on behalf of West Yorkshire and Harrogate Cancer Alliance across West Yorkshire and Harrogate. West Yorkshire and Harrogate Cancer Alliance is hosted by NHS West Yorkshire ICB and covers a population of 2.7 million people. Calderdale and Huddersfield NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor.
NHS West Yorkshire ICB works with health organisations across West Yorkshire and Harrogate including 6 acute providers, 3 community providers and 9 hospices.
Acute Providers
Airedale NHS Foundation Trust
Bradford Teaching Hospitals NHS Foundation Trust
Calderdale and Huddersfield NHS Foundation Trust
Harrogate and District NHS Foundation Trust
Leeds Teaching Hospitals NHS Trust
Mid Yorkshire Hospitals NHS Trust
ICBs
NHS West Yorkshire ICB
Community Providers
Bradford District Care Trust
Leeds Community Healthcare NHS Trust
Hospices
Manorlands, Bradford
Marie Curie Hospice, Bradford
Overgate Hospice, Calderdale
St Michaels, Harrogate
Kirkwood Hospice, Huddersfield
St Gemma's, Leeds
Wheatfield House, Leeds
Wakefield Hospice
The Prince of Wales Hospice, Pontefract
Data access
The CWT system provides one organisation (the lead organisation) representing each Cancer Alliance, with access to the following;
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool
Lead organisations will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients' ICB of responsibility. This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients. Cancer Patients. CCGs no longer exist in statute but NHS England use the CCG field in the data as he geographical variable to split the CWT extracts that are sent to Cancer Alliances.
A) Aggregate reports including small numbers
Aggregate data is available in the form of reports at Provider (Trust) and ICB level.
Small numbers may be included in the aggregate data reports and are essential for analyses carried out by lead organisations. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful and allowed action to be taken to improve patient care.
Investigating breaches
Lead organisations routinely monitor performance and standards using the CWT system, particularly in relation to breaches of the 62 day wait target. Due to the large number of potential Trust/ICB combinations, breach counts could result in small numbers as in some cases there are less than 6 breaches in a whole year. Given that financial penalties are linked to target breaches counts must accurately reflect the true percentage without suppression.
Mitigating risk of re-identification
Risk of disclosure is minimised as the dataset does not include patient demographics (increasing risk of re-identification) that may allow users to identify an individual e.g. there are no age, ethnic categories or geographic breakdowns.
Additionally, the aggregation categories are such that the data is not at a lesser granular level e.g. the source NCWTMDS data collects information at ICD diagnosis code level, but the CWT system aggregates at tumour group level – e.g. Head & Neck, Upper GI, lower GI, Breast etc.
B) Pseudonymised record level extracts
Lead organisations will access record level pseudonymised data which includes the system generated pseudo CWT patient ID.
Any record level data extracted from the system will not be processed outside of the authorised users of the system.
C) i-View Plus .
iView Plus uses cube functionality to allow lead organisations to produce graphs, charts and tabulations from the data through the construction of queries. The data in iView plus is split by operational standard being measured and can then be analysed against a range of dimensions collected in the data and measures such as count, percentage and median. The outputs of iView Plus are aggregate, and no record level data can be obtained, however some queries may result in small numbers and these currently have limited disclosure control applied, see A) for further explanation.
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to ICB level and other health hierarchies.
Lead organisations will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider Cancer pathway improvements.
Lead organisations use of the data will fall into two separate categories, each requiring different levels of suppression, and onward sharing both within the Cancer Alliance and with wider NHS stakeholders;
Purpose One - Aggregate local reports
Generation of routine Cancer Waiting Times reports at Provider (Trust) or ICB level. Lead organisations will access a summary of the totals for the Providers (Trust) and the ICB that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ICB they are aligned to). This analysis would then be shared with the providers and commissioners and used to inform service improvement by providing benchmarked comparable data. The format of this report would be in a tabulated or graphical form (i.e. not record level) but may contain small numbers. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful.
Examples of this type of analysis include:
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs across the geography
b. Analysis of Cancer Waiting Times performance by treatment modality
c. Grouping length of waits for standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks
h. Reviewing routes to diagnosis of patients
i. Quantifying treatment volumes by provider organisation including analysis treatment rates
Purpose Two - Sharing of record level data (including free text breach reasons) with providers and commissioners responsible for direct patient care for that patient. This will be for local clinical audit purposes.
The two broad purposes for this would be;
1) To support local clinical audit work
2) Investigate individual outliers to the national standards
Pathway analysis will be undertaken, identifying trends in reasons for breaches. The analysis will inform system wide pathway improvements and compliance to the national standards. Examples of potential changes to achieve this could be to support trusts in additional resources and processes and also to facilitate discuss between trusts for example in reaching agreement for diagnostics between trusts.
Examples of the types of reasons for this include;
a. Patients waiting excessively long period of time to seen of received treatment
b. Free text breach reasons identifying areas of concern which require more detail or clarification from provider
c. Identification of 28 day standard exceptions - National guidance states patients who are diagnosed with cancer should be informed face to face, this would highlights numbers of patients who are not told in person by provider
d. Audits to review orphan records which require local providers to review local patients records
Record level data (pseudonymised) will be shared via NHS.net email accounts and access will be controlled by password protecting all files.
Processing activities
Access to the Cancer Wait Times (CWT) System will enable Cancer Alliances to undertake a wide range of locally-determined and locally-specific analyses to support the Long-Term Plan ambitions for early diagnosis and survival and the previous Cancer Taskforce vision for improving services, care and outcomes for everyone with Cancer.
As NHS West Yorkshire ICB are acting as the lead organisation in a Cancer Alliance their access is via the same route as other Cancer Alliances i.e via the Cancer Wait Times (CWT) System. The team doing this processing within NHS West Yorkshire ICB are separate from the commissioning team and would not have access to data provide via the DSCRO route. Additionally any separate agreement that NHS West Yorkshire ICB have to access CWT may include other processors and purposes.
Only the lead organisation NHS West Yorkshire ICB will directly access the Cancer Waiting Times system. Extracts can be downloaded and will be stored on the NHS West Yorkshire ICB servers. Role Based Access Control prevents access to data downloads to employees outside of the analytical team responsible for producing outputs; the Health and Care Partnership Analytics Team and NHS West Yorkshire ICB analytics team.
The CWT system is hosted by NHS England, access to and usage of the system is fully auditable. Users must comply with the use of the data as specified in this agreement. The CWT system complies with the requirements of NHS England Code of Practice on Confidential Information, the Caldicott Principles and other relevant statutory requirements and guidance to protect confidentiality.
Calderdale and Huddersfield NHS Foundation Trust, supply IT infrastructure and are therefore listed as a data processor. They supply support to the system, but do not access data. Therefore, any access to the data held under this agreement would be considered a breach of the agreement. This includes granting of access to the database[s] containing the data.
Access to the CWT system will be granted to individual users only when a valid Data Usage Certificate (DUC) form is submitted to NHS England via the lead organisations Senior Information Risk Officer (SIRO), and where there is a valid Data Sharing Agreement between the lead organisation and NHS England.
Approved users will log into the system via an N3 connection and will use a Single Sign-On (users are prompted to create a unique username and password).
NHS West Yorkshire ICB users will access:
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool (aggregated - access to produce graphs, charts/tabulations from the data through the construction of queries). This will give users access to run bespoke analysis on pre-defined measures and dimensions. It delivers the same data that is available through the reports and record level downloads (i.e. it will not contain patient identifiable data).
Any record level data extracted from the system will not be processed outside of NHS West Yorkshire ICB unless otherwise specified in this agreement. Following completion of the analysis the record level data will be securely destroyed.
Users are not permitted to upload data into the system.
Data will only be available for the Providers (Trust) and the ICB that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ICB that this Cancer Alliance is aligned to).
The data will only be shared with other members of the Cancer Alliance in the format described in purpose 1 and purpose 2 of this agreement. The primary method for sharing outputs is nhs.net email.
Aggregate data/ graphical outputs may be shared via e-mail; for example as part of Alliance meeting papers.
Where record level data is shared with individual trusts these are shared only with trust(s) who were involved in the direct care of the patient, only via NHS.net email accounts.
Data will only be shared as described in purpose one and purpose two of this agreement and where recipient organisations hold a valid Data Sharing Agreement with NHS Digital to access Cancer Waiting Times data.
Training on the CWT system is not required as it is a data delivery system and it does not provide functionality to conduct bespoke detailed analysis. User guides are available for further assistance.
Access to the CWT system data is restricted to Cancer Alliance employees who are substantively employed by the Data Controller in fulfilment of their public health function.
The Cancer Alliances will use the data to produce a range of quantitative measures (counts, crude and standardised rates and ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data.
Typical uses will include:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs.
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays.
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer patients outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The members of the Health and Care Partnership Analytics Team who will process the data are all substantive employees of NHS West Yorkshire ICB.
Expected output
Outputs fall into the following categories:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs.
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays.
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer patient’s outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve Cancer pathways including reducing Cancer incidence and mortality, improving Cancer survival, improving patient experience, improving service efficiency and meeting national constitution standards relating to Cancer patients. The outputs produced will be in the form of reports, presentations and associated slide decks, and verbal updates relaying findings obtained from analysing the data. These outputs will have small number suppression applied where there is a risk of secondary disclosure as per HES guidance.
Expected measurable benefits
Benefits type: Supporting delivery of CWT standards
The Cancer Waiting Times standards are key operational standards for the NHS, which aim to reduce the waits for diagnosis and treatment for Cancer patients, which will support improvements to survival rates and improve patient experience. This includes the new 28 day faster diagnosis standard being introduced as a standard from April 2020.
A key enabler to achieve these standards, and thus improve survival and patient experience is the role of Cancer Alliances locally to work with providers and commissioners to improve patient pathways. Access to the Cancer Waiting Times data as detailed in the above will enable Cancer Alliances to have informed discussions and allocate resources optimally to improve performance against these standards. It will also enable Cancer Alliances to work with local providers and commissioners to identify outliers against the standards, and mitigate the risk of similar delays for other patients.
Improvement would be expected on an on-going basis with standards already in place for nine standards:-
• 2 week wait urgent GP referral – 93%
• 2 week wait breast symptomatic – 93%
• 31 day 1st treatment - 96%
• 31 day subsequent surgery – 94%
• 31 day subsequent drugs – 98%
• 31 day subsequent radiotherapy – 94%
• 62 day (GP) referral to 1st treatment – 85%
• 62 day (screening ) referral to 1st treatment – 90%
• 62 day upgrade to 1st treatment – locally agreed standard
In addition this access and use of data will be key in delivering the new 28 day faster diagnosis standard being introduced from 2020
2) Benefits type: Improvements beyond constitutional standards
This access and resulting analysis will enable Cancer Alliances to undertake local analysis beyond the Cancer Waiting times operational standards to support improvements to Cancer patients pathways beyond those already achieved by improving performance against standard set. This could include reviewing times between treatments, or treatment rates.
The overall aim of this type of additional analysis would be to support improvements to Cancer patient’s survival and experience. The NHS Long Term Plan sets two bold ambitions for improving cancer outcomes. These build on and accelerate the progress made through delivery of the recommendations of the Independent Cancer Taskforce (2015):
- By 2028, 55,000 more people nationally will survive cancer for five years or more each year, and
- By 2028, 75% of people will be diagnosed at an early stage (stage one or two). For both of these improvements to the diagnostic and treatment pathways are key, and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset.
Benefits reported so far
Previously, West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits data in the form of pre-analysed reports from NHS England. These have enabled the Alliance and its Board to identify priority pathways and parts of pathways for remedial action to deliver improved clinical pathways and faster diagnosis and treatment. The Alliance has used the data files provided by NHS England to develop a range of analytical products to support and inform its activities. This has included such products as:
- The Cancer Wait Times (CWT) Dashboard, which includes analysis of the 28 day faster diagnosis standard, 62 day referral to first definitive treatment and 31 day decision to treat to treatment. These data are available by tumour group and at Cancer Alliance/Trust level geography. The CWT data are intertwined with other data sources to provide a more detailed and granular representation of the cancer landscape across West Yorkshire & Harrogate that enables key stakeholders to make more informed decisions.
- For example, tumour site specific data packs for Optimal Pathway Groups have been produced. Insights into Cancer Waiting Times performance presented in these packs have been used to drive targeted improvement work, where stakeholder Trusts have been brought together to develop system wide solutions to shared challenges.
These Optimal Pathway Group data packs also include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data. These products have been used to provide monthly updates to the senior leadership team of the cancer alliance, and have been used to create reports for groups such as:
• Cancer Alliance Board
• West Yorkshire Association of Acute Trusts (WYAAT) Board
• WYAAT Committee in Common (CiC)
The Cancer Waiting Times data is presented alongside Cancer Patient Tracking List data to monitor Trust performance and achievement against the trajectories set during the ICB and Cancer Alliance planning processes. This analysis is reflected back to Trusts through regular Cancer Waiting Times catch ups with Trust Cancer Managers and the Cancer Performance recovery group. Regular discussions around this data allow the alliance to identify both Trust specific and system wide challenges as quickly as possible so that we can work together to support Trusts in achieving both operational and planning targets.
The record level cancer wait times data has been used to provide a more granular insight into cancer waiting times performance and associated trends. For example, this data allows analysis of performance at ICD10 code level, rather than broad tumour groupings. The data has also been used to analyse whole pathways, rather than snapshots based on individual standards. Examples of pieces of work created using this data are:
• Median pathway times, by Trust and tumour group, for each of the CWT standards, and for whole pathways
• Assessing the relationship between achieving different CWT standards. For example, looking at whether achieving the Faster Diagnosis Standard impacts whether the 62 day standard is achieved.
• More granular versions of previous CWT performance reports, including more defined tumour types and groups, e.g. HPB within Upper Gastrointestinal.
• Treatment Variation – assessing performance against recommendations from the lung GIRFT report, as part of a national reporting requirement. This could be expanded to other tumour groups in the future.
These products have been shared to a limited number of groups so far, including tumour specific optimal pathway groups. In future they will be used to create reports that will be shared with the other groups outlined above.
Datasets on the current version
Legal basis for provision: Health and Social Care Act 2012 – s261(2)(a)
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS) | Anonymised - ICO Code Compliant | Sensitive | System Access | Does not include the flow of confidential data |
Files released
Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.
No files recorded as released under this agreement.
Version history
The register lists each renewal of this agreement as a separate row. This site has 4 versions.
DARS-NIC-204520-B1V2G-v3.4 9 January 2026 to 8 January 2029
- Title
- Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System
- Commercial
- No
- Sublicensing
- No
- Datasets
- 1
- Files released
- 0
Datasets: National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
What changed from DARS-NIC-204520-B1V2G-v2.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2026-01-09 | |
| End date | 2029-01-08 |
Objective for processing
Improvements for Cancer
patients
patients:
The
In 2015, the
independent Cancer Taskforce set out an ambitious vision for improving services, care
[35 words unchanged]
being supported to live as well as possible after treatment has finished.
In 2019, the NHS Long Term Plan was published and it aims to improve how we diagnose and treat cancer. The plan included cancer care as one of its clinical priorities and aimed to boost cancer survival rates by focusing on early diagnosis. The plan set new targets that, by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise to 75% of cancer patients. Further, an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis.
Cancer
Alliances
Alliances:
Cancer Alliances, which have been set up across England, are key to driving the change needed across the country to achieve the Taskforce’s vision. Bringing together local clinical and managerial leaders from providers and commissioners who represent the whole Cancer pathway, Cancer Alliances provide the opportunity for a different way of working to improve and transform Cancer services. Cancer Alliance partners will take a whole population, whole pathway approach to improving outcomes across their geographical ‘footprints’, building on their relevant Sustainability and Transformation Plans (STPs). They will bring together influential local decision-makers and be responsible for directing funding to transform services and care across whole pathways, reducing variation in the availability of good care and treatment for all people with Cancer, and delivering continuous improvement and reduction in inequality of experience. They will particularly focus on leading transformations at scale to improve survival, early diagnosis, patient experience and long-term quality of life. Successful delivery will be shown in improvements in ratings in the The NHS Oversight Framework, including, importantly, in the 62 day wait from referral to first treatment standard.
Cancer Alliances have a crucial role to play by being the cancer arms of their ICSs and being the leaders for cancer within their ICB and ICS footprint. Their role is to lead the planning and delivery of the Long-Term Plan ambitions for cancer for their populations, to provide system oversight and co-ordination for cancer services and to oversee the delivery of critical programmes of work within that footprint. They do this by:
https://www.england.nhs.uk/publication/nhs-oversight-framework-22-23/
• Collaborating with partners (ICSs, commissioners and providers) to provide system level oversight and co-ordination to deliver the operational standards for cancer and the Long Term plan ambitions across their cancer system;
Cancer Wait Times (CWT) system
• Deploying service development funding in a way that supports their whole population, and which complements baseline investment so that it maximises the impact on improving cancer outcomes;
• Providing clinical leadership for cancer services across their area to ensure the delivery of a consistently high level of service to patients and to drive the rapid adoption of new approaches; and
• Working as part of the NHS Cancer Programme to share best practice and solutions, and to provide peer support to other Alliance teams.
Cancer Alliance boundaries encompass the range of providers that a cancer patient will typically use. This gives them an opportunity to organise services across organisation boundaries – reducing variation and inequalities, and overall benefitting patients
Cancer Wait Times (CWT) system:
[3 paragraphs unchanged]
NHS West Yorkshire Integrated Care Board (ICB) will directly access the Cancer
[43 words unchanged]
Trust supply IT infrastructure and are therefore listed as a data processor.
The data is processed under the following articles: 6(1)e, as the Cancer Alliance and the ICB are both tasked with improving the delivery of the health and care system and have the public interest at heart; and article 9(2)h as those two bodies are tasked with the management of health and social care systems.
[28 paragraphs unchanged]
Lead organisations will only access patient records which fall within the Cancer
[11 words unchanged]
This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients.
Cancer Patients. CCGs no longer exist in statute but NHS England use the CCG field in the data as he geographical variable to split the CWT extracts that are sent to Cancer Alliances.
[39 paragraphs unchanged]
Processing activities
Access to the Cancer Wait Times (CWT) System will enable Cancer Alliances to undertake a wide range of locally-determined and locally-specific analyses to support the
Long-Term Plan ambitions for early diagnosis and survival and the previous
Cancer Taskforce vision for improving services, care and outcomes for everyone with Cancer.
Access to the CWT system data is restricted to Cancer Alliance employees who are substantively employed by the Data Controller in fulfilment of their public health function.
[2 paragraphs unchanged]
The CWT system is hosted by NHS
Digital,
England,
access to and usage of the system is fully auditable. Users must
[9 words unchanged]
in this agreement. The CWT system complies with the requirements of NHS
Digital
England
Code of Practice on Confidential Information, the Caldicott Principles and other relevant statutory requirements and guidance to protect confidentiality.
[1 paragraph unchanged]
Access to the CWT system will be granted to individual users only when a valid Data Usage Certificate (DUC) form is submitted to NHS
Digital
England
via the lead organisations Senior Information Risk Officer (SIRO), and where there is a valid Data Sharing Agreement between the lead organisation and NHS
Digital.
England.
[14 paragraphs unchanged]
The Cancer Alliances will use the data to produce a range of quantitative measures (counts, crude and standardised rates and
ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data.
ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data.
[9 paragraphs unchanged]
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer
patient’s
patients
outcomes or patient experience. Examples for use of the data may include
[20 words unchanged]
and using the data source to validate surgical numbers by provider trust.
[1 paragraph unchanged]
Benefits reported
Previously, West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits
[36 words unchanged]
diagnosis and treatment. The Alliance has used the data files provided by
the Cancer Alliance Data, Evidence and Analysis Service (CADEAS)
NHS England
to develop a range of analytical products to support and inform its activities. This has included such products as:
- The Cancer Wait Times (CWT) Dashboard, which includes analysis of the
2 week wait pathway,
28 day faster diagnosis
standard and
standard,
62 day referral to first definitive
treatment and 31 day decision to treat to
treatment. These data are available by tumour group and at
cancer alliance/trust
Cancer Alliance/Trust
level geography. The CWT data are intertwined with other data sources to
[13 words unchanged]
Yorkshire & Harrogate that enables key stakeholders to make more informed decisions.
- For example, tumour site specific data packs for Optimal Pathway Groups have been produced.
Insights into Cancer Waiting Times performance presented in these packs have been used to drive targeted improvement work, where stakeholder Trusts have been brought together to develop system wide solutions to shared challenges.
These
Optimal Pathway Group data packs also
include data on incidence & mortality, survival, early stage diagnosis, emergency presentation,
[31 words unchanged]
alliance, and have been used to create reports for groups such as:
-
•
Cancer Alliance Board
-
•
West Yorkshire Association of Acute Trusts (WYAAT) Board
-
•
WYAAT Committee in Common (CiC)
- Clinical Advisory Board (the group that oversees the Optimal Pathway Groups)
The Cancer Waiting Times data is presented alongside Cancer Patient Tracking List data to monitor Trust performance and achievement against the trajectories set during the ICB and Cancer Alliance planning processes. This analysis is reflected back to Trusts through regular Cancer Waiting Times catch ups with Trust Cancer Managers and the Cancer Performance recovery group. Regular discussions around this data allow the alliance to identify both Trust specific and system wide challenges as quickly as possible so that we can work together to support Trusts in achieving both operational and planning targets.
The
Open Exeter
record level cancer wait times
data has been used to provide a more granular insight into cancer
[38 words unchanged]
individual standards. Examples of pieces of work created using this data are:
-
•
Median pathway times, by
trust
Trust
and tumour group, for each of the CWT standards, and for whole pathways
-
•
Assessing the relationship between achieving different CWT standards. For example, looking at whether achieving the
2 week wait standard
Faster Diagnosis Standard
impacts whether the 62 day standard is achieved.
-
•
More granular versions of previous CWT performance reports, including more defined tumour types and groups, e.g. HPB within Upper Gastrointestinal.
•
Treatment Variation – assessing performance against recommendations from the lung GIRFT report,
[6 words unchanged]
requirement. This could be expanded to other tumour groups in the future.
These products have been shared to a limited number of groups so far, including tumour specific optimal pathway groups. In future they will be used to create reports
for
that will be shared with
the
rest of the
other
groups outlined above.
Unchanged: Expected output, Expected measurable benefits.
DARS-NIC-204520-B1V2G-v2.2 4 January 2023 to 3 January 2026
- Title
- Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System
- Commercial
- No
- Sublicensing
- No
- Datasets
- 1
- Files released
- 0
Datasets: National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
What changed from DARS-NIC-204520-B1V2G-v1.3
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2023-01-04 | |
| End date | 2026-01-03 | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): legal basis | Health and Social Care Act 2012 – s261(2)(a) |
Objective for processing
[3 paragraphs unchanged]
Cancer Alliances, which have been set up across England, are key to
[139 words unchanged]
life. Successful delivery will be shown in improvements in ratings in the
Clinical Commissioning Group (CCG) Improvement and Assessment Framework (IAF),
The NHS Oversight Framework,
including, importantly, in the 62 day wait from referral to first treatment standard.
https://www.england.nhs.uk/publication/ccg-iaf-methodology-manual/
https://www.england.nhs.uk/publication/nhs-oversight-framework-22-23/
[4 paragraphs unchanged]
Wakefield CCG
NHS West Yorkshire Integrated Care Board (ICB)
will directly access the Cancer Waiting Times System on behalf of West
[7 words unchanged]
Yorkshire and Harrogate. West Yorkshire and Harrogate Cancer Alliance is hosted by
Wakefield CCG
NHS West Yorkshire ICB
and covers a population of 2.7 million people. Calderdale and Huddersfield NHS Foundation Trust supply IT infrastructure and are therefore listed as a data
processor, along with Wakefield CCG. Wakefield CCG is the data controller.
processor.
The data is processed under the following articles: 6(1)e, as the Cancer Alliance and the
CCG
ICB
are both tasked with improving the delivery of the health and care
[14 words unchanged]
bodies are tasked with the management of health and social care systems.
Wakefield CCG
NHS West Yorkshire ICB
works with health organisations across West Yorkshire and Harrogate including 6 acute providers,
9 clinical commissioning groups,
3 community providers and 9 hospices.
[7 paragraphs unchanged]
CCGs
ICBs
NHS Airedale, Wharfdale and Craven CCG
NHS West Yorkshire ICB
NHS Bradford City CCG
NHS Bradford Districts CCG
NHS Calderdale CCG
NHS Greater Huddersfield CCG
NHS Harrogate and Rural District CCG
NHS Leeds CCG
NHS North Kirklees CCG
NHS Wakefield CCG
[3 paragraphs unchanged]
Locala
[4 paragraphs unchanged]
St
Micheals,
Michaels,
Harrogate
[10 paragraphs unchanged]
Lead organisations will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients'
CCG
ICB
of responsibility. This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients.
[1 paragraph unchanged]
Aggregate data is available in the form of reports at Provider (Trust) and
Clinical Commissioning Group (CCG)
ICB
level.
[2 paragraphs unchanged]
Lead organisations routinely monitor performance and standards using the CWT system, particularly
[5 words unchanged]
the 62 day wait target. Due to the large number of potential
Trust/CCG
Trust/ICB
combinations, breach counts could result in small numbers as in some cases
[16 words unchanged]
to target breaches counts must accurately reflect the true percentage without suppression.
[8 paragraphs unchanged]
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to
CCG
ICB
level and other health hierarchies.
[3 paragraphs unchanged]
Generation of routine Cancer Waiting Times reports at Provider (Trust) or
CCG
ICB
level. Lead organisations will access a summary of the totals for the Providers (Trust) and
CCGs
the ICB
that are treating cancer patients where they have a commissioning responsibility for that patient (based on the
CCGs
ICB
they are aligned to). This analysis would then be shared with the
[57 words unchanged]
where small numbers would be essential to ensure the report is meaningful.
[1 paragraph unchanged]
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and
CCGs
ICBs
across the geography
[19 paragraphs unchanged]
Processing activities
[1 paragraph unchanged]
As
Wakefield CCG
NHS West Yorkshire ICB
are acting as the lead organisation in a Cancer Alliance their access
[11 words unchanged]
the Cancer Wait Times (CWT) System. The team doing this processing within
Wakefield CCG
NHS West Yorkshire ICB
are separate from the commissioning team and would not have access to data provide via the DSCRO route. Additionally any separate agreement that
Wakefield CCG
NHS West Yorkshire ICB
have to access CWT may include other processors and purposes.
Only the lead organisation
Wakefield CCG
NHS West Yorkshire ICB
will directly access the Cancer Waiting Times system. Extracts can be downloaded and will be stored on the
Wakefield CCG
NHS West Yorkshire ICB
servers. Role Based Access Control prevents access to data downloads to employees
[5 words unchanged]
responsible for producing outputs; the Health and Care Partnership Analytics Team and
Wakefield CCG
NHS West Yorkshire ICB
analytics team.
[4 paragraphs unchanged]
Wakefield CCG
NHS West Yorkshire ICB
users will access:
[3 paragraphs unchanged]
Any record level data extracted from the system will not be processed outside of
Wakefield CCG
NHS West Yorkshire ICB
unless otherwise specified in this agreement. Following completion of the analysis the record level data will be securely destroyed.
[1 paragraph unchanged]
Data will only be available for the Providers (Trust) and
CCGs
the ICB
that are treating cancer patients where they have a commissioning responsibility for that patient (based on the
CCGs
ICB
that this Cancer Alliance is aligned to).
[10 paragraphs unchanged]
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and
CCGs.
ICBs.
[7 paragraphs unchanged]
The members of the Health and Care Partnership Analytics Team who will process the data are all substantive employees of
Wakefield CCG.
NHS West Yorkshire ICB.
Expected output
[2 paragraphs unchanged]
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and
CCGs.
ICBs.
[8 paragraphs unchanged]
Benefits reported
To date
Previously,
West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits data
[26 words unchanged]
remedial action to deliver improved clinical pathways and faster diagnosis and treatment.
To date there
The Alliance
has
been no specific use
used the data files provided by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) to develop a range
of
data from the Open Exeter system.
analytical products to support and inform its activities. This has included such products as:
The Alliance has used the data files provided by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) to develop a range of analytical products to support and inform its activities. This has included such products as:
[1 paragraph unchanged]
- For example, tumour site specific data packs for Optimal Pathway Groups have been produced.
These include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data.
These include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data.
These products have been used to provide monthly updates to the senior
[5 words unchanged]
alliance, and have been used to create reports for groups such as:
[4 paragraphs unchanged]
The Open Exeter data has been used to provide a more granular insight into cancer waiting times performance and associated trends. For example, this data allows analysis of performance at ICD10 code level, rather than broad tumour groupings. The data has also been used to analyse whole pathways, rather than snapshots based on individual standards. Examples of pieces of work created using this data are:
- Median pathway times, by trust and tumour group, for each of the CWT standards, and for whole pathways
- Assessing the relationship between achieving different CWT standards. For example, looking at whether achieving the 2 week wait standard impacts whether the 62 day standard is achieved.
- More granular versions of previous CWT performance reports, including more defined tumour types and groups, e.g. HPB within Upper Gastrointestinal.
Treatment Variation – assessing performance against recommendations from the lung GIRFT report, as part of a national reporting requirement. This could be expanded to other tumour groups in the future.
These products have been shared to a limited number of groups so far, including tumour specific optimal pathway groups. In future they will be used to create reports for the rest of the groups outlined above.
Data controllers: renamed from NHS West Yorkshire ICB to NHS West Yorkshire Integrated Care Board. The same organisation under a new name, so not counted as a change.
Unchanged: Expected measurable benefits.
Objective for processing
Improvements for Cancer patients
The independent Cancer Taskforce set out an ambitious vision for improving services, care and outcomes for everyone with Cancer: fewer people getting Cancer, more people surviving Cancer, more people having a good experience of their treatment and care, whoever they are and wherever they live, and more people being supported to live as well as possible after treatment has finished.
Cancer Alliances
Cancer Alliances, which have been set up across England, are key to driving the change needed across the country to achieve the Taskforce’s vision. Bringing together local clinical and managerial leaders from providers and commissioners who represent the whole Cancer pathway, Cancer Alliances provide the opportunity for a different way of working to improve and transform Cancer services. Cancer Alliance partners will take a whole population, whole pathway approach to improving outcomes across their geographical ‘footprints’, building on their relevant Sustainability and Transformation Plans (STPs). They will bring together influential local decision-makers and be responsible for directing funding to transform services and care across whole pathways, reducing variation in the availability of good care and treatment for all people with Cancer, and delivering continuous improvement and reduction in inequality of experience. They will particularly focus on leading transformations at scale to improve survival, early diagnosis, patient experience and long-term quality of life. Successful delivery will be shown in improvements in ratings in the The NHS Oversight Framework, including, importantly, in the 62 day wait from referral to first treatment standard.
https://www.england.nhs.uk/publication/nhs-oversight-framework-22-23/
Cancer Wait Times (CWT) system
The Cancer Wait Times (CWT) system collects and validates the National Cancer Waiting Times Monitoring Data Set (NCWTMDS), allowing performance to be measured against operational Cancer standards. Data is validated and records merged to the same pathway to cover the period from referral to first definitive treatment for Cancer and any additional subsequent treatments.
The CWT system then determines whether the operational standard(s) that apply were met or not for the patient and the accountable provider(s). The CWT system holds NCWTMDS in a series of pre-aggregated static reports. These reports are available monthly and quarterly data (aligned with the National Statistics for Cancer Waiting Times published by NHS England). Users can query the CWT system to generate reports to feedback on the progress towards meeting these targets.
West Yorkshire and Harrogate Cancer Alliance
NHS West Yorkshire Integrated Care Board (ICB) will directly access the Cancer Waiting Times System on behalf of West Yorkshire and Harrogate Cancer Alliance across West Yorkshire and Harrogate. West Yorkshire and Harrogate Cancer Alliance is hosted by NHS West Yorkshire ICB and covers a population of 2.7 million people. Calderdale and Huddersfield NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor. The data is processed under the following articles: 6(1)e, as the Cancer Alliance and the ICB are both tasked with improving the delivery of the health and care system and have the public interest at heart; and article 9(2)h as those two bodies are tasked with the management of health and social care systems.
NHS West Yorkshire ICB works with health organisations across West Yorkshire and Harrogate including 6 acute providers, 3 community providers and 9 hospices.
Acute Providers
Airedale NHS Foundation Trust
Bradford Teaching Hospitals NHS Foundation Trust
Calderdale and Huddersfield NHS Foundation Trust
Harrogate and District NHS Foundation Trust
Leeds Teaching Hospitals NHS Trust
Mid Yorkshire Hospitals NHS Trust
ICBs
NHS West Yorkshire ICB
Community Providers
Bradford District Care Trust
Leeds Community Healthcare NHS Trust
Hospices
Manorlands, Bradford
Marie Curie Hospice, Bradford
Overgate Hospice, Calderdale
St Michaels, Harrogate
Kirkwood Hospice, Huddersfield
St Gemma's, Leeds
Wheatfield House, Leeds
Wakefield Hospice
The Prince of Wales Hospice, Pontefract
Data access
The CWT system provides one organisation (the lead organisation) representing each Cancer Alliance, with access to the following;
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool
Lead organisations will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients' ICB of responsibility. This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients.
A) Aggregate reports including small numbers
Aggregate data is available in the form of reports at Provider (Trust) and ICB level.
Small numbers may be included in the aggregate data reports and are essential for analyses carried out by lead organisations. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful and allowed action to be taken to improve patient care.
Investigating breaches
Lead organisations routinely monitor performance and standards using the CWT system, particularly in relation to breaches of the 62 day wait target. Due to the large number of potential Trust/ICB combinations, breach counts could result in small numbers as in some cases there are less than 6 breaches in a whole year. Given that financial penalties are linked to target breaches counts must accurately reflect the true percentage without suppression.
Mitigating risk of re-identification
Risk of disclosure is minimised as the dataset does not include patient demographics (increasing risk of re-identification) that may allow users to identify an individual e.g. there are no age, ethnic categories or geographic breakdowns.
Additionally, the aggregation categories are such that the data is not at a lesser granular level e.g. the source NCWTMDS data collects information at ICD diagnosis code level, but the CWT system aggregates at tumour group level – e.g. Head & Neck, Upper GI, lower GI, Breast etc.
B) Pseudonymised record level extracts
Lead organisations will access record level pseudonymised data which includes the system generated pseudo CWT patient ID.
Any record level data extracted from the system will not be processed outside of the authorised users of the system.
C) i-View Plus .
iView Plus uses cube functionality to allow lead organisations to produce graphs, charts and tabulations from the data through the construction of queries. The data in iView plus is split by operational standard being measured and can then be analysed against a range of dimensions collected in the data and measures such as count, percentage and median. The outputs of iView Plus are aggregate, and no record level data can be obtained, however some queries may result in small numbers and these currently have limited disclosure control applied, see A) for further explanation.
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to ICB level and other health hierarchies.
Lead organisations will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider Cancer pathway improvements.
Lead organisations use of the data will fall into two separate categories, each requiring different levels of suppression, and onward sharing both within the Cancer Alliance and with wider NHS stakeholders;
Purpose One - Aggregate local reports
Generation of routine Cancer Waiting Times reports at Provider (Trust) or ICB level. Lead organisations will access a summary of the totals for the Providers (Trust) and the ICB that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ICB they are aligned to). This analysis would then be shared with the providers and commissioners and used to inform service improvement by providing benchmarked comparable data. The format of this report would be in a tabulated or graphical form (i.e. not record level) but may contain small numbers. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful.
Examples of this type of analysis include:
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs across the geography
b. Analysis of Cancer Waiting Times performance by treatment modality
c. Grouping length of waits for standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks
h. Reviewing routes to diagnosis of patients
i. Quantifying treatment volumes by provider organisation including analysis treatment rates
Purpose Two - Sharing of record level data (including free text breach reasons) with providers and commissioners responsible for direct patient care for that patient. This will be for local clinical audit purposes.
The two broad purposes for this would be;
1) To support local clinical audit work
2) Investigate individual outliers to the national standards
Pathway analysis will be undertaken, identifying trends in reasons for breaches. The analysis will inform system wide pathway improvements and compliance to the national standards. Examples of potential changes to achieve this could be to support trusts in additional resources and processes and also to facilitate discuss between trusts for example in reaching agreement for diagnostics between trusts.
Examples of the types of reasons for this include;
a. Patients waiting excessively long period of time to seen of received treatment
b. Free text breach reasons identifying areas of concern which require more detail or clarification from provider
c. Identification of 28 day standard exceptions - National guidance states patients who are diagnosed with cancer should be informed face to face, this would highlights numbers of patients who are not told in person by provider
d. Audits to review orphan records which require local providers to review local patients records
Record level data (pseudonymised) will be shared via NHS.net email accounts and access will be controlled by password protecting all files.
Expected output
Outputs fall into the following categories:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and ICBs.
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays.
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer patient’s outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve Cancer pathways including reducing Cancer incidence and mortality, improving Cancer survival, improving patient experience, improving service efficiency and meeting national constitution standards relating to Cancer patients. The outputs produced will be in the form of reports, presentations and associated slide decks, and verbal updates relaying findings obtained from analysing the data. These outputs will have small number suppression applied where there is a risk of secondary disclosure as per HES guidance.
Benefits reported
Previously, West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits data in the form of pre-analysed reports from NHS England. These have enabled the Alliance and its Board to identify priority pathways and parts of pathways for remedial action to deliver improved clinical pathways and faster diagnosis and treatment. The Alliance has used the data files provided by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) to develop a range of analytical products to support and inform its activities. This has included such products as:
- The Cancer Wait Times (CWT) Dashboard, which includes analysis of the 2 week wait pathway, 28 day faster diagnosis standard and 62 day referral to first definitive treatment. These data are available by tumour group and at cancer alliance/trust level geography. The CWT data are intertwined with other data sources to provide a more detailed and granular representation of the cancer landscape across West Yorkshire & Harrogate that enables key stakeholders to make more informed decisions.
- For example, tumour site specific data packs for Optimal Pathway Groups have been produced.
These include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data. These products have been used to provide monthly updates to the senior leadership team of the cancer alliance, and have been used to create reports for groups such as:
- Cancer Alliance Board
- West Yorkshire Association of Acute Trusts (WYAAT) Board
- WYAAT Committee in Common (CiC)
- Clinical Advisory Board (the group that oversees the Optimal Pathway Groups)
The Open Exeter data has been used to provide a more granular insight into cancer waiting times performance and associated trends. For example, this data allows analysis of performance at ICD10 code level, rather than broad tumour groupings. The data has also been used to analyse whole pathways, rather than snapshots based on individual standards. Examples of pieces of work created using this data are:
- Median pathway times, by trust and tumour group, for each of the CWT standards, and for whole pathways
- Assessing the relationship between achieving different CWT standards. For example, looking at whether achieving the 2 week wait standard impacts whether the 62 day standard is achieved.
- More granular versions of previous CWT performance reports, including more defined tumour types and groups, e.g. HPB within Upper Gastrointestinal.
Treatment Variation – assessing performance against recommendations from the lung GIRFT report, as part of a national reporting requirement. This could be expanded to other tumour groups in the future.
These products have been shared to a limited number of groups so far, including tumour specific optimal pathway groups. In future they will be used to create reports for the rest of the groups outlined above.
DARS-NIC-204520-B1V2G-v1.3 1 February 2020 to 31 January 2023
- Title
- Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System
- Commercial
- No
- Sublicensing
- No
- Datasets
- 1
- Files released
- 0
Datasets: National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
What changed from DARS-NIC-204520-B1V2G-v0.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Applicant organisation | WEST YORKSHIRE AND HARROGATE CANCER ALLIANCE | |
| Organisation type | Network | |
| Start date | 2020-02-01 | |
| End date | 2023-01-31 | |
| National Cancer Waiting Times Monitoring DataSet (NCWTMDS): sensitivity | Sensitive |
Objective for processing
[9 paragraphs unchanged] Wakefield CCG will directly access the Cancer Waiting Times System on behalf [19 words unchanged] hosted by Wakefield CCG and covers a population of 2.7 million people. Calderdale and Huddersfield NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor, along with Wakefield CCG. Wakefield CCG is the data controller. The data is processed under the following articles: 6(1)e, as the Cancer Alliance and the CCG are both tasked with improving the delivery of the health and care system and have the public interest at heart; and article 9(2)h as those two bodies are tasked with the management of health and social care systems. [40 paragraphs unchanged] Small numbers may be included in the aggregate data reports and are essential for analyses carried out by lead organisations. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful and allowed action to be taken to improve patient care. [36 paragraphs unchanged]
Processing activities
Access to the Cancer Wait Times (CWT) System will enable Cancer Alliances
[14 words unchanged]
Taskforce vision for improving services, care and outcomes for everyone with Cancer.
Access to the CWT system data is restricted to Cancer Alliance employees who are substantively employed by the Data Controller in fulfilment of their public health function.
As Wakefield CCG are acting as the lead organisation in a Cancer
[20 words unchanged]
The team doing this processing within Wakefield CCG are separate from the
the
commissioning team and would not have access to data provide via the
[7 words unchanged]
Wakefield CCG have to access CWT may include other processors and purposes.
[31 paragraphs unchanged]
Expected output
[10 paragraphs unchanged] The overarching aim of all future analysis/outputs is to inform priorities and [18 words unchanged] improving service efficiency and meeting national constitution standards relating to Cancer patients. The outputs produced will be in the form of reports, presentations and associated slide decks, and verbal updates relaying findings obtained from analysing the data. These outputs will have small number suppression applied where there is a risk of secondary disclosure as per HES guidance.
Expected measurable benefits
1)
Benefits type: Supporting delivery of CWT standards
[15 paragraphs unchanged]
The overall aim of this type of additional analysis would be to support improvements to Cancer
patients
patient’s
survival and experience. The
NHS Long Term Plan sets two bold ambitions for improving cancer outcomes. These build on and accelerate the progress made through delivery of the recommendations of the Independent
Cancer Taskforce
recommendation set out a number of ambitions to be met nationally and locally by 2020 including improving 1 year survival for Cancer to 75%, and improving the proportions of patients staged 1 or 2 to 62%. For both of these improvements to the diagnostic and treatment pathways are key, and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset to identify sub-optimum pathways and resulting improvements.
(2015):
- By 2028, 55,000 more people nationally will survive cancer for five years or more each year, and
- By 2028, 75% of people will be diagnosed at an early stage (stage one or two). For both of these improvements to the diagnostic and treatment pathways are key, and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset.
Benefits reported
[1 paragraph unchanged] The Alliance has used the data files provided by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) to develop a range of analytical products to support and inform its activities. This has included such products as: - The Cancer Wait Times (CWT) Dashboard, which includes analysis of the 2 week wait pathway, 28 day faster diagnosis standard and 62 day referral to first definitive treatment. These data are available by tumour group and at cancer alliance/trust level geography. The CWT data are intertwined with other data sources to provide a more detailed and granular representation of the cancer landscape across West Yorkshire & Harrogate that enables key stakeholders to make more informed decisions. - For example, tumour site specific data packs for Optimal Pathway Groups have been produced. These include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data. These products have been used to provide monthly updates to the senior leadership team of the cancer alliance, and have been used to create reports for groups such as: - Cancer Alliance Board - West Yorkshire Association of Acute Trusts (WYAAT) Board - WYAAT Committee in Common (CiC) - Clinical Advisory Board (the group that oversees the Optimal Pathway Groups)
Objective for processing
Improvements for Cancer patients
The independent Cancer Taskforce set out an ambitious vision for improving services, care and outcomes for everyone with Cancer: fewer people getting Cancer, more people surviving Cancer, more people having a good experience of their treatment and care, whoever they are and wherever they live, and more people being supported to live as well as possible after treatment has finished.
Cancer Alliances
Cancer Alliances, which have been set up across England, are key to driving the change needed across the country to achieve the Taskforce’s vision. Bringing together local clinical and managerial leaders from providers and commissioners who represent the whole Cancer pathway, Cancer Alliances provide the opportunity for a different way of working to improve and transform Cancer services. Cancer Alliance partners will take a whole population, whole pathway approach to improving outcomes across their geographical ‘footprints’, building on their relevant Sustainability and Transformation Plans (STPs). They will bring together influential local decision-makers and be responsible for directing funding to transform services and care across whole pathways, reducing variation in the availability of good care and treatment for all people with Cancer, and delivering continuous improvement and reduction in inequality of experience. They will particularly focus on leading transformations at scale to improve survival, early diagnosis, patient experience and long-term quality of life. Successful delivery will be shown in improvements in ratings in the Clinical Commissioning Group (CCG) Improvement and Assessment Framework (IAF), including, importantly, in the 62 day wait from referral to first treatment standard.
https://www.england.nhs.uk/publication/ccg-iaf-methodology-manual/
Cancer Wait Times (CWT) system
The Cancer Wait Times (CWT) system collects and validates the National Cancer Waiting Times Monitoring Data Set (NCWTMDS), allowing performance to be measured against operational Cancer standards. Data is validated and records merged to the same pathway to cover the period from referral to first definitive treatment for Cancer and any additional subsequent treatments.
The CWT system then determines whether the operational standard(s) that apply were met or not for the patient and the accountable provider(s). The CWT system holds NCWTMDS in a series of pre-aggregated static reports. These reports are available monthly and quarterly data (aligned with the National Statistics for Cancer Waiting Times published by NHS England). Users can query the CWT system to generate reports to feedback on the progress towards meeting these targets.
West Yorkshire and Harrogate Cancer Alliance
Wakefield CCG will directly access the Cancer Waiting Times System on behalf of West Yorkshire and Harrogate Cancer Alliance across West Yorkshire and Harrogate. West Yorkshire and Harrogate Cancer Alliance is hosted by Wakefield CCG and covers a population of 2.7 million people. Calderdale and Huddersfield NHS Foundation Trust supply IT infrastructure and are therefore listed as a data processor, along with Wakefield CCG. Wakefield CCG is the data controller. The data is processed under the following articles: 6(1)e, as the Cancer Alliance and the CCG are both tasked with improving the delivery of the health and care system and have the public interest at heart; and article 9(2)h as those two bodies are tasked with the management of health and social care systems.
Wakefield CCG works with health organisations across West Yorkshire and Harrogate including 6 acute providers, 9 clinical commissioning groups, 3 community providers and 9 hospices.
Acute Providers
Airedale NHS Foundation Trust
Bradford Teaching Hospitals NHS Foundation Trust
Calderdale and Huddersfield NHS Foundation Trust
Harrogate and District NHS Foundation Trust
Leeds Teaching Hospitals NHS Trust
Mid Yorkshire Hospitals NHS Trust
CCGs
NHS Airedale, Wharfdale and Craven CCG
NHS Bradford City CCG
NHS Bradford Districts CCG
NHS Calderdale CCG
NHS Greater Huddersfield CCG
NHS Harrogate and Rural District CCG
NHS Leeds CCG
NHS North Kirklees CCG
NHS Wakefield CCG
Community Providers
Bradford District Care Trust
Leeds Community Healthcare NHS Trust
Locala
Hospices
Manorlands, Bradford
Marie Curie Hospice, Bradford
Overgate Hospice, Calderdale
St Micheals, Harrogate
Kirkwood Hospice, Huddersfield
St Gemma's, Leeds
Wheatfield House, Leeds
Wakefield Hospice
The Prince of Wales Hospice, Pontefract
Data access
The CWT system provides one organisation (the lead organisation) representing each Cancer Alliance, with access to the following;
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool
Lead organisations will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients' CCG of responsibility. This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients.
A) Aggregate reports including small numbers
Aggregate data is available in the form of reports at Provider (Trust) and Clinical Commissioning Group (CCG) level.
Small numbers may be included in the aggregate data reports and are essential for analyses carried out by lead organisations. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful and allowed action to be taken to improve patient care.
Investigating breaches
Lead organisations routinely monitor performance and standards using the CWT system, particularly in relation to breaches of the 62 day wait target. Due to the large number of potential Trust/CCG combinations, breach counts could result in small numbers as in some cases there are less than 6 breaches in a whole year. Given that financial penalties are linked to target breaches counts must accurately reflect the true percentage without suppression.
Mitigating risk of re-identification
Risk of disclosure is minimised as the dataset does not include patient demographics (increasing risk of re-identification) that may allow users to identify an individual e.g. there are no age, ethnic categories or geographic breakdowns.
Additionally, the aggregation categories are such that the data is not at a lesser granular level e.g. the source NCWTMDS data collects information at ICD diagnosis code level, but the CWT system aggregates at tumour group level – e.g. Head & Neck, Upper GI, lower GI, Breast etc.
B) Pseudonymised record level extracts
Lead organisations will access record level pseudonymised data which includes the system generated pseudo CWT patient ID.
Any record level data extracted from the system will not be processed outside of the authorised users of the system.
C) i-View Plus .
iView Plus uses cube functionality to allow lead organisations to produce graphs, charts and tabulations from the data through the construction of queries. The data in iView plus is split by operational standard being measured and can then be analysed against a range of dimensions collected in the data and measures such as count, percentage and median. The outputs of iView Plus are aggregate, and no record level data can be obtained, however some queries may result in small numbers and these currently have limited disclosure control applied, see A) for further explanation.
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to CCG level and other health hierarchies.
Lead organisations will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider Cancer pathway improvements.
Lead organisations use of the data will fall into two separate categories, each requiring different levels of suppression, and onward sharing both within the Cancer Alliance and with wider NHS stakeholders;
Purpose One - Aggregate local reports
Generation of routine Cancer Waiting Times reports at Provider (Trust) or CCG level. Lead organisations will access a summary of the totals for the Providers (Trust) and CCGs that are treating cancer patients where they have a commissioning responsibility for that patient (based on the CCGs they are aligned to). This analysis would then be shared with the providers and commissioners and used to inform service improvement by providing benchmarked comparable data. The format of this report would be in a tabulated or graphical form (i.e. not record level) but may contain small numbers. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful.
Examples of this type of analysis include:
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and CCGs across the geography
b. Analysis of Cancer Waiting Times performance by treatment modality
c. Grouping length of waits for standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks
h. Reviewing routes to diagnosis of patients
i. Quantifying treatment volumes by provider organisation including analysis treatment rates
Purpose Two - Sharing of record level data (including free text breach reasons) with providers and commissioners responsible for direct patient care for that patient. This will be for local clinical audit purposes.
The two broad purposes for this would be;
1) To support local clinical audit work
2) Investigate individual outliers to the national standards
Pathway analysis will be undertaken, identifying trends in reasons for breaches. The analysis will inform system wide pathway improvements and compliance to the national standards. Examples of potential changes to achieve this could be to support trusts in additional resources and processes and also to facilitate discuss between trusts for example in reaching agreement for diagnostics between trusts.
Examples of the types of reasons for this include;
a. Patients waiting excessively long period of time to seen of received treatment
b. Free text breach reasons identifying areas of concern which require more detail or clarification from provider
c. Identification of 28 day standard exceptions - National guidance states patients who are diagnosed with cancer should be informed face to face, this would highlights numbers of patients who are not told in person by provider
d. Audits to review orphan records which require local providers to review local patients records
Record level data (pseudonymised) will be shared via NHS.net email accounts and access will be controlled by password protecting all files.
Expected output
Outputs fall into the following categories:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and CCGs.
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays.
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer patient’s outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve Cancer pathways including reducing Cancer incidence and mortality, improving Cancer survival, improving patient experience, improving service efficiency and meeting national constitution standards relating to Cancer patients. The outputs produced will be in the form of reports, presentations and associated slide decks, and verbal updates relaying findings obtained from analysing the data. These outputs will have small number suppression applied where there is a risk of secondary disclosure as per HES guidance.
Benefits reported
To date West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits data in the form of pre-analysed reports from NHS England. These have enabled the Alliance and its Board to identify priority pathways and parts of pathways for remedial action to deliver improved clinical pathways and faster diagnosis and treatment. To date there has been no specific use of data from the Open Exeter system.
The Alliance has used the data files provided by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) to develop a range of analytical products to support and inform its activities. This has included such products as:
- The Cancer Wait Times (CWT) Dashboard, which includes analysis of the 2 week wait pathway, 28 day faster diagnosis standard and 62 day referral to first definitive treatment. These data are available by tumour group and at cancer alliance/trust level geography. The CWT data are intertwined with other data sources to provide a more detailed and granular representation of the cancer landscape across West Yorkshire & Harrogate that enables key stakeholders to make more informed decisions.
- For example, tumour site specific data packs for Optimal Pathway Groups have been produced. These include data on incidence & mortality, survival, early stage diagnosis, emergency presentation, screening rates and patient experience which are wrapped around tumour site specific CWT data.
These products have been used to provide monthly updates to the senior leadership team of the cancer alliance, and have been used to create reports for groups such as:
- Cancer Alliance Board
- West Yorkshire Association of Acute Trusts (WYAAT) Board
- WYAAT Committee in Common (CiC)
- Clinical Advisory Board (the group that oversees the Optimal Pathway Groups)
DARS-NIC-204520-B1V2G-v0.2 1 March 2019 to 31 January 2020
- Title
- Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System
- Commercial
- No
- Sublicensing
- No
- Datasets
- 1
- Files released
- 0
Datasets: National Cancer Waiting Times Monitoring DataSet (NCWTMDS)
Objective for processing
Improvements for Cancer patients
The independent Cancer Taskforce set out an ambitious vision for improving services, care and outcomes for everyone with Cancer: fewer people getting Cancer, more people surviving Cancer, more people having a good experience of their treatment and care, whoever they are and wherever they live, and more people being supported to live as well as possible after treatment has finished.
Cancer Alliances
Cancer Alliances, which have been set up across England, are key to driving the change needed across the country to achieve the Taskforce’s vision. Bringing together local clinical and managerial leaders from providers and commissioners who represent the whole Cancer pathway, Cancer Alliances provide the opportunity for a different way of working to improve and transform Cancer services. Cancer Alliance partners will take a whole population, whole pathway approach to improving outcomes across their geographical ‘footprints’, building on their relevant Sustainability and Transformation Plans (STPs). They will bring together influential local decision-makers and be responsible for directing funding to transform services and care across whole pathways, reducing variation in the availability of good care and treatment for all people with Cancer, and delivering continuous improvement and reduction in inequality of experience. They will particularly focus on leading transformations at scale to improve survival, early diagnosis, patient experience and long-term quality of life. Successful delivery will be shown in improvements in ratings in the Clinical Commissioning Group (CCG) Improvement and Assessment Framework (IAF), including, importantly, in the 62 day wait from referral to first treatment standard.
https://www.england.nhs.uk/publication/ccg-iaf-methodology-manual/
Cancer Wait Times (CWT) system
The Cancer Wait Times (CWT) system collects and validates the National Cancer Waiting Times Monitoring Data Set (NCWTMDS), allowing performance to be measured against operational Cancer standards. Data is validated and records merged to the same pathway to cover the period from referral to first definitive treatment for Cancer and any additional subsequent treatments.
The CWT system then determines whether the operational standard(s) that apply were met or not for the patient and the accountable provider(s). The CWT system holds NCWTMDS in a series of pre-aggregated static reports. These reports are available monthly and quarterly data (aligned with the National Statistics for Cancer Waiting Times published by NHS England). Users can query the CWT system to generate reports to feedback on the progress towards meeting these targets.
West Yorkshire and Harrogate Cancer Alliance
Wakefield CCG will directly access the Cancer Waiting Times System on behalf of West Yorkshire and Harrogate Cancer Alliance across West Yorkshire and Harrogate. West Yorkshire and Harrogate Cancer Alliance is hosted by Wakefield CCG and covers a population of 2.7 million people.
Wakefield CCG works with health organisations across West Yorkshire and Harrogate including 6 acute providers, 9 clinical commissioning groups, 3 community providers and 9 hospices.
Acute Providers
Airedale NHS Foundation Trust
Bradford Teaching Hospitals NHS Foundation Trust
Calderdale and Huddersfield NHS Foundation Trust
Harrogate and District NHS Foundation Trust
Leeds Teaching Hospitals NHS Trust
Mid Yorkshire Hospitals NHS Trust
CCGs
NHS Airedale, Wharfdale and Craven CCG
NHS Bradford City CCG
NHS Bradford Districts CCG
NHS Calderdale CCG
NHS Greater Huddersfield CCG
NHS Harrogate and Rural District CCG
NHS Leeds CCG
NHS North Kirklees CCG
NHS Wakefield CCG
Community Providers
Bradford District Care Trust
Leeds Community Healthcare NHS Trust
Locala
Hospices
Manorlands, Bradford
Marie Curie Hospice, Bradford
Overgate Hospice, Calderdale
St Micheals, Harrogate
Kirkwood Hospice, Huddersfield
St Gemma's, Leeds
Wheatfield House, Leeds
Wakefield Hospice
The Prince of Wales Hospice, Pontefract
Data access
The CWT system provides one organisation (the lead organisation) representing each Cancer Alliance, with access to the following;
a) Aggregate reports (which may include unsuppressed small numbers)
b) Pseudonymised record level data - users can directly download this data from the CWT system
c) I-View Plus tool
Lead organisations will only access patient records which fall within the Cancer Alliances' footprint of responsibility based on the patients' CCG of responsibility. This Cancer Alliance is limited to West Yorkshire and Harrogate Cancer Patients.
A) Aggregate reports including small numbers
Aggregate data is available in the form of reports at Provider (Trust) and Clinical Commissioning Group (CCG) level.
Small numbers may be included in the aggregate data reports and are essential for analyses carried out by lead organisations.
Investigating breaches
Lead organisations routinely monitor performance and standards using the CWT system, particularly in relation to breaches of the 62 day wait target. Due to the large number of potential Trust/CCG combinations, breach counts could result in small numbers as in some cases there are less than 6 breaches in a whole year. Given that financial penalties are linked to target breaches counts must accurately reflect the true percentage without suppression.
Mitigating risk of re-identification
Risk of disclosure is minimised as the dataset does not include patient demographics (increasing risk of re-identification) that may allow users to identify an individual e.g. there are no age, ethnic categories or geographic breakdowns.
Additionally, the aggregation categories are such that the data is not at a lesser granular level e.g. the source NCWTMDS data collects information at ICD diagnosis code level, but the CWT system aggregates at tumour group level – e.g. Head & Neck, Upper GI, lower GI, Breast etc.
B) Pseudonymised record level extracts
Lead organisations will access record level pseudonymised data which includes the system generated pseudo CWT patient ID.
Any record level data extracted from the system will not be processed outside of the authorised users of the system.
C) i-View Plus .
iView Plus uses cube functionality to allow lead organisations to produce graphs, charts and tabulations from the data through the construction of queries. The data in iView plus is split by operational standard being measured and can then be analysed against a range of dimensions collected in the data and measures such as count, percentage and median. The outputs of iView Plus are aggregate, and no record level data can be obtained, however some queries may result in small numbers and these currently have limited disclosure control applied, see A) for further explanation.
iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to CCG level and other health hierarchies.
Lead organisations will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider Cancer pathway improvements.
Lead organisations use of the data will fall into two separate categories, each requiring different levels of suppression, and onward sharing both within the Cancer Alliance and with wider NHS stakeholders;
Purpose One - Aggregate local reports
Generation of routine Cancer Waiting Times reports at Provider (Trust) or CCG level. Lead organisations will access a summary of the totals for the Providers (Trust) and CCGs that are treating cancer patients where they have a commissioning responsibility for that patient (based on the CCGs they are aligned to). This analysis would then be shared with the providers and commissioners and used to inform service improvement by providing benchmarked comparable data. The format of this report would be in a tabulated or graphical form (i.e. not record level) but may contain small numbers. An example of where small numbers would not be suppressed would be in relation to cases of breaches against a standard where small numbers would be essential to ensure the report is meaningful.
Examples of this type of analysis include:
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and CCGs across the geography
b. Analysis of Cancer Waiting Times performance by treatment modality
c. Grouping length of waits for standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Reviewing waits between surgery and radiotherapy for Head and Neck Cancer patients with a maximum recommended wait of 6 weeks
h. Reviewing routes to diagnosis of patients
i. Quantifying treatment volumes by provider organisation including analysis treatment rates
Purpose Two - Sharing of record level data (including free text breach reasons) with providers and commissioners responsible for direct patient care for that patient. This will be for local clinical audit purposes.
The two broad purposes for this would be;
1) To support local clinical audit work
2) Investigate individual outliers to the national standards
Pathway analysis will be undertaken, identifying trends in reasons for breaches. The analysis will inform system wide pathway improvements and compliance to the national standards. Examples of potential changes to achieve this could be to support trusts in additional resources and processes and also to facilitate discuss between trusts for example in reaching agreement for diagnostics between trusts.
Examples of the types of reasons for this include;
a. Patients waiting excessively long period of time to seen of received treatment
b. Free text breach reasons identifying areas of concern which require more detail or clarification from provider
c. Identification of 28 day standard exceptions - National guidance states patients who are diagnosed with cancer should be informed face to face, this would highlights numbers of patients who are not told in person by provider
d. Audits to review orphan records which require local providers to review local patients records
Record level data (pseudonymised) will be shared via NHS.net email accounts and access will be controlled by password protecting all files.
Expected output
Outputs fall into the following categories:
1) Analysis to support delivery of Cancer Waiting Times standard and identify variation, including clinical discussions to improve patient pathways
a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site (i.e. ICD10 code) level for Trusts and CCGs.
b. Analysis of Cancer Waiting Times performance by treatment modality to inform discussions
c. Grouping length of waits for standards to inform discussions on going beyond constitutional standards
d. Analysis of free text and derived breach reason fields to identify trends in reasons for delays.
e. To provide assurance through comparative analysis (e.g. orphan record identification, active monitoring proportions and validation of waiting list adjustments entered)
f. Analysis of flows of patients including analysis by provider trust site
g. Outlier identification including exceptionally long waits to inform individual queries to providers
2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact Cancer patient’s outcomes or patient experience. Examples for use of the data may include reviewing waits between surgery and radiotherapy for Head and Neck cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.
The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve Cancer pathways including reducing Cancer incidence and mortality, improving Cancer survival, improving patient experience, improving service efficiency and meeting national constitution standards relating to Cancer patients.
Benefits reported
To date West Yorkshire and Harrogate Cancer Alliance has mainly received cancer waits data in the form of pre-analysed reports from NHS England. These have enabled the Alliance and its Board to identify priority pathways and parts of pathways for remedial action to deliver improved clinical pathways and faster diagnosis and treatment. To date there has been no specific use of data from the Open Exeter system.
Register history
When this agreement appeared in, or was edited in, each monthly edition of the register. Built by comparing every edition this site holds, the earliest of which is July 2021.
-
July 2021 —
already listed in the earliest edition this site holds, so it may be older. 2 versions: DARS-NIC-204520-B1V2G-v0.2, DARS-NIC-204520-B1V2G-v1.3
-
October 2022
Succeeded Applicant organisation: NHS Wakefield CCG succeeded by NHS West Yorkshire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.Succeeded Data controllers: NHS Wakefield CCG succeeded by NHS West Yorkshire ICB from 1 July 2022, according to NHS ODS. Not counted as a change.
-
December 2022
Register-wide edit DARS-NIC-204520-B1V2G-v0.2, DARS-NIC-204520-B1V2G-v1.3 — Datasets: legal basis: “
s261(1) and” taken out. Made to 639 agreements in this edition, so it is reported once, on the changes page, and not counted as an amendment of this agreement. -
February 2023
1 version added: DARS-NIC-204520-B1V2G-v2.2
-
February 2026
1 version added: DARS-NIC-204520-B1V2G-v3.4
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-204520-B1V2G, “Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-204520-b1v2g/ (accessed [date]).
This address stays the same, but the page is rebuilt with each monthly edition, so the citation names the edition it shows. Every edition's data is kept in the facts store.
Source: datausesregister_september2026.xlsx, September 2026 edition of the NHS England Data Uses Register. Search that workbook for DARS-NIC-204520-B1V2G to see the original rows.