Cancer Alliance access to National Cancer Waiting Times Monitoring Data Set (NCWTMDS) from the Cancer Wait Times (CWT) System

The Clatterbridge Cancer Centre NHS Foundation Trust · NHS Trust

In term In term in the September 2026 edition: the latest version runs to 29 November 2027.

Reference: DARS-NIC-204580-F5B0C
Current version: v4.2
Term of current version: 10 July 2026 to 29 November 2027
Start date: 18 February 2019
Data controller: Sole Data Controller
Commercial purposes: No
Sublicensing: No
Files released to date: 0

Why the data was released

Objective for processing

This agreement is for the Cheshire and Merseyside Cancer Alliance to access Cancer Waiting Times data. However, the Cancer Alliance is not a legal entity - its staff (and those accessing the Cancer Waiting Times data) are substantively employed by the Clatterbridge Cancer Centre NHS Foundation Trust. The Clatterbridge Cancer Centre NHS Foundation Trust is therefore the lead organisation, and the controller who also processes data. In this agreement, therefore, all references to accessing the data refer to the legal entity - the Clatterbridge Cancer Centre NHS Foundation Trust. The data will be processed under UK GDPR Article 6(1)(e) and UK GDPR Article 9(2)(h).

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 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 are 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 as 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.

Cheshire and Merseyside Cancer Alliance:

The Clatterbridge Cancer Centre NHS Foundation Trust (the Clatterbridge Cancer Centre) will directly access the Cancer Waiting Times System on behalf of Cheshire and Merseyside Cancer Alliance , which covers a population of more than 2 million people.

The Clatterbridge Cancer Centre NHS Foundation Trust works with health organisations across Cheshire and Merseyside including 11 acute and specialist providers, 1 Integrated Care Board (ICB) containing 9 sub-regions, 1 community provider, and 8 hospices.

Acute/Specialist Providers:

- Countess of Chester Hospital NHS Foundation Trust (Acute)

- East Cheshire NHS Trust (Acute)

- Mid Cheshire Hospitals NHS Foundation Trust (Acute)

- Alder Hey Children’s NHS Foundation Trust (Specialist)

- Liverpool Heart and Chest Hospital NHS Foundation Trust (Specialist)

- Liverpool Women’s NHS Foundation Trust (Specialist)

- The Walton Centre NHS Foundation Trust (Specialist)

- Warrington and Halton NHS Foundation Trust (Acute)

- Wirral University Teaching Hospital NHS Foundation Trust (Acute)

- Liverpool University Hospitals NHS Foundation Trust (Acute)

- Mersey and West Lancashire Teaching Hospitals NHS Foundation Trust (Acute)

ICB:

- Cheshire and Merseyside ICB

ICB Sub-regions:

- 27D (NHS Cheshire)

- 99A (NHS Liverpool)

- 01F (NHS Halton)

- 01J (NHS Knowsley)

- 01T (NHS South Sefton)

- 01V (NHS Southport and Formby)

- 01X (NHS St Helens)

- 02E (NHS Warrington)

- 12F (NHS Wirral)

Community Providers:

- Bridgewater Community NHS Trust

Hospices:

- Claire House

- Hospice of the Good Shepherd

- Halton Haven

- Wirral Hospice St Johns

- St Roccos Hospice

- Queenscourt Hospice

- Wollowbrook Hospice

- St Josephs Hospice

- Woodlands Hospice

- Marie Curie Hospice

Data access:

The CWT system provides one organisation (the Clatterbridge Cancer Centre NHS Foundation Trust) 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

The Clatterbridge Cancer Centre NHS Foundation Trust 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 the ICB's listed above cancer patients. CCGs no longer exist in statute, but NHS England use the CCG field as the 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 sub-region level.

Small numbers may be included in the aggregate data reports and are essential for analyses carried out by the Clatterbridge Cancer Centre NHS Foundation Trust.

Investigating breaches:

The Clatterbridge Cancer Centre NHS Foundation Trust 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 sub-region 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 based on patient postcode.

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:

The Clatterbridge Cancer Centre 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 the Clatterbridge Cancer Centre NHS Foundation Trust 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 sub-region level and other health hierarchies.

The Clatterbridge Cancer Centre NHS Foundation Trust will use the data to both monitor and improve performance against the Cancer Waiting Time standards and to inform wider cancer pathway improvements.

The Clatterbridge Cancer Centre NHS Foundation Trust’s 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 sub-region level. The Clatterbridge Cancer Centre NHS Foundation Trust will access a summary of the totals for the Providers (Trust) and ICB sub-region's 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 ICB sub-regions 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 audit purposes.

The two broad purposes for this would be:

1) To support 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.

Only the Clatterbridge Cancer Centre NHS Foundation Trust will directly access the Cancer Waiting Times system. Extracts can be downloaded and will be stored on the Clatterbridge Cancer Centre NHS Foundation Trust servers. Role Based Access Control prevents access to data downloads to employees outside of the analytical team responsible for producing outputs.

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.

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 organisation’s 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).

The Clatterbridge Cancer Centre NHS Foundation Trust 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 the Clatterbridge Cancer Centre NHS Foundation Trust 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 ICBs 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). Cheshire and Merseyside Cancer Alliance will only access data for patients within their geographical remit - namely in the Cheshire and Merseyside region.

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 via NHSmail.

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, and only via NHS.net email accounts.

As part of partnership working to improve Cancer Waiting Times performance, outputs may be shared with national/regional bodies including NHS England, local ICBs, and Providers. 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 England 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 Clatterbridge Cancer Centre NHS Foundation Trust 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 ICB sub-regions

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.

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.

Expected measurable benefits

1) 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. These include the 3 combined operational standards which came into existence in October 2023 (28 day Faster Diagnosis, 31 day Treatment and 62 day Standards).

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 the combined standards, based on the previous nine standards, being in place since October 2023:

8-day Faster Diagnosis Standard (75%)

31-day decision to treat to treatment standard (96%)

62-day referral to treatment standard (85%)

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 patients survival and experience. The NHS Long-Term plan built on the previous Cancer Taskforce recommendations relating to survival and early diagnosis, and has set out ambitions to improve early diagnosis (patients stage 1 or 2) to 75% and that an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis by 2028. For both of these improvements to the diagnostic and treatment pathways are key, and key and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset to identify sub-optimum pathways and resulting improvements.

Benefits reported so far

Cancer Alliances have previously had access to Cancer Waiting Times reports and pseudonymised data through the system on Open Exeter, under an agreement with NHS England. This has enabled analysis to inform service improvement both to achieve the national Cancer Waiting Times standards and also wider Cancer pathway improvement work, which will have contributed to oncoming improvements to Cancer survival, and patient experience.

Examples of specific work undertaken by this Cancer Alliance include:

- To inform interventions and priorities for cancer planning, in line with national guidance, with a focus on challenged services with high volume breaches

- To inform interventions and priorities for cancer planning, in line with national guidance, with a focus on rarer tumour sites with challenged pathways

- Data to support operational performance planning

- Monthly reports to inform discussions with Acute Provider COOs, Cancer Clinicians and Cancer Managers across the area

- Information to support the development of transformational funding bids

- Data to support Clinical Quality Groups in tumour specific areas, to develop best practice and cross-organisational working practices e.g. post covid mutual aid initiatives

Datasets on the current version

Legal basis for provision: Health and Social Care Act 2012 – s261(2)(a)

Datasets approved under DARS-NIC-204580-F5B0C-v4.2
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 5 versions.

DARS-NIC-204580-F5B0C-v4.2 10 July 2026 to 29 November 2027

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-204580-F5B0C-v3.3

Text removed is ~~struck through~~; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Fields changed from DARS-NIC-204580-F5B0C-v3.3
Field	Was	Became
Applicant organisation	~~CHESHIRE AND MERSEYSIDE CANCER ALLIANCE~~	THE CLATTERBRIDGE CANCER CENTRE NHS FOUNDATION TRUST
Organisation type	~~Network~~	NHS Trust
Start date	~~2023-11-30~~	2026-07-10
End date	~~2026-11-29~~	2027-11-29

Objective for processing

[2 paragraphs unchanged] ~~The~~ In 2015, the independent Cancer Taskforce set out an ambitious vision for improving services, ~~care,~~ care and outcomes for everyone with ~~cancer: Fewer~~ Cancer: fewer people getting ~~cancer,~~ Cancer, more people surviving ~~cancer,~~ Cancer, more people having a good experience of their treatment and care, whoever [9 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. [1 paragraph unchanged] 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 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: • 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 [48 paragraphs unchanged] The Clatterbridge Cancer Centre NHS Foundation Trust will only access patient records [16 words unchanged] This Cancer Alliance is limited to the ICB's listed above cancer patients. CCGs no longer exist in statute, but NHS England use the CCG field as the geographical variable to split the CWT extracts that are sent to Cancer Alliances. [39 paragraphs unchanged]

Processing activities

Expected measurable benefits

[1 paragraph unchanged] The Cancer Waiting Times standards are key operational standards for the NHS, [12 words unchanged] patients, which will support improvements to survival rates and improve patient experience. ~~This includes~~ These include the ~~new 28~~ 3 combined operational standards which came into existence in October 2023 (28 day ~~faster diagnosis standard introduced as a standard from April 2020.~~ Faster Diagnosis, 31 day Treatment and 62 day Standards). [1 paragraph unchanged] Improvement would be expected on an on-going basis with ~~standards already~~ the combined standards, based on the previous nine standards, being in place ~~for nine standards:~~ since October 2023: ~~• 2 week wait urgent GP referral – 93%~~ 8-day Faster Diagnosis Standard (75%) ~~• 2 week wait breast symptomatic – 93%~~ 31-day decision to treat to treatment standard (96%) ~~• 31 day 1st treatment – 96%~~ 62-day referral to treatment standard (85%) ~~• 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 introduced from 2020.~~ [2 paragraphs unchanged] The overall aim of this type of additional analysis would be to support improvements to ~~cancer~~ Cancer patients survival and experience. The NHS Long-Term plan built on the previous Cancer Taskforce ~~recommendation~~ recommendations relating to survival and early diagnosis, and has set out ~~a number of~~ ambitions to ~~be met nationally and locally, including improving 1 year survival for cancer to 75%, and improving the proportions of patients staged~~ improve early diagnosis (patients stage 1 or 2 2) to ~~62%.~~ 75% and that an extra 55,000 people each year will survive for 5 years or more following their cancer diagnosis by 2028. For both of these improvements to the diagnostic and treatment pathways are key, and key and require Cancer Alliances to be able to analyse the Cancer Waiting Times dataset to identify sub-optimum pathways and resulting improvements.

Benefits reported

Cancer Alliances have previously had access to Cancer Waiting Times reports and pseudonymised data through the system on Open ~~Exeter~~ Exeter, under an agreement with NHS England. This has enabled analysis to inform service improvement both to achieve the national Cancer Waiting Times standards and also wider ~~cancer~~ Cancer pathway improvement work, which will have contributed to oncoming improvements to ~~cancer~~ Cancer survival, and patient experience. Examples of specific work undertaken by this Cancer Alliance ~~previously:~~ include: - To inform interventions and priorities for ~~planning~~ cancer planning, in line with national guidance, with a focus on challenged services with high volume breaches - To inform interventions and priorities for cancer planning, in line with national guidance, with a focus on rarer tumour sites with challenged pathways [1 paragraph unchanged] ~~- Baselining mapping work with acute providers to understand cancer pathways~~ - Monthly reports to inform discussions with Acute Provider COOs, Cancer Clinicians and Cancer Managers across the area ~~- Monthly reports to inform discussions with Acute Provider CEOs, Cancer Clinicians, and Cancer Managers across the area~~ - Information to support the development of transformational funding bids ~~- Information to support the development of transformational funding bids and plans which focus on pilot work on vague symptom pathways, clinical triage, and patient navigator work~~ - Data to support Clinical Quality Groups in tumour specific areas, to develop best practice and cross-organisational working practices e.g. post covid mutual aid initiatives ~~- Data to support clinical discussions within their 12 Tumour Site Specific Group Meetings~~

Unchanged: Expected output.

DARS-NIC-204580-F5B0C-v3.3 30 November 2023 to 29 November 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-204580-F5B0C-v2.2

Text removed is ~~struck through~~; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Fields changed from DARS-NIC-204580-F5B0C-v2.2
Field	Was	Became
Start date	~~2021-02-19~~	2023-11-30
End date	~~2024-02-18~~	2026-11-29
National Cancer Waiting Times Monitoring DataSet (NCWTMDS): legal basis	~~Health and Social Care Act 2012 - s261 - 'Other dissemination of information'~~	Health and Social Care Act 2012 – s261(2)(a)

Objective for processing

This agreement is for the Cheshire and Merseyside Cancer Alliance to access [16 words unchanged] (and those accessing the Cancer Waiting Times data) are substantively employed by ~~The~~ the Clatterbridge Cancer Centre NHS Foundation Trust. The Clatterbridge Cancer Centre NHS Foundation Trust is therefore the lead organisation, and the ~~data~~ controller who also processes data. In this agreement, therefore, all references to accessing the data refer to the legal entity - ~~The~~ the Clatterbridge Cancer Centre NHS Foundation Trust. The data will be processed under UK GDPR Article ~~6 (1) (e)~~ 6(1)(e) and UK GDPR Article ~~9 (2) (h).~~ 9(2)(h). Improvements for Cancer ~~patients~~ patients: The independent Cancer Taskforce set out an ambitious vision for improving services, ~~care~~ care, and outcomes for everyone with ~~Cancer: fewer~~ cancer: Fewer people getting ~~Cancer,~~ cancer, more people surviving ~~Cancer,~~ cancer, more people having a good experience of their treatment and care, whoever [9 words unchanged] being supported to live as well as possible after treatment has finished. Cancer ~~Alliances~~ Alliances: Cancer Alliances, which have been set up across England, are key to [15 words unchanged] clinical and managerial leaders from providers and commissioners who represent the whole ~~Cancer~~ cancer pathway, Cancer Alliances provide the opportunity for a different way of working to improve and transform ~~Cancer~~ cancer services. Cancer Alliance partners will take a whole population, whole pathway approach [39 words unchanged] in the availability of good care and treatment for all people with ~~Cancer,~~ 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~~ 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: ~~Cancer Wait Times (CWT) system~~ The 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 are merged to the same pathway to cover the period from referral to first definitive treatment for cancer and any additional subsequent treatments. 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 as 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. 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. Cheshire and Merseyside Cancer Alliance: ~~Cheshire and Merseyside Cancer Alliance~~ [1 paragraph unchanged] The Clatterbridge Cancer Centre NHS Foundation ~~Trustworks~~ Trust works with health organisations across Cheshire and Merseyside including 14 11 acute and specialist providers, ~~12 clinical commissioning groups,~~ 1 Integrated Care Board (ICB) containing 9 sub-regions, 1 community ~~providers~~ provider, and 8 hospices. Acute/Specialist ~~Providers~~ Providers: - Countess of Chester Hospital NHS Foundation Trust (Acute) - East Cheshire NHS Trust (Acute) - Mid Cheshire Hospitals NHS Foundation Trust (Acute) ~~Aintree University Hospital~~ - Alder Hey Children’s NHS Foundation Trust ~~(Acute)~~ (Specialist) ~~Alder Hey Children’s~~ - Liverpool Heart and Chest Hospital NHS Foundation Trust (Specialist) - Liverpool ~~Heart and Chest Hospital~~ Women’s NHS Foundation Trust (Specialist) ~~Liverpool Women’s~~ - The Walton Centre NHS Foundation Trust (Specialist) ~~Royal Liverpool~~ - Warrington and ~~Broadgreen University Hospitals~~ Halton NHS Foundation Trust (Acute) ~~Southport and Ormskirk~~ - Wirral University Teaching Hospital NHS Foundation Trust (Acute) ~~St Helens and Knowsley Teaching~~ - Liverpool University Hospitals NHS Foundation Trust (Acute) ~~The Walton Centre NHS Foundation Trust (Specialist)~~ - Mersey and West Lancashire Teaching Hospitals NHS Foundation Trust (Acute) ~~Warrington and Halton NHS Foundation Trust (Acute)~~ ICB: ~~Wirral University Teaching Hospital NHS Foundation Trust (Acute)~~ - Cheshire and Merseyside ICB ~~CCGs~~ ICB Sub-regions: ~~NHS Cheshire~~ - 27D (NHS Cheshire) ~~NHS Liverpool~~ - 99A (NHS Liverpool) ~~NHS Halton~~ - 01F (NHS Halton) ~~NHS Knowsley~~ - 01J (NHS Knowsley) ~~NHS South Sefton~~ - 01T (NHS South Sefton) ~~NHS~~ - 01V (NHS Southport and ~~Formby~~ Formby) ~~NHS St Helens~~ - 01X (NHS St Helens) ~~NHS Warrington~~ - 02E (NHS Warrington) ~~NHS Wirral~~ - 12F (NHS Wirral) Community ~~Providers~~ Providers: - Bridgewater Community NHS Trust ~~Hospices~~ Hospices: - Claire House - Hospice of the Good Shepherd - Halton Haven - Wirral Hospice St Johns - St Roccos Hospice - Queenscourt Hospice - Wollowbrook Hospice - St Josephs Hospice - Woodlands Hospice - Marie Curie Hospice Data ~~access~~ access: The CWT system provides one organisation (the Clatterbridge Cancer Centre NHS Foundation Trust) representing each Cancer Alliance, with access to the ~~following;~~ following: [3 paragraphs unchanged] The Clatterbridge Cancer Centre NHS Foundation Trust 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 ~~12 CCG's~~ the ICB's listed above cancer patients. A) a) Aggregate reports including small ~~numbers~~ numbers: Aggregate data is available in the form of reports at Provider (Trust) and ~~Clinical Commissioning Group (CCG)~~ ICB sub-region level. [1 paragraph unchanged] Investigating ~~breaches~~ breaches: The Clatterbridge Cancer Centre NHS Foundation Trust routinely monitor performance and standards [10 words unchanged] the 62 day wait target. Due to the large number of potential ~~Trust/CCG~~ Trust/ICB sub-region combinations, breach counts could result in small numbers as in some cases [6 words unchanged] in a whole year. Given that financial penalties are linked to target ~~breaches~~ breaches, counts must accurately reflect the true percentage without suppression. Mitigating risk of ~~re-identification~~ 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.~~ individual, e.g., there are no age, ethnic ~~categories~~ categories, or geographic breakdowns based on patient postcode. Additionally, the aggregation categories are such that the data is not at a lesser granular ~~level e.g.~~ level, e.g., the source NCWTMDS data collects information at ICD diagnosis code level, but [7 words unchanged] level – e.g. Head & Neck, Upper GI, lower GI, Breast etc. B) b) Pseudonymised record level ~~extracts~~ extracts: [2 paragraphs unchanged] ~~C) i-View Plus .~~ c) i-View Plus: iView Plus uses cube functionality to allow the Clatterbridge Cancer Centre NHS Foundation Trust to produce graphs, ~~charts~~ charts, and tabulations from the data through the construction of queries. The data [17 words unchanged] range of dimensions collected in the data and measures such as count, ~~percentage~~ percentage, and median. The outputs of iView Plus are aggregate, and no record [8 words unchanged] may result in small numbers and these currently have limited disclosure control ~~applied,~~ applied - see A) a) for further explanation. iView Plus holds published data, the lowest organisational granularity is trust level, data can also be aggregated to ~~CCG~~ ICB sub-region level and other health hierarchies. [2 paragraphs unchanged] Purpose One - Aggregate local ~~reports~~ reports: Generation of routine Cancer Waiting Times reports at Provider (Trust) or ~~CCG~~ ICB sub-region level. The Clatterbridge Cancer Centre NHS Foundation Trust will access a summary of the totals for the Providers (Trust) and ~~CCG's~~ ICB sub-region's that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ~~CCG~~ ICB they are aligned to). This analysis would then be shared with the [15 words unchanged] format of this report would be in a tabulated or graphical form ~~(i.e.~~ (i.e., not record level) but may contain small numbers. An example of where [17 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~~ ICB sub-regions across the geography [3 paragraphs unchanged] e. To provide assurance through comparative analysis ~~(e.g.~~ (e.g., orphan record identification, active monitoring ~~proportions~~ proportions, and validation of waiting list adjustments entered) [5 paragraphs unchanged] The two broad purposes for this would ~~be;~~ be: [3 paragraphs unchanged] Examples of the types of reasons for this ~~include;~~ include: [5 paragraphs unchanged]

Processing activities

Access to the Cancer Wait Times (CWT) System will enable Cancer Alliances [7 words unchanged] and locally-specific analyses to support the Cancer Taskforce vision for improving services, ~~care~~ care, and outcomes for everyone with ~~Cancer.~~ cancer. [1 paragraph 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~~ Principles, and other relevant statutory requirements and guidance to protect confidentiality. 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 organisation’s Senior Information Risk Officer (SIRO), and where there is a valid Data Sharing Agreement between the lead organisation and NHS ~~Digital.~~ England. [4 paragraphs unchanged] c) I-View Plus tool (aggregated - access to produce graphs, charts/tabulations from [24 words unchanged] same data that is available through the reports and record level downloads ~~(i.e.~~ (i.e., it will not contain patient identifiable data). [2 paragraphs unchanged] Data will only be available for the Providers (Trust) and ~~CCG's~~ ICBs that are treating cancer patients where they have a commissioning responsibility for that patient (based on the ~~CCG~~ ICB that this Cancer Alliance is aligned to). Cheshire and Merseyside Cancer Alliance will only access data for patients within their geographical ~~remit-~~ remit - namely in the Cheshire and Merseyside region. [1 paragraph unchanged] Aggregate ~~data/ graphical~~ data/graphical outputs may be shared via ~~e-mail;~~ e-mail, for example as part of Alliance meeting papers. Where record level data is shared with individual ~~trusts~~ trusts, these are shared only with trust(s) who were involved in the direct care of the patient, and only via NHS.net email accounts. As part of partnership working to improve Cancer Waiting Times performance, outputs may be shared with ~~national/ regional~~ national/regional bodies including NHS England, ~~NHS Improvement,~~ local ~~CCG's~~ ICBs, and Providers. Data will only be shared as described in purpose one [6 words unchanged] and where recipient organisations hold a valid Data Sharing Agreement with NHS ~~Digital~~ England to access Cancer Waiting Times data. [2 paragraphs unchanged] The Cancer Alliances will use the data to produce a range of quantitative measures (counts, crude and standardised ~~rates~~ rates, and ratios) that will form the basis for a range of statistical analyses of the fields contained in the supplied data. [2 paragraphs unchanged] a. Comparative Cancer Waiting Times performance at tumour group and individual tumour site ~~(i.e.~~ (i.e., ICD10 code) level for Trusts and ~~CCGs.~~ ICB sub-regions [2 paragraphs unchanged] d. Analysis of free text and derived breach reason fields to identify trends in reasons for ~~delays.~~ delays [3 paragraphs unchanged] 2) Cancer Waits analysis (not directly linked to constitutional standards) for the aim of identifying variation which may impact ~~Cancer patient’s~~ 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~~ Cancer patients with a maximum recommended wait of 6 weeks and using the data source to validate surgical numbers by provider trust.

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 [2 paragraphs unchanged] d. Analysis of free text and derived breach reason fields to identify trends in reasons for ~~delays.~~ delays [4 paragraphs unchanged] The overarching aim of all future analysis/outputs is to inform priorities and potential investment to improve ~~Cancer~~ cancer pathways including reducing ~~Cancer~~ cancer incidence and mortality, improving ~~Cancer~~ cancer survival, improving patient experience, improving service ~~efficiency~~ efficiency, and meeting national constitution standards relating to ~~Cancer~~ cancer patients.

Expected measurable benefits

1) Benefits type: Supporting delivery of CWT ~~standards~~ 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~~ 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 [55 words unchanged] to work with local providers and commissioners to identify outliers against the ~~standards,~~ 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:-~~ standards: [9 paragraphs unchanged] In ~~addition~~ addition, this access and use of data will be key in delivering the new 28 day faster diagnosis standard ~~being~~ introduced from ~~2020~~ 2020. 2) Benefits type: Improvements beyond constitutional ~~standards~~ 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~~ cancer patients pathways beyond those already achieved by improving performance against standard set. This could include reviewing times between ~~treatments,~~ treatments or treatment rates. The overall aim of this type of additional analysis would be to support improvements to ~~Cancer~~ cancer patients survival and experience. The Cancer Taskforce recommendation set out a number of ambitions to be met nationally and ~~locally by 2020~~ locally, including improving 1 year survival for ~~Cancer~~ cancer to 75%, and improving the proportions of patients staged 1 or 2 [24 words unchanged] the Cancer Waiting Times dataset to identify sub-optimum pathways and resulting improvements.

Benefits reported

Cancer Alliances have previously had access to Cancer Waiting Times reports and pseudonymised data through the system on Open ~~Exeter,~~ Exeter under an agreement with NHS England. This has enabled analysis to inform service improvement both to achieve the national Cancer Waiting Times standards and also wider ~~Cancer~~ cancer pathway improvement work, which will have contributed to oncoming improvements to ~~Cancer~~ cancer survival, and patient experience. Examples of specific work undertaken by this Cancer Alliance ~~previously include:-:-~~ previously: - ~~Previously and being used to~~ To inform interventions and priorities for planning with a focus on challenged services with high volume breaches ~~- Allows more comprehensive and detailed analysis to be undertaken~~ [1 paragraph unchanged] - Baselining mapping work with acute providers to understand cancer ~~pathways,~~ pathways - Monthly reports to inform discussions with Acute Provider CEOs, Cancer ~~Clinicians~~ Clinicians, and Cancer Managers across the ~~area,~~ area - Information to support the development of transformational funding bids and plans which focus on pilot work on vague symptom pathways, clinical triage, and patient navigator work ~~- Triage and patient navigator work.~~ - Data to support clinical discussions within their 12 Tumour Site Specific Group Meetings ~~- Data to support clinical discussions within their 12 Tumour Site Specific Group Meetings.~~

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 the 62 day wait from referral to first treatment standard.