National Cancer Waiting Times Monitoring Data Set (NCWTMDS) with derivation of deprivation age and gender

The National Cancer Waiting Times Monitoring DataSet (NCWTMDS) is a national, patient level data collection by NHS Digital, under a Direction from NHS England (NHSE). The data are used for monitoring times taken to diagnose and treat patients with cancer and ensure these are in line with the expectations and rights of patients in the NHS Constitution.

As a patient moves through the stages of their treatment pathway, data on referrals, treatments and diagnosis are derived from care records locally.

The NCWTMDS provides the data used to publish the official cancer 62 day treatment target which is one of the key national statistics used to monitor the performance of the NHS. After collection, the cancer waiting times data can also be queried by NHS organisations, cancer networks and the Department of Health to provide reports and feedback on the progress towards meeting these targets.

The NHS Long term plan states:

"For all major conditions, the quality of care and the outcomes for patients are now measurably better than a decade ago. Childbirth is the safest it has ever been, cancer survival is at an all-time high, deaths from cardiovascular disease have halved since 1990, and male suicide is at a 31-year low. But there is good evidence to suggest that over the next decade the NHS should be doing even better. Partly that’s because there’s currently too much variation in service quality between clinical teams and between different parts of the country. Partly we’ll need to improve by tackling previously unmet need – for example in young people’s mental health services. And partly we’ll be able to do better because the worldwide frontier of medical possibility will continue to advance."

NHS England require additional information to understand variation in cancer standard achievement and ultimately cancer outcomes.

In addition to the access granted under DARS-NIC-192305-X3T0Y-v3.2 NHS England requires access NCWTMDS for the following purpose(s):

1. The Operations and Information directorate require NCWTMDS linked to deprivation data to allow understanding of associations between deprivation and cancer waiting times

2. The Operations and Information directorate require NCWTMDS linked to age and gender to understand whether standardising for these factors influences overall outcome achievement.

The data cannot be used for any other purpose than that stated above. The data will not be shared with any third party. Data will only ever be used for purposes relating to healthcare or the promotion of health in line with the requirements of the Health and Social Care Act 2012 as amended by the Care Act 2014. Any record level data extracted from the system will not be processed outside of the analytics team, with only aggregate data to be shared with other NHS England teams.

Data will only be accessed by individuals within NHS England who have authorisation from the SIRO or IAO to access the data for the purposes described, all of whom are personnel working under appropriate supervision on behalf of NHS England. Following completion of the analysis any record level data will be securely destroyed. The data will not be used for commercial use. The data will not be linked with any record level data and there will be no requirement nor attempt to re-identify individuals from the data.

The raw data will not be made available to any third parties except in the form of aggregated outputs with small numbers suppressed in line with appropriate disclosure controls, such as Official Statistics.

All organisations party to this agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by Personnel (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data).

NHS England will use this data for the specific purpose of understanding whether there is an association between deprivation, age and gender and cancer waiting times. This is a one-off piece of analysis for internal purposes and will be used to understand the value of further work in this area. Additional work and any routine derivation of deprivation, age and gender will need subsequent amendments or new data sharing agreements to be put in place.

All outputs will contain only data that is compliant with the relevant disclosure control rules including suppression and rounding.

This additional analysis will allow NHS England to better understand the impact of deprivation on access and effectiveness of cancer pathways and to assess the value of routinely adding additional derivations to the NCWTMDS. The additional requested data attributes LSOA and IMD_Rank will be used to understand how deprived an area of residence is, and the additional fields Gender and Age will test the impact of standardisation i.e. to test if degree of inequality varies by age and gender.

Enabling analysis of the Cancer Waiting Times data on a system wide basis will provide insight to focus service improvements on most effective areas to improve performance. In particular you would expect that access to the data be essential to delivery of the Cancer Waiting Times 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

• 28 day referral to diagnosis - TBC

Yielded Benefits is not a requirement for new applications.