National Cancer Audit Collaborating Centre (NATCAN)
The Royal College of Surgeons of England · Academic
In term In term in the September 2026 edition: the latest version runs to 30 September 2027.
- Reference
- DARS-NIC-709865-W9X6H
- Current version
- v3.4
- Term of current version
- 7 November 2025 to 30 September 2027
- Start date
- 27 October 2023
- Data controller
- Joint Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 145
Data controllers
Why the data was released
Objective for processing
The Healthcare Quality Improvement Partnership (HQIP) and NHS England require access to patient data for the purpose of the following National Audit Centre: The National Cancer Audit Collaborating Centre (NATCAN).
NATCAN is commissioned by HQIP on behalf of NHS England and is a part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NATCAN has been awarded to the Royal College of Surgeons of England (RCS England) Clinical Effectiveness Unit (CEU), a collaboration between the RCS England and the London School of Hygiene and Tropical Medicine (LSHTM). The CEU is physically located in the RCS England and was established in March 1998 as an academic collaboration between the RCS England and the Department of Health Services Research & Policy of the LSHTM. The activities of the CEU are overseen by the RCS England Research Committee which includes RCS England Council members, surgeons from various subspecialties, and senior academics.
NATCAN will deliver ten clinical audits of care delivered by NHS Providers, the audits are as follows:
• National Audit of Primary Breast cancer (NaoPri)
• National Audit of Metastatic Breast cancer (NaoMe)
• National Ovarian Cancer Audit (NOCA)
• National Pancreatic Cancer Audit (NPaCA)
• National Non-Hodgkin Lymphoma Audit (NNHLA)
• National Kidney Cancer Audit (NKCA)
• National Lung Cancer Audit (NLCA)
• National Prostate Cancer Audit (NPCA)
• National Bowel Cancer Audit (NBOCA)
• National Oesophago-gastric Cancer Audit (NOGCA)
Overall as generic aims of the audits, NATCAN will;
1. Provide regular and timely evidence to cancer services on patterns of care in England and Wales so they can benchmark their performance and identify where there is unwarranted variation.
2. Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives.
3. Stimulate improvements in cancer detection, treatment and outcomes including survival.
The following Datasets will be accessed in support of the centre's aims:
• National Disease Registration Service (NDRS) Cancer Registrations- including items contained within the Cancer Outcomes and Services Dataset (COSD) and Death Registration Information – necessary to understand patient characteristics
• NDRS Rapid Cancer Registrations- necessary to understand patient characteristics
• NDRS National Radiotherapy Dataset (RTDS)- necessary to understand treatment pathways
• NDRS Systemic Anti-Cancer Therapy (SACT) Dataset- necessary to understand treatment pathways
• NDRS Linked Cancer Waiting Times (CWT)- necessary to understand waiting times and cancer care pathways
• NDRS Cancer Patient Experience Survey (CPES)- to better understand patient experience and incorporate this into measures of care quality
• NDRS Somatic Molecular Testing Dataset- to better understand the use of molecular testing within the disease areas covered by NATCAN
• Hospital Episode Statistics (HES)- Admitted Patient Care (APC), Outpatient (OP) and Accident & Emergency (A&E) subsets- necessary to build a more comprehensive view of patient pathways and outcomes.
• Emergency Care Dataset (ECDS)
• Diagnostic Imaging Dataset (DIDs)- necessary to understand the imaging pathways employed.
• Medicines Dispensed in Primary Care- for breast, pancreatic, prostate and Oesophago-gastric cancer only to enable the audits to determine whether the care (treatments) received is in line with national guidance. Specifically the audit will use the data to highlight patient safety in relation to national prescribing guidelines, i.e. those patients who may be at risk where guidelines don’t appear to be followed; and indicate medication effectiveness for those patients who are receiving treatments in line with national prescribing guidelines, which aligns with the directions for which the data are permitted to be accessed and used.
The level of the Data will be Pseudonymised.
The Data will be minimised as follows:
• Limited to a study cohort identified as having been diagnosed with one (or more) of the following (each being defined by specific ICD codes): Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer, Lung Cancer, prostate Cancer, Bowel cancer, Oesophago-gastric cancer between 01.01.2015 to the Latest Available Cancer Registrations.
• All datasets will be limited to the point of diagnosis to the latest available information for each individual patient unless otherwise stated. Appropriate measures will be put in place to account for imperfections in diagnosis date recording.
• HES APC which will be limited to all admissions up to 24 months prior to diagnosis to the latest available information.
• NDRS Rapid Cancer Registration Data is limited to records from 01.01.2018 onwards.
• The Medicines Dispensed in Primary Care Dataset will be limited to patients diagnosed with Breast, Pancreatic, prostate and Oesophago-gastric cancers
Once in receipt of the requested data The Royal College of Surgeons of England (RCS England), who act as Processor under this Agreement, will further minimise the data ensuring that each individual audit only has access to information that is relevant to the disease area of said audit.
• Limited to the following diagnostic codes for all patients aged ≥ 18 years for the following audits:
National Lung Cancer Audit (NLCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C33 -C34).
National Prostate Cancer Audit (NPCA) - with a new diagnosis of prostate cancer (ICD-10 diagnosis code: C61).
National Bowel Cancer Audit (NBOCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C18, C19 or C20).
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of OG cancer (ICD-10 diagnosis code: C15x, C16x). Also, D00.1 to capture of High-Grade Dysplasia (HGD).
NATCAN is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NHS England and HQIP are the joint controllers for the data, as together both organisations determine the purposes and means of processing.
HQIP and NHS England both rely on Article 6(1)(e) of the UK GDPR as the lawful basis of processing - "processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller". This is justified through commissioning arrangements which link back to NHS England with statutory responsibilities to improve the quality of health care services.
HQIP rely on Article 9(2)(i) as the legal basis for processing under UK GDPR - "processing is necessary for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices, on the basis of Union or Member State law which provides for suitable and specific measures to safeguard the rights and freedoms of the data subject, in particular, professional secrecy". This is justified as all projects aim to drive improvements in the quality and safety of care and to improve outcomes for patients. The processing meets Schedule 1 Part 1 condition 3 of the Data Protection Act 2018 as the processing is carried out by the Royal College of Surgeons on behalf of NHS England.
NHS England relies on Article 9(2)(h) of the UK GDPR as the legal basis for processing. "Processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to a contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3". NHS England is responsible for the provision of health and social care, and the management of systems and compliance.
The funding is provided by NHS England via the intermediary of HQIP.
The funder will have no ability to suppress or otherwise limit the publication of findings.
The RCS England is a processor acting under the instructions of the Controllers. The RCS England are required to fulfil the contracted deliverables to HQIP and NHS England.
NATCAN has an organisational structure with a high-level overarching management body (NATCAN Executive Team). The individual Audit teams report into this Executive team. This set-up aims to provide a transparent and responsive management structure allowing each Audit to cater for the individual attributes of the different cancer types, while also providing an integrated and consistent approach across the Audits. More information on the structure can be accessed via https://www.natcan.org.uk/resources/2675/
An over-arching NATCAN Board provides top-level governance with overall responsibility for the operational and strategic management of the centre. The NATCAN Board provides project governance and oversees the delivery of the contract, and includes members of leading professional bodies, patient representatives, the commissioning body (HQIP), and the commissioned organisation (RCS England). The NATCAN Executive Team reports to the NATCAN Board, providing formal accountability for the delivery of the centre and the individual Audits.
The Audit teams within NATCAN are supported by a Technical Advisory Group (which advises on national cancer data collection, statistical methodology, development of relevant and robust performance indicators to stimulate QI, and communication to practitioners and lay audiences) and a Quality Improvement (QI) Team of external experts with extensive experience in QI and implementation science (which directs the QI work of the Audits including the design and delivery of QI initiatives for each Audit).
Each Audit has a Clinical Reference Group (CRG) that supports and shapes the implementation of the audit aims. The CRGs include representation of patients and stakeholder organisations and act as consultative groups to the Audit Teams on clinical issues as well as issues related to methodology, quality improvement and the dissemination of audit results/recommendations.
The stakeholder organisations or specialities involved in the Audit Clinical Reference Groups include patient charities, patients, professional organisations, multi-disciplinary experts in the relevant area of cancer care, data providers, commissioners/regulators of care, and policymakers. Each Audit will also have a standalone Patient and Public Involvement Forum to ensure the patient voice is central to the work of the Audit, guiding the development of the Audit QI goals and activities.
These groups serve in an advisory capacity only. The controllers listed within this Agreement maintain overall responsibility for determining the purpose and means of processing. Only those substantively employed by RCS England, or those with an honorary contract with RCS England, are permitted to process the data covered under this Agreement.
Individuals employed by LSHTM have an honorary contract with the RCS England to carry out work within the RCS England CEU. LSHTM is providing the academic expertise to design and interpret data and RCS England is responsible for data processing. LSHTM does not have any operational control over data processing activities, and the responsibilities for data handling rest with RCS England (under instruction from HQIP).
Patients and Patient Charities have already been involved in the scoping exercises for each individual audit covered under NATCAN. Going forward each individual audit will have its own Patient and Public Involvement Group (PPIG), patients and relevant charities will be involved in the development of the Terms of Reference for each of these Groups.
The composition of the PPIG for each disease area will vary. NATCAN have given careful consideration to the nature of each disease area when determining if and when it is appropriate to invite patients to join the PPIG; taking into consideration survival rates, the toll of treatment and whether it is more appropriate to invite a family member in place of the patient.
The existing audits in lung, prostate, bowel and oesophago-gastric cancer have existing standalone PPIGs.
Processing activities
No data will flow to NHS England from the applicant for the purposes of this Data Sharing Agreement (DSA).
The cohort mentioned within the data products is generated by NHS England for each specific audit requirements.
NHS England will provide the relevant records from the above-listed datasets to RCS England CEU. The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient.
Once in receipt of the data the RCS England will not transfer it to any other locations. The Data will be stored on servers at the RCS England.
The Data will be accessed by authorised personnel via remote access. The Data will remain on the servers at RCS England at all times.
The Data will only be accessed by individuals in the following roles for the following reasons within the CEU:
• Data Managers will produce subsets of the Data for each individual audit and perform data quality checks
• IT Colleagues will supply support to the system
• The NATCAN Director of Operations and the CEU Director will ensure that internal governance processes are being followed and manage compliance with this DSA
• The Data Scientists, Methodologists and the Clinical Fellows will process the relevant NHS England data to perform the analysis required to produce the information to be published in the reports for each audit as a multi-disciplinary approach.
Data Quality
Local Patient ID is required as the Audits will also provide support to Trusts when needed with their local quality improvement activities following publication of the Audit reports. On request, the Audits will also provide de-identified patient-level, minimum data for all patients included in estimating the indicator/s of interest for their Trust. The inclusion of a Local Patient ID will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract. Local Patient ID will solely be used for the purposes stated above and will not be used for reidentification and the analysts at RCS England (LSHTM) will not reidentify any individuals for the purposes of producing the audit reports.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
Remote processing will only be through a secure electronic network and organisational controls prevent personnel from downloading or copying data to local devices.
Remote processing will be subject to the following being in place:
• Multifactor authentication (MFA);
• Access controls granting users the minimum level of access required;
• Secure connections (e.g., VPNs or secure protocols) to protect data during remote access;
• Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls.
All remote access is undertaken within the scope of the relevant organisations’ DSPT (or other security arrangements as per this Data Sharing Agreement (DSA)).
The Data will not leave or be accessed outside of England at any time.
Access to any data disseminated under this Agreement is restricted to 1) substantive employees of the RCS England or 2) substantive employees of London School of Hygiene and Tropical Medicine who have an honorary contract with RCS England.
All personnel accessing the Data have been appropriately trained in data protection and confidentiality.
The Data will not be linked with any other data outside the scope of this DSA.
There will be no requirement and no attempt by the controller or the processor on this DSA to reidentify individuals when using the Data.
Analysts based at the RCS England CEU will analyse the Data for the purposes described above.
Expected output
The expected outputs of the processing will be:
• ‘State of the Nation’ (SotN) reports for each individual Audit in will be made publicly available. Publication will begin ~September 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will occur annually from that point forward.
• Where appropriate, outputs of the audits that reflect key findings or methodological developments will be submitted to peer-reviewed journals.
• Presentations at appropriate conferences
• Publication of dashboards on the NATCAN website from early 2024 onwards
Quarterly reports for each individual Audit in will be made publicly available. Publication will begin April 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will continue quarterly in the following cycle : April, July, October, January
The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.
The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Social media
• Public reports
• Industry newsletters
• Press/media engagement
• Reports aimed at Clinicians, Commissioners and Policy Makers
• Reports aimed at Patients and the General Public
Outputs will begin to be disseminated from early 2024, dissemination of outputs will continue until the end of RCS England's contract with HQIP.
Expected measurable benefits
The findings of the audits are expected to contribute to evidence-based decision-making for policy-makers, and local decision-makers such as doctors, and patients to inform best practice to improve the care, treatment and experience of healthcare users relevant to the subject matter of the study.
The role of a national clinical audit is to stimulate healthcare improvement through the provision of high-quality information on the organisation, delivery and outcomes of healthcare, together with tools and support to enable healthcare providers and other audiences to make best use of this information.
Improvements in care quality and outcomes are anticipated along with the reduction in unwarranted variation in treatments and outcomes between providers, and improvement in the equity of care across different demographic groups (age, gender, ethnicity), geography, level of deprivation and other population factors.
It is hoped that through publication of findings in appropriate media, the findings of this these audits will add to the body of evidence that is considered by the bodies, organisations and individual care practitioners charged with making policy decisions for or within the NHS or treatment decisions in relation to specific patients.
Patients and Patient Charities have been engaged to ensure that the findings reach a wide audience to maximise the potential public benefits.
Benefits reported so far
Not stated in the register.
Datasets on the current version
Legal basis for provision: Health and Social Care Act 2012 – s261(2)(a); Health and Social Care Act 2012 – s261(2)(a); National Health Service Act 2006 - s251 - 'Control of patient information'.
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Civil Registrations of Death | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| Civil Registrations of Death - Secondary Care Cut | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| Demographics | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| Diagnostic Imaging Data Set (DID) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| Emergency Care Data Set (ECDS) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| Emergency Care Data Set (ECDS) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| HES-ID to MPS-ID HES Accident and Emergency | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| HES-ID to MPS-ID HES Admitted Patient Care | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| HES-ID to MPS-ID HES Outpatients | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Hospital Episode Statistics Accident and Emergency (HES A and E) | Anonymised - ICO Code Compliant | Non-Sensitive | One-Off | Does not include the flow of confidential data |
| Hospital Episode Statistics Accident and Emergency (HES A and E) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| Hospital Episode Statistics Admitted Patient Care (HES APC) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| Hospital Episode Statistics Admitted Patient Care (HES APC) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| Hospital Episode Statistics Outpatients (HES OP) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| Hospital Episode Statistics Outpatients (HES OP) | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| Medicines dispensed in Primary Care (NHSBSA data) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| MRIS - Cause of Death Report | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| MRIS - Flagging Current Status Report | Identifiable | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Cancer Registrations | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked Cancer Waiting Times (Treatments only) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked Cancer Waiting Times (Treatments only) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked DIDs | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| NDRS Linked HES AE | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| NDRS Linked HES AE | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked HES APC | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| NDRS Linked HES APC | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| NDRS Linked HES APC | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked HES APC | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Linked HES Outpatient | Anonymised - ICO Code Compliant | Sensitive | One-Off | Does not include the flow of confidential data |
| NDRS Linked HES Outpatient | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS National Cancer Patient Experience Survey (CPES) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS National Radiotherapy Dataset (RTDS) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS National Radiotherapy Dataset (RTDS) | Anonymised - ICO Code Compliant | Non-Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Rapid Cancer Registrations | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Somatic Molecular Dataset | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Systemic Anti-Cancer Therapy Dataset (SACT) | Anonymised - ICO Code Compliant | Sensitive | Ongoing | Does not include the flow of confidential data |
| NDRS Systemic Anti-Cancer Therapy Dataset (SACT) | Anonymised - ICO Code Compliant | Sensitive | Ongoing | 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.
Patient opt-outs were not applied to any of the 145 files released under this agreement, across every version. About opt-outs
Files released against version 3.4 of this agreement, summarised by dataset.
| Dataset | Files | First released | Last released | Opt-outs applied |
|---|---|---|---|---|
| NDRS Linked Cancer Waiting Times (Treatments only) | 6 | November 2025 | August 2026 | No |
| NDRS National Radiotherapy Dataset (RTDS) | 6 | November 2025 | August 2026 | No |
| NDRS Systemic Anti-Cancer Therapy Dataset (SACT) | 6 | November 2025 | August 2026 | No |
| NDRS Rapid Cancer Registrations | 5 | November 2025 | August 2026 | No |
| Emergency Care Data Set (ECDS) | 4 | December 2025 | June 2026 | No |
| Hospital Episode Statistics Admitted Patient Care (HES APC) | 4 | December 2025 | June 2026 | No |
| Hospital Episode Statistics Outpatients (HES OP) | 4 | December 2025 | June 2026 | No |
| Diagnostic Imaging Data Set (DID) | 2 | January 2026 | January 2026 | No |
| Medicines dispensed in Primary Care (NHSBSA data) | 1 | January 2026 | January 2026 | No |
| NDRS Cancer Registrations | 1 | November 2025 | November 2025 | No |
| NDRS National Cancer Patient Experience Survey (CPES) | 1 | November 2025 | November 2025 | No |
| NDRS Somatic Molecular Dataset | 1 | November 2025 | November 2025 | No |
Version history
The register lists each renewal of this agreement as a separate row. This site has 4 versions.
DARS-NIC-709865-W9X6H-v3.4 7 November 2025 to 30 September 2027
- Title
- National Cancer Audit Collaborating Centre (NATCAN)
- Commercial
- No
- Sublicensing
- No
- Datasets
- 37
- Files released
- 41
Datasets: Civil Registrations of Death; Civil Registrations of Death - Secondary Care Cut; Demographics; Diagnostic Imaging Data Set (DID); Emergency Care Data Set (ECDS); Emergency Care Data Set (ECDS); HES-ID to MPS-ID HES Accident and Emergency; HES-ID to MPS-ID HES Admitted Patient Care; HES-ID to MPS-ID HES Outpatients; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Hospital Episode Statistics Outpatients (HES OP); Medicines dispensed in Primary Care (NHSBSA data); MRIS - Cause of Death Report; MRIS - Flagging Current Status Report; NDRS Cancer Registrations; NDRS Linked Cancer Waiting Times (Treatments only); NDRS Linked Cancer Waiting Times (Treatments only); NDRS Linked DIDs; NDRS Linked HES AE; NDRS Linked HES AE; NDRS Linked HES APC; NDRS Linked HES APC; NDRS Linked HES APC; NDRS Linked HES APC; NDRS Linked HES Outpatient; NDRS Linked HES Outpatient; NDRS National Cancer Patient Experience Survey (CPES); NDRS National Radiotherapy Dataset (RTDS); NDRS National Radiotherapy Dataset (RTDS); NDRS Rapid Cancer Registrations; NDRS Somatic Molecular Dataset; NDRS Systemic Anti-Cancer Therapy Dataset (SACT); NDRS Systemic Anti-Cancer Therapy Dataset (SACT)
What changed from DARS-NIC-709865-W9X6H-v2.4
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2025-11-07 | |
| Civil Registrations of Death - Secondary Care Cut: sensitivity | Sensitive | |
| Demographics: sensitivity | Sensitive | |
| NDRS Cancer Registrations: sensitivity | Sensitive | |
| NDRS Rapid Cancer Registrations: sensitivity | Sensitive | |
| NDRS Somatic Molecular Dataset: sensitivity | Sensitive | |
| NDRS Systemic Anti-Cancer Therapy Dataset (SACT): sensitivity | Sensitive |
Datasets: + HES-ID to MPS-ID HES Accident and Emergency; + HES-ID to MPS-ID HES Admitted Patient Care; + HES-ID to MPS-ID HES Outpatients; + MRIS - Cause of Death Report; + MRIS - Flagging Current Status Report; + NDRS Linked DIDs; + NDRS Linked HES A&E; + NDRS Linked HES APC; + NDRS Linked HES Outpatient
Objective for processing
The Healthcare Quality Improvement Partnership (HQIP) and NHS England require access to
[5 words unchanged]
of the following National Audit Centre: The National Cancer Audit Collaborating Centre
(NATCAN)
(NATCAN).
NATCAN is commissioned by HQIP on behalf of NHS England and is
[12 words unchanged]
NATCAN has been awarded to the Royal College of Surgeons of England
(RCSEng)
(RCS England)
Clinical Effectiveness Unit (CEU), a collaboration between the
RCSEng
RCS England
and the London School of Hygiene and Tropical Medicine (LSHTM).
The CEU is physically located in the RCS England and was established in March 1998 as an academic collaboration between the RCS England and the Department of Health Services Research & Policy of the LSHTM. The activities of the CEU are overseen by the RCS England Research Committee which includes RCS England Council members, surgeons from various subspecialties, and senior academics.
[11 paragraphs unchanged]
With the exception of breast cancer, NCAPOP has not previously incorporated clinical audits in these specific disease areas. The previous National Audit of Breast Cancer in Older Patients (NABCOP) completed in 2022.
[16 paragraphs unchanged]
The following will be received on an annual basis linked to the NDRS Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• NDRS CPES
• NDRS Somatic Molecular Testing Data
• HES APC, HES OP
• ECDS
• Medicines Dispensed in Primary Care
• DIDS
Of which the following will be received on a quarterly basis linked to the NDRS Rapid Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• HES APC, HES OP
• ECDS
[1 paragraph unchanged]
Local Patient ID is required to support the outlier process and to support providers with their local quality improvement activities on request. Each Audit in NATCAN will carry out an Outlier Process in keeping with the updated “Detection and Management of Outliers for National Clinical Audit” guidance in England and Wales. The Audits in NATCAN will provide Trusts identified as potential alert or alarm outliers with de-identified patient-level, minimum data for all patients included in estimating the indicator for their Trust. This will provide limited but sufficient information regarding patient (for example: month and year of birth, sex, performance status), treatment (for example: procedure date) and tumour characteristics (for example: stage, risk category).
The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
[6 paragraphs unchanged]
Once in receipt of the requested data The Royal College of Surgeons of England
(RCSEng),
(RCS England),
who act as Processor under this Agreement, will further minimise the data
[8 words unchanged]
to information that is relevant to the disease area of said audit.
[4 paragraphs unchanged]
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of OG cancer (ICD-10 diagnosis code: C15x, C16x). Also, D00.1 to capture of High-Grade Dysplasia
(HGD), For rationale, see below)
(HGD).
[HGD: Rationale. When advising on the priorities for the audit, the NOGCA Patient and Public Involvement (PPI) forum identified as a priority the inclusion of people with oesophageal high grade dysplasia (HGD). The data (both Rapid Cancer Registration Data & “Gold Standard” Registration Data) received by NOGCA contains patients with HGD through “C15._” with behaviour 2 in ICDO3 morphology. However, the volumes look to be low. In discussion with experts at the NDRS, it has become apparent that some cases of oesophageal HGD are recorded in the cancer registry using the ICD-10 diagnosis “D00.1”. We are therefore requesting the addition of ICD-10 code “D00.1” to improve the capture of oesophageal HGD, in addition to the C15 + C16 diagnosis codes currently specified. In this regard, we are not requesting for a change in scope but an adaptation to our definition that reflects the different ways in which people might be coding people with oesophageal HGD. These cases are considered synonymous with carcinoma in situ.]
[4 paragraphs unchanged]
The funding is provided by NHS England via the intermediary of HQIP.
The funding is specifically for the audit described.
[1 paragraph unchanged]
The
RCSEng
RCS England
is a processor acting under the instructions of the Controllers. The
RCSEng
RCS England
are required to fulfil the contracted deliverables to HQIP and NHS England.
[1 paragraph unchanged]
An over-arching NATCAN Board provides top-level governance with overall responsibility for the
[25 words unchanged]
professional bodies, patient representatives, the commissioning body (HQIP), and the commissioned organisation
(RCSeng).
(RCS England).
The NATCAN Executive Team reports to the NATCAN Board, providing formal accountability for the delivery of the centre and the individual Audits.
[3 paragraphs unchanged]
These groups serve in an advisory capacity only. The controllers listed within
[6 words unchanged]
determining the purpose and means of processing. Only those substantively employed by
RCSEng,
RCS England,
or those with an honorary contract with
RCSEng,
RCS England,
are permitted to process the data covered under this Agreement.
Individuals employed by LSHTM have an honorary contract with the RCS England to carry out work within the RCS England CEU. LSHTM is providing the academic expertise to design and interpret data and RCS England is responsible for data processing. LSHTM does not have any operational control over data processing activities, and the responsibilities for data handling rest with RCS England (under instruction from HQIP).
[3 paragraphs unchanged]
Processing activities
No data will flow to NHS England
from the applicant
for the purposes of this Data Sharing Agreement (DSA).
NHS England will provide the relevant records from the above-listed datasets to RCSEng CEU. The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient.
The cohort mentioned within the data products is generated by NHS England for each specific audit requirements.
Once in receipt of the data the RCSEng will not transfer it to any other locations. The Data will be stored on servers at the RCSEng.
NHS England will provide the relevant records from the above-listed datasets to RCS England CEU. The Data will contain no direct identifying data items. The Data will be pseudonymised and individuals cannot be reidentified through linkage with other data in the possession of the recipient.
The Data will be accessed by authorised personnel via remote access. The Data will remain on the servers at RCSEng at all times.
Once in receipt of the data the RCS England will not transfer it to any other locations. The Data will be stored on servers at the RCS England.
The Data will be accessed by authorised personnel via remote access. The Data will remain on the servers at RCS England at all times.
The Data will only be accessed by individuals in the following roles for the following reasons within the CEU:
• Data Managers will produce subsets of the Data for each individual audit and perform data quality checks
• IT Colleagues will supply support to the system
• The NATCAN Director of Operations and the CEU Director will ensure that internal governance processes are being followed and manage compliance with this DSA
• The Data Scientists, Methodologists and the Clinical Fellows will process the relevant NHS England data to perform the analysis required to produce the information to be published in the reports for each audit as a multi-disciplinary approach.
Data Quality
Local Patient ID is required as the Audits will also provide support to Trusts when needed with their local quality improvement activities following publication of the Audit reports. On request, the Audits will also provide de-identified patient-level, minimum data for all patients included in estimating the indicator/s of interest for their Trust. The inclusion of a Local Patient ID will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract. Local Patient ID will solely be used for the purposes stated above and will not be used for reidentification and the analysts at RCS England (LSHTM) will not reidentify any individuals for the purposes of producing the audit reports.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
[8 paragraphs unchanged]
The master NATCAN dataset will only be accessed by a small number of individuals within the CEU
Access to any data disseminated under this Agreement is restricted to 1) substantive employees of the RCS England or 2) substantive employees of London School of Hygiene and Tropical Medicine who have an honorary contract with RCS England.
• Data Managers at the CEU- to create extracts for each individual audit and to perform data quality checks
• IT Colleagues- to supply support to the system
• The NATCAN Director of Operations- to ensure that internal governance processes are being followed and to manage compliance with this Data Sharing Agreement
• The CEU Director- to ensure that internal governance processes are being followed and to manage compliance with this Data Sharing Agreement
The data managers will produce subsets of the Data that will be accessed by the teams associated with each individual audit.
Access to any data disseminated under this Agreement is restricted to 1) substantive employees of the RCSEng or 2) substantive employees of London School of Hygiene and Tropical Medicine who have an honorary contract with RCSEng (N.B The CEU is collaboration between LSTHM and RCSEng).
[1 paragraph unchanged]
The Data will not be linked with any other data outside the scope of this
Agreement.
DSA.
[1 paragraph unchanged]
Analysts based at the
RCSEng
RCS England
CEU will analyse the Data for the purposes described above.
Expected output
[2 paragraphs unchanged]
The SotN reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – April 2024, April 2025
• National Prostate Cancer Audit (NPCA) – January 2024, January 2025,
• National Bowel Cancer Audit (NBOCA)- January 2025
• National Oesophago-gastric Cancer Audit (NOGCA) - January 2025
[4 paragraphs unchanged]
The quarterly reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – quarterly reporting started in October 2023 under the current contract and will continue quarterly in the following cycle : January, April, July, October each year
• National Prostate Cancer Audit (NPCA) – quarterly reporting will start in January 2024 under the current contract and will continue quarterly in the following cycle: February, May, August, November
• National Bowel Cancer Audit (NBOCA)- quarterly reporting started in July 2023 under the current contract and will continue quarterly and will continue quarterly in the following cycle : January, April, July, October each year
• National Oesophago-gastric Cancer Audit (NOGCA) – quarterly reporting will start in July 2024 and will continue quarterly in the following cycle : January, April, July, October each year
[9 paragraphs unchanged]
Outputs will begin to be disseminated from early 2024, dissemination of outputs will continue until the end of
RCSEng's
RCS England's
contract with HQIP.
Unchanged: Expected measurable benefits.
DARS-NIC-709865-W9X6H-v2.4 4 April 2025 to 30 September 2027
- Title
- National Cancer Audit Collaborating Centre (NATCAN)
- Commercial
- No
- Sublicensing
- No
- Datasets
- 22
- Files released
- 18
Datasets: Civil Registrations of Death; Civil Registrations of Death - Secondary Care Cut; Demographics; Diagnostic Imaging Data Set (DID); Emergency Care Data Set (ECDS); Emergency Care Data Set (ECDS); Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Hospital Episode Statistics Outpatients (HES OP); Medicines dispensed in Primary Care (NHSBSA data); NDRS Cancer Registrations; NDRS Linked Cancer Waiting Times (Treatments only); NDRS Linked Cancer Waiting Times (Treatments only); NDRS National Cancer Patient Experience Survey (CPES); NDRS National Radiotherapy Dataset (RTDS); NDRS National Radiotherapy Dataset (RTDS); NDRS Rapid Cancer Registrations; NDRS Somatic Molecular Dataset; NDRS Systemic Anti-Cancer Therapy Dataset (SACT); NDRS Systemic Anti-Cancer Therapy Dataset (SACT)
What changed from DARS-NIC-709865-W9X6H-v1.4
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2025-04-04 | |
| End date | 2027-09-30 | |
| Hospital Episode Statistics Outpatients (HES OP): type of data | Identifiable |
Objective for processing
[47 paragraphs unchanged]
Local Patient ID is required to support the outlier
process.
process and to support providers with their local quality improvement activities on request.
Each Audit in NATCAN will carry out an Outlier Process in keeping
[67 words unchanged]
(for example: procedure date) and tumour characteristics (for example: stage, risk category).
The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
[12 paragraphs unchanged]
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of
lung
OG
cancer (ICD-10 diagnosis code: C15x, C16x).
Also, D00.1 to capture of High-Grade Dysplasia (HGD), For rationale, see below)
[HGD: Rationale. When advising on the priorities for the audit, the NOGCA Patient and Public Involvement (PPI) forum identified as a priority the inclusion of people with oesophageal high grade dysplasia (HGD). The data (both Rapid Cancer Registration Data & “Gold Standard” Registration Data) received by NOGCA contains patients with HGD through “C15._” with behaviour 2 in ICDO3 morphology. However, the volumes look to be low. In discussion with experts at the NDRS, it has become apparent that some cases of oesophageal HGD are recorded in the cancer registry using the ICD-10 diagnosis “D00.1”. We are therefore requesting the addition of ICD-10 code “D00.1” to improve the capture of oesophageal HGD, in addition to the C15 + C16 diagnosis codes currently specified. In this regard, we are not requesting for a change in scope but an adaptation to our definition that reflects the different ways in which people might be coding people with oesophageal HGD. These cases are considered synonymous with carcinoma in situ.]
[4 paragraphs unchanged]
The funding is provided by NHS England via the intermediary of HQIP. The funding is specifically for the audit described.
Funding is in place until 30/09/2025.
[11 paragraphs unchanged]
Unchanged: Processing activities, Expected output, Expected measurable benefits.
Objective for processing
The Healthcare Quality Improvement Partnership (HQIP) and NHS England require access to patient data for the purpose of the following National Audit Centre: The National Cancer Audit Collaborating Centre (NATCAN)
NATCAN is commissioned by HQIP on behalf of NHS England and is a part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NATCAN has been awarded to the Royal College of Surgeons of England (RCSEng) Clinical Effectiveness Unit (CEU), a collaboration between the RCSEng and the London School of Hygiene and Tropical Medicine (LSHTM).
NATCAN will deliver ten clinical audits of care delivered by NHS Providers, the audits are as follows:
• National Audit of Primary Breast cancer (NaoPri)
• National Audit of Metastatic Breast cancer (NaoMe)
• National Ovarian Cancer Audit (NOCA)
• National Pancreatic Cancer Audit (NPaCA)
• National Non-Hodgkin Lymphoma Audit (NNHLA)
• National Kidney Cancer Audit (NKCA)
• National Lung Cancer Audit (NLCA)
• National Prostate Cancer Audit (NPCA)
• National Bowel Cancer Audit (NBOCA)
• National Oesophago-gastric Cancer Audit (NOGCA)
With the exception of breast cancer, NCAPOP has not previously incorporated clinical audits in these specific disease areas. The previous National Audit of Breast Cancer in Older Patients (NABCOP) completed in 2022.
Overall as generic aims of the audits, NATCAN will;
1. Provide regular and timely evidence to cancer services on patterns of care in England and Wales so they can benchmark their performance and identify where there is unwarranted variation.
2. Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives.
3. Stimulate improvements in cancer detection, treatment and outcomes including survival.
The following Datasets will be accessed in support of the centre's aims:
• National Disease Registration Service (NDRS) Cancer Registrations- including items contained within the Cancer Outcomes and Services Dataset (COSD) and Death Registration Information – necessary to understand patient characteristics
• NDRS Rapid Cancer Registrations- necessary to understand patient characteristics
• NDRS National Radiotherapy Dataset (RTDS)- necessary to understand treatment pathways
• NDRS Systemic Anti-Cancer Therapy (SACT) Dataset- necessary to understand treatment pathways
• NDRS Linked Cancer Waiting Times (CWT)- necessary to understand waiting times and cancer care pathways
• NDRS Cancer Patient Experience Survey (CPES)- to better understand patient experience and incorporate this into measures of care quality
• NDRS Somatic Molecular Testing Dataset- to better understand the use of molecular testing within the disease areas covered by NATCAN
• Hospital Episode Statistics (HES)- Admitted Patient Care (APC), Outpatient (OP) and Accident & Emergency (A&E) subsets- necessary to build a more comprehensive view of patient pathways and outcomes.
• Emergency Care Dataset (ECDS)
• Diagnostic Imaging Dataset (DIDs)- necessary to understand the imaging pathways employed.
• Medicines Dispensed in Primary Care- for breast, pancreatic, prostate and Oesophago-gastric cancer only to enable the audits to determine whether the care (treatments) received is in line with national guidance. Specifically the audit will use the data to highlight patient safety in relation to national prescribing guidelines, i.e. those patients who may be at risk where guidelines don’t appear to be followed; and indicate medication effectiveness for those patients who are receiving treatments in line with national prescribing guidelines, which aligns with the directions for which the data are permitted to be accessed and used.
The following will be received on an annual basis linked to the NDRS Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• NDRS CPES
• NDRS Somatic Molecular Testing Data
• HES APC, HES OP
• ECDS
• Medicines Dispensed in Primary Care
• DIDS
Of which the following will be received on a quarterly basis linked to the NDRS Rapid Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• HES APC, HES OP
• ECDS
The level of the Data will be Pseudonymised.
Local Patient ID is required to support the outlier process and to support providers with their local quality improvement activities on request. Each Audit in NATCAN will carry out an Outlier Process in keeping with the updated “Detection and Management of Outliers for National Clinical Audit” guidance in England and Wales. The Audits in NATCAN will provide Trusts identified as potential alert or alarm outliers with de-identified patient-level, minimum data for all patients included in estimating the indicator for their Trust. This will provide limited but sufficient information regarding patient (for example: month and year of birth, sex, performance status), treatment (for example: procedure date) and tumour characteristics (for example: stage, risk category).
The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
The Data will be minimised as follows:
• Limited to a study cohort identified as having been diagnosed with one (or more) of the following (each being defined by specific ICD codes): Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer, Lung Cancer, prostate Cancer, Bowel cancer, Oesophago-gastric cancer between 01.01.2015 to the Latest Available Cancer Registrations.
• All datasets will be limited to the point of diagnosis to the latest available information for each individual patient unless otherwise stated. Appropriate measures will be put in place to account for imperfections in diagnosis date recording.
• HES APC which will be limited to all admissions up to 24 months prior to diagnosis to the latest available information.
• NDRS Rapid Cancer Registration Data is limited to records from 01.01.2018 onwards.
• The Medicines Dispensed in Primary Care Dataset will be limited to patients diagnosed with Breast, Pancreatic, prostate and Oesophago-gastric cancers
Once in receipt of the requested data The Royal College of Surgeons of England (RCSEng), who act as Processor under this Agreement, will further minimise the data ensuring that each individual audit only has access to information that is relevant to the disease area of said audit.
• Limited to the following diagnostic codes for all patients aged ≥ 18 years for the following audits:
National Lung Cancer Audit (NLCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C33 -C34).
National Prostate Cancer Audit (NPCA) - with a new diagnosis of prostate cancer (ICD-10 diagnosis code: C61).
National Bowel Cancer Audit (NBOCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C18, C19 or C20).
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of OG cancer (ICD-10 diagnosis code: C15x, C16x). Also, D00.1 to capture of High-Grade Dysplasia (HGD), For rationale, see below)
[HGD: Rationale. When advising on the priorities for the audit, the NOGCA Patient and Public Involvement (PPI) forum identified as a priority the inclusion of people with oesophageal high grade dysplasia (HGD). The data (both Rapid Cancer Registration Data & “Gold Standard” Registration Data) received by NOGCA contains patients with HGD through “C15._” with behaviour 2 in ICDO3 morphology. However, the volumes look to be low. In discussion with experts at the NDRS, it has become apparent that some cases of oesophageal HGD are recorded in the cancer registry using the ICD-10 diagnosis “D00.1”. We are therefore requesting the addition of ICD-10 code “D00.1” to improve the capture of oesophageal HGD, in addition to the C15 + C16 diagnosis codes currently specified. In this regard, we are not requesting for a change in scope but an adaptation to our definition that reflects the different ways in which people might be coding people with oesophageal HGD. These cases are considered synonymous with carcinoma in situ.]
NATCAN is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NHS England and HQIP are the joint controllers for the data, as together both organisations determine the purposes and means of processing.
HQIP and NHS England both rely on Article 6(1)(e) of the UK GDPR as the lawful basis of processing - "processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller". This is justified through commissioning arrangements which link back to NHS England with statutory responsibilities to improve the quality of health care services.
HQIP rely on Article 9(2)(i) as the legal basis for processing under UK GDPR - "processing is necessary for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices, on the basis of Union or Member State law which provides for suitable and specific measures to safeguard the rights and freedoms of the data subject, in particular, professional secrecy". This is justified as all projects aim to drive improvements in the quality and safety of care and to improve outcomes for patients. The processing meets Schedule 1 Part 1 condition 3 of the Data Protection Act 2018 as the processing is carried out by the Royal College of Surgeons on behalf of NHS England.
NHS England relies on Article 9(2)(h) of the UK GDPR as the legal basis for processing. "Processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to a contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3". NHS England is responsible for the provision of health and social care, and the management of systems and compliance.
The funding is provided by NHS England via the intermediary of HQIP. The funding is specifically for the audit described.
The funder will have no ability to suppress or otherwise limit the publication of findings.
The RCSEng is a processor acting under the instructions of the Controllers. The RCSEng are required to fulfil the contracted deliverables to HQIP and NHS England.
NATCAN has an organisational structure with a high-level overarching management body (NATCAN Executive Team). The individual Audit teams report into this Executive team. This set-up aims to provide a transparent and responsive management structure allowing each Audit to cater for the individual attributes of the different cancer types, while also providing an integrated and consistent approach across the Audits. More information on the structure can be accessed via https://www.natcan.org.uk/resources/2675/
An over-arching NATCAN Board provides top-level governance with overall responsibility for the operational and strategic management of the centre. The NATCAN Board provides project governance and oversees the delivery of the contract, and includes members of leading professional bodies, patient representatives, the commissioning body (HQIP), and the commissioned organisation (RCSeng). The NATCAN Executive Team reports to the NATCAN Board, providing formal accountability for the delivery of the centre and the individual Audits.
The Audit teams within NATCAN are supported by a Technical Advisory Group (which advises on national cancer data collection, statistical methodology, development of relevant and robust performance indicators to stimulate QI, and communication to practitioners and lay audiences) and a Quality Improvement (QI) Team of external experts with extensive experience in QI and implementation science (which directs the QI work of the Audits including the design and delivery of QI initiatives for each Audit).
Each Audit has a Clinical Reference Group (CRG) that supports and shapes the implementation of the audit aims. The CRGs include representation of patients and stakeholder organisations and act as consultative groups to the Audit Teams on clinical issues as well as issues related to methodology, quality improvement and the dissemination of audit results/recommendations.
The stakeholder organisations or specialities involved in the Audit Clinical Reference Groups include patient charities, patients, professional organisations, multi-disciplinary experts in the relevant area of cancer care, data providers, commissioners/regulators of care, and policymakers. Each Audit will also have a standalone Patient and Public Involvement Forum to ensure the patient voice is central to the work of the Audit, guiding the development of the Audit QI goals and activities.
These groups serve in an advisory capacity only. The controllers listed within this Agreement maintain overall responsibility for determining the purpose and means of processing. Only those substantively employed by RCSEng, or those with an honorary contract with RCSEng, are permitted to process the data covered under this Agreement.
Patients and Patient Charities have already been involved in the scoping exercises for each individual audit covered under NATCAN. Going forward each individual audit will have its own Patient and Public Involvement Group (PPIG), patients and relevant charities will be involved in the development of the Terms of Reference for each of these Groups.
The composition of the PPIG for each disease area will vary. NATCAN have given careful consideration to the nature of each disease area when determining if and when it is appropriate to invite patients to join the PPIG; taking into consideration survival rates, the toll of treatment and whether it is more appropriate to invite a family member in place of the patient.
The existing audits in lung, prostate, bowel and oesophago-gastric cancer have existing standalone PPIGs.
Expected output
The expected outputs of the processing will be:
• ‘State of the Nation’ (SotN) reports for each individual Audit in will be made publicly available. Publication will begin ~September 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will occur annually from that point forward.
The SotN reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – April 2024, April 2025
• National Prostate Cancer Audit (NPCA) – January 2024, January 2025,
• National Bowel Cancer Audit (NBOCA)- January 2025
• National Oesophago-gastric Cancer Audit (NOGCA) - January 2025
• Where appropriate, outputs of the audits that reflect key findings or methodological developments will be submitted to peer-reviewed journals.
• Presentations at appropriate conferences
• Publication of dashboards on the NATCAN website from early 2024 onwards
Quarterly reports for each individual Audit in will be made publicly available. Publication will begin April 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will continue quarterly in the following cycle : April, July, October, January
The quarterly reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – quarterly reporting started in October 2023 under the current contract and will continue quarterly in the following cycle : January, April, July, October each year
• National Prostate Cancer Audit (NPCA) – quarterly reporting will start in January 2024 under the current contract and will continue quarterly in the following cycle: February, May, August, November
• National Bowel Cancer Audit (NBOCA)- quarterly reporting started in July 2023 under the current contract and will continue quarterly and will continue quarterly in the following cycle : January, April, July, October each year
• National Oesophago-gastric Cancer Audit (NOGCA) – quarterly reporting will start in July 2024 and will continue quarterly in the following cycle : January, April, July, October each year
The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.
The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Social media
• Public reports
• Industry newsletters
• Press/media engagement
• Reports aimed at Clinicians, Commissioners and Policy Makers
• Reports aimed at Patients and the General Public
Outputs will begin to be disseminated from early 2024, dissemination of outputs will continue until the end of RCSEng's contract with HQIP.
DARS-NIC-709865-W9X6H-v1.4 10 May 2024 to 30 September 2025
- Title
- National Cancer Audit Collaborating Centre (NATCAN)
- Commercial
- No
- Sublicensing
- No
- Datasets
- 22
- Files released
- 46
Datasets: Civil Registrations of Death; Civil Registrations of Death - Secondary Care Cut; Demographics; Diagnostic Imaging Data Set (DID); Emergency Care Data Set (ECDS); Emergency Care Data Set (ECDS); Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Hospital Episode Statistics Outpatients (HES OP); Medicines dispensed in Primary Care (NHSBSA data); NDRS Cancer Registrations; NDRS Linked Cancer Waiting Times (Treatments only); NDRS Linked Cancer Waiting Times (Treatments only); NDRS National Cancer Patient Experience Survey (CPES); NDRS National Radiotherapy Dataset (RTDS); NDRS National Radiotherapy Dataset (RTDS); NDRS Rapid Cancer Registrations; NDRS Somatic Molecular Dataset; NDRS Systemic Anti-Cancer Therapy Dataset (SACT); NDRS Systemic Anti-Cancer Therapy Dataset (SACT)
What changed from DARS-NIC-709865-W9X6H-v0.9
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2024-05-10 | |
| Hospital Episode Statistics Admitted Patient Care (HES APC): type of data | Identifiable |
Datasets: + Civil Registrations of Death; + Civil Registrations of Death - Secondary Care Cut; + Demographics
Objective for processing
[2 paragraphs unchanged]
NATCAN will deliver
six
ten
clinical audits of care delivered by NHS Providers, the audits are as follows:
[6 paragraphs unchanged]
• National Lung Cancer Audit (NLCA)
• National Prostate Cancer Audit (NPCA)
• National Bowel Cancer Audit (NBOCA)
• National Oesophago-gastric Cancer Audit (NOGCA)
[1 paragraph unchanged]
Each individual audit broadly aims to:
Overall as generic aims of the audits, NATCAN will;
[14 paragraphs unchanged]
• Medicines Dispensed in Primary Care- for
breast
breast, pancreatic, prostate
and
pancreatic
Oesophago-gastric
cancer only to enable the audits to determine whether the care (treatments)
[60 words unchanged]
directions for which the data are permitted to be accessed and used.
[17 paragraphs unchanged]
Local Patient ID is required to support the outlier process. Each Audit in NATCAN will carry out an Outlier Process in keeping with the updated “Detection and Management of Outliers for National Clinical Audit” guidance in England and Wales. The Audits in NATCAN will provide Trusts identified as potential alert or alarm outliers with de-identified patient-level, minimum data for all patients included in estimating the indicator for their Trust. This will provide limited but sufficient information regarding patient (for example: month and year of birth, sex, performance status), treatment (for example: procedure date) and tumour characteristics (for example: stage, risk category). The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
[1 paragraph unchanged]
• Limited to a study cohort identified as having been diagnosed with
[10 words unchanged]
specific ICD codes): Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney
Cancer
Cancer, Lung Cancer, prostate Cancer, Bowel cancer, Oesophago-gastric cancer
between 01.01.2015 to the Latest Available Cancer Registrations.
[3 paragraphs unchanged]
• The Medicines Dispensed in Primary Care Dataset will be limited to patients diagnosed with
Breast and/or Pancreatic Cancer.
Breast, Pancreatic, prostate and Oesophago-gastric cancers
[1 paragraph unchanged]
• Limited to the following diagnostic codes for all patients aged ≥ 18 years for the following audits:
National Lung Cancer Audit (NLCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C33 -C34).
National Prostate Cancer Audit (NPCA) - with a new diagnosis of prostate cancer (ICD-10 diagnosis code: C61).
National Bowel Cancer Audit (NBOCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C18, C19 or C20).
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C15x, C16x).
[1 paragraph unchanged]
HQIP and NHS England both rely on Article 6(1)(e) of the
UK
GDPR as the lawful basis of processing - "processing is necessary for
[33 words unchanged]
England with statutory responsibilities to improve the quality of health care services.
HQIP rely on Article 9(2)(i) as the legal basis for processing under
UK
GDPR - "processing is necessary for reasons of public interest in the
[104 words unchanged]
out by the Royal College of Surgeons on behalf of NHS England.
NHS England relies on Article 9(2)(h) of the
UK
GDPR as the legal basis for processing. "Processing is necessary for the
[75 words unchanged]
of health and social care, and the management of systems and compliance.
[11 paragraphs unchanged]
In line with the National data opt-out policy, opt-outs are not applied because the data is not Confidential Patient Information as defined in sections 251(10) and (11) of the National Health Service Act 2006
The existing audits in lung, prostate, bowel and oesophago-gastric cancer have existing standalone PPIGs.
Where individuals have opted out of disease registration by the National Disease Registration Service (NDRS), their data has been permanently removed from the registry and therefore will not be disseminated under this Data Sharing Agreement (DSA). https://digital.nhs.uk/ndrs/patients/opting-out
Processing activities
[21 paragraphs unchanged] There will be no requirement and no attempt by the controller or the processor on this DSA to reidentify individuals when using the Data. [1 paragraph unchanged]
Expected output
[1 paragraph unchanged]
• ‘State of the Nation’ (SotN) reports for each individual Audit
in
will be made publicly available. Publication will begin ~September 2024
for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer
and will occur annually from that point forward.
The Audit teams will also produce a ‘lay-friendly’ version of the SotN report each year.
The SotN reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – April 2024, April 2025
• National Prostate Cancer Audit (NPCA) – January 2024, January 2025,
• National Bowel Cancer Audit (NBOCA)- January 2025
• National Oesophago-gastric Cancer Audit (NOGCA) - January 2025
[3 paragraphs unchanged]
Quarterly reports for each individual Audit in will be made publicly available. Publication will begin April 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will continue quarterly in the following cycle : April, July, October, January
The quarterly reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – quarterly reporting started in October 2023 under the current contract and will continue quarterly in the following cycle : January, April, July, October each year
• National Prostate Cancer Audit (NPCA) – quarterly reporting will start in January 2024 under the current contract and will continue quarterly in the following cycle: February, May, August, November
• National Bowel Cancer Audit (NBOCA)- quarterly reporting started in July 2023 under the current contract and will continue quarterly and will continue quarterly in the following cycle : January, April, July, October each year
• National Oesophago-gastric Cancer Audit (NOGCA) – quarterly reporting will start in July 2024 and will continue quarterly in the following cycle : January, April, July, October each year
[10 paragraphs unchanged]
Expected measurable benefits
[3 paragraphs unchanged]
It is hoped that through publication of findings in appropriate media, the findings of this
research
these audits
will add to the body of evidence that is considered by the
[12 words unchanged]
or within the NHS or treatment decisions in relation to specific patients.
[1 paragraph unchanged]
Benefits reported
Stated in the previous version and removed here.
Yielded Benefits is not a requirement for new applications.
Objective for processing
The Healthcare Quality Improvement Partnership (HQIP) and NHS England require access to patient data for the purpose of the following National Audit Centre: The National Cancer Audit Collaborating Centre (NATCAN)
NATCAN is commissioned by HQIP on behalf of NHS England and is a part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NATCAN has been awarded to the Royal College of Surgeons of England (RCSEng) Clinical Effectiveness Unit (CEU), a collaboration between the RCSEng and the London School of Hygiene and Tropical Medicine (LSHTM).
NATCAN will deliver ten clinical audits of care delivered by NHS Providers, the audits are as follows:
• National Audit of Primary Breast cancer (NaoPri)
• National Audit of Metastatic Breast cancer (NaoMe)
• National Ovarian Cancer Audit (NOCA)
• National Pancreatic Cancer Audit (NPaCA)
• National Non-Hodgkin Lymphoma Audit (NNHLA)
• National Kidney Cancer Audit (NKCA)
• National Lung Cancer Audit (NLCA)
• National Prostate Cancer Audit (NPCA)
• National Bowel Cancer Audit (NBOCA)
• National Oesophago-gastric Cancer Audit (NOGCA)
With the exception of breast cancer, NCAPOP has not previously incorporated clinical audits in these specific disease areas. The previous National Audit of Breast Cancer in Older Patients (NABCOP) completed in 2022.
Overall as generic aims of the audits, NATCAN will;
1. Provide regular and timely evidence to cancer services on patterns of care in England and Wales so they can benchmark their performance and identify where there is unwarranted variation.
2. Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives.
3. Stimulate improvements in cancer detection, treatment and outcomes including survival.
The following Datasets will be accessed in support of the centre's aims:
• National Disease Registration Service (NDRS) Cancer Registrations- including items contained within the Cancer Outcomes and Services Dataset (COSD) and Death Registration Information – necessary to understand patient characteristics
• NDRS Rapid Cancer Registrations- necessary to understand patient characteristics
• NDRS National Radiotherapy Dataset (RTDS)- necessary to understand treatment pathways
• NDRS Systemic Anti-Cancer Therapy (SACT) Dataset- necessary to understand treatment pathways
• NDRS Linked Cancer Waiting Times (CWT)- necessary to understand waiting times and cancer care pathways
• NDRS Cancer Patient Experience Survey (CPES)- to better understand patient experience and incorporate this into measures of care quality
• NDRS Somatic Molecular Testing Dataset- to better understand the use of molecular testing within the disease areas covered by NATCAN
• Hospital Episode Statistics (HES)- Admitted Patient Care (APC), Outpatient (OP) and Accident & Emergency (A&E) subsets- necessary to build a more comprehensive view of patient pathways and outcomes.
• Emergency Care Dataset (ECDS)
• Diagnostic Imaging Dataset (DIDs)- necessary to understand the imaging pathways employed.
• Medicines Dispensed in Primary Care- for breast, pancreatic, prostate and Oesophago-gastric cancer only to enable the audits to determine whether the care (treatments) received is in line with national guidance. Specifically the audit will use the data to highlight patient safety in relation to national prescribing guidelines, i.e. those patients who may be at risk where guidelines don’t appear to be followed; and indicate medication effectiveness for those patients who are receiving treatments in line with national prescribing guidelines, which aligns with the directions for which the data are permitted to be accessed and used.
The following will be received on an annual basis linked to the NDRS Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• NDRS CPES
• NDRS Somatic Molecular Testing Data
• HES APC, HES OP
• ECDS
• Medicines Dispensed in Primary Care
• DIDS
Of which the following will be received on a quarterly basis linked to the NDRS Rapid Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• HES APC, HES OP
• ECDS
The level of the Data will be Pseudonymised.
Local Patient ID is required to support the outlier process. Each Audit in NATCAN will carry out an Outlier Process in keeping with the updated “Detection and Management of Outliers for National Clinical Audit” guidance in England and Wales. The Audits in NATCAN will provide Trusts identified as potential alert or alarm outliers with de-identified patient-level, minimum data for all patients included in estimating the indicator for their Trust. This will provide limited but sufficient information regarding patient (for example: month and year of birth, sex, performance status), treatment (for example: procedure date) and tumour characteristics (for example: stage, risk category). The inclusion of a local patient id will enable Trusts to recognise the patient in their own identifiable data and thereby determine potential areas where improvement in practice is required. Minimal, de-identified data will be securely transferred in an encrypted, password protected extract.
Consultant code is requested to enable the Audits to determine the impact of surgeon-level factors (for example, surgical volume, grade, experience) on patient outcomes.
The Data will be minimised as follows:
• Limited to a study cohort identified as having been diagnosed with one (or more) of the following (each being defined by specific ICD codes): Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer, Lung Cancer, prostate Cancer, Bowel cancer, Oesophago-gastric cancer between 01.01.2015 to the Latest Available Cancer Registrations.
• All datasets will be limited to the point of diagnosis to the latest available information for each individual patient unless otherwise stated. Appropriate measures will be put in place to account for imperfections in diagnosis date recording.
• HES APC which will be limited to all admissions up to 24 months prior to diagnosis to the latest available information.
• NDRS Rapid Cancer Registration Data is limited to records from 01.01.2018 onwards.
• The Medicines Dispensed in Primary Care Dataset will be limited to patients diagnosed with Breast, Pancreatic, prostate and Oesophago-gastric cancers
Once in receipt of the requested data The Royal College of Surgeons of England (RCSEng), who act as Processor under this Agreement, will further minimise the data ensuring that each individual audit only has access to information that is relevant to the disease area of said audit.
• Limited to the following diagnostic codes for all patients aged ≥ 18 years for the following audits:
National Lung Cancer Audit (NLCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C33 -C34).
National Prostate Cancer Audit (NPCA) - with a new diagnosis of prostate cancer (ICD-10 diagnosis code: C61).
National Bowel Cancer Audit (NBOCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C18, C19 or C20).
National Oesophago-gastric Cancer Audit (NOGCA) – with a new diagnosis of lung cancer (ICD-10 diagnosis code: C15x, C16x).
NATCAN is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NHS England and HQIP are the joint controllers for the data, as together both organisations determine the purposes and means of processing.
HQIP and NHS England both rely on Article 6(1)(e) of the UK GDPR as the lawful basis of processing - "processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller". This is justified through commissioning arrangements which link back to NHS England with statutory responsibilities to improve the quality of health care services.
HQIP rely on Article 9(2)(i) as the legal basis for processing under UK GDPR - "processing is necessary for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices, on the basis of Union or Member State law which provides for suitable and specific measures to safeguard the rights and freedoms of the data subject, in particular, professional secrecy". This is justified as all projects aim to drive improvements in the quality and safety of care and to improve outcomes for patients. The processing meets Schedule 1 Part 1 condition 3 of the Data Protection Act 2018 as the processing is carried out by the Royal College of Surgeons on behalf of NHS England.
NHS England relies on Article 9(2)(h) of the UK GDPR as the legal basis for processing. "Processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to a contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3". NHS England is responsible for the provision of health and social care, and the management of systems and compliance.
The funding is provided by NHS England via the intermediary of HQIP. The funding is specifically for the audit described. Funding is in place until 30/09/2025.
The funder will have no ability to suppress or otherwise limit the publication of findings.
The RCSEng is a processor acting under the instructions of the Controllers. The RCSEng are required to fulfil the contracted deliverables to HQIP and NHS England.
NATCAN has an organisational structure with a high-level overarching management body (NATCAN Executive Team). The individual Audit teams report into this Executive team. This set-up aims to provide a transparent and responsive management structure allowing each Audit to cater for the individual attributes of the different cancer types, while also providing an integrated and consistent approach across the Audits. More information on the structure can be accessed via https://www.natcan.org.uk/resources/2675/
An over-arching NATCAN Board provides top-level governance with overall responsibility for the operational and strategic management of the centre. The NATCAN Board provides project governance and oversees the delivery of the contract, and includes members of leading professional bodies, patient representatives, the commissioning body (HQIP), and the commissioned organisation (RCSeng). The NATCAN Executive Team reports to the NATCAN Board, providing formal accountability for the delivery of the centre and the individual Audits.
The Audit teams within NATCAN are supported by a Technical Advisory Group (which advises on national cancer data collection, statistical methodology, development of relevant and robust performance indicators to stimulate QI, and communication to practitioners and lay audiences) and a Quality Improvement (QI) Team of external experts with extensive experience in QI and implementation science (which directs the QI work of the Audits including the design and delivery of QI initiatives for each Audit).
Each Audit has a Clinical Reference Group (CRG) that supports and shapes the implementation of the audit aims. The CRGs include representation of patients and stakeholder organisations and act as consultative groups to the Audit Teams on clinical issues as well as issues related to methodology, quality improvement and the dissemination of audit results/recommendations.
The stakeholder organisations or specialities involved in the Audit Clinical Reference Groups include patient charities, patients, professional organisations, multi-disciplinary experts in the relevant area of cancer care, data providers, commissioners/regulators of care, and policymakers. Each Audit will also have a standalone Patient and Public Involvement Forum to ensure the patient voice is central to the work of the Audit, guiding the development of the Audit QI goals and activities.
These groups serve in an advisory capacity only. The controllers listed within this Agreement maintain overall responsibility for determining the purpose and means of processing. Only those substantively employed by RCSEng, or those with an honorary contract with RCSEng, are permitted to process the data covered under this Agreement.
Patients and Patient Charities have already been involved in the scoping exercises for each individual audit covered under NATCAN. Going forward each individual audit will have its own Patient and Public Involvement Group (PPIG), patients and relevant charities will be involved in the development of the Terms of Reference for each of these Groups.
The composition of the PPIG for each disease area will vary. NATCAN have given careful consideration to the nature of each disease area when determining if and when it is appropriate to invite patients to join the PPIG; taking into consideration survival rates, the toll of treatment and whether it is more appropriate to invite a family member in place of the patient.
The existing audits in lung, prostate, bowel and oesophago-gastric cancer have existing standalone PPIGs.
Expected output
The expected outputs of the processing will be:
• ‘State of the Nation’ (SotN) reports for each individual Audit in will be made publicly available. Publication will begin ~September 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will occur annually from that point forward.
The SotN reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – April 2024, April 2025
• National Prostate Cancer Audit (NPCA) – January 2024, January 2025,
• National Bowel Cancer Audit (NBOCA)- January 2025
• National Oesophago-gastric Cancer Audit (NOGCA) - January 2025
• Where appropriate, outputs of the audits that reflect key findings or methodological developments will be submitted to peer-reviewed journals.
• Presentations at appropriate conferences
• Publication of dashboards on the NATCAN website from early 2024 onwards
Quarterly reports for each individual Audit in will be made publicly available. Publication will begin April 2024 for the Audits in Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer and will continue quarterly in the following cycle : April, July, October, January
The quarterly reports for the existing audits will be published as follows:
• National Lung Cancer Audit (NLCA) – quarterly reporting started in October 2023 under the current contract and will continue quarterly in the following cycle : January, April, July, October each year
• National Prostate Cancer Audit (NPCA) – quarterly reporting will start in January 2024 under the current contract and will continue quarterly in the following cycle: February, May, August, November
• National Bowel Cancer Audit (NBOCA)- quarterly reporting started in July 2023 under the current contract and will continue quarterly and will continue quarterly in the following cycle : January, April, July, October each year
• National Oesophago-gastric Cancer Audit (NOGCA) – quarterly reporting will start in July 2024 and will continue quarterly in the following cycle : January, April, July, October each year
The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.
The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Social media
• Public reports
• Industry newsletters
• Press/media engagement
• Reports aimed at Clinicians, Commissioners and Policy Makers
• Reports aimed at Patients and the General Public
Outputs will begin to be disseminated from early 2024, dissemination of outputs will continue until the end of RCSEng's contract with HQIP.
DARS-NIC-709865-W9X6H-v0.9 27 October 2023 to 30 September 2025
- Title
- National Cancer Audit Collaborating Centre (NATCAN)
- Commercial
- No
- Sublicensing
- No
- Datasets
- 19
- Files released
- 40
Datasets: Diagnostic Imaging Data Set (DID); Emergency Care Data Set (ECDS); Emergency Care Data Set (ECDS); Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); Hospital Episode Statistics Outpatients (HES OP); Medicines dispensed in Primary Care (NHSBSA data); NDRS Cancer Registrations; NDRS Linked Cancer Waiting Times (Treatments only); NDRS Linked Cancer Waiting Times (Treatments only); NDRS National Cancer Patient Experience Survey (CPES); NDRS National Radiotherapy Dataset (RTDS); NDRS National Radiotherapy Dataset (RTDS); NDRS Rapid Cancer Registrations; NDRS Somatic Molecular Dataset; NDRS Systemic Anti-Cancer Therapy Dataset (SACT); NDRS Systemic Anti-Cancer Therapy Dataset (SACT)
Objective for processing
The Healthcare Quality Improvement Partnership (HQIP) and NHS England require access to patient data for the purpose of the following National Audit Centre: The National Cancer Audit Collaborating Centre (NATCAN)
NATCAN is commissioned by HQIP on behalf of NHS England and is a part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NATCAN has been awarded to the Royal College of Surgeons of England (RCSEng) Clinical Effectiveness Unit (CEU), a collaboration between the RCSEng and the London School of Hygiene and Tropical Medicine (LSHTM).
NATCAN will deliver six clinical audits of care delivered by NHS Providers, the audits are as follows:
• National Audit of Primary Breast cancer (NaoPri)
• National Audit of Metastatic Breast cancer (NaoMe)
• National Ovarian Cancer Audit (NOCA)
• National Pancreatic Cancer Audit (NPaCA)
• National Non-Hodgkin Lymphoma Audit (NNHLA)
• National Kidney Cancer Audit (NKCA)
With the exception of breast cancer, NCAPOP has not previously incorporated clinical audits in these specific disease areas. The previous National Audit of Breast Cancer in Older Patients (NABCOP) completed in 2022.
Each individual audit broadly aims to:
1. Provide regular and timely evidence to cancer services on patterns of care in England and Wales so they can benchmark their performance and identify where there is unwarranted variation.
2. Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives.
3. Stimulate improvements in cancer detection, treatment and outcomes including survival.
The following Datasets will be accessed in support of the centre's aims:
• National Disease Registration Service (NDRS) Cancer Registrations- including items contained within the Cancer Outcomes and Services Dataset (COSD) and Death Registration Information – necessary to understand patient characteristics
• NDRS Rapid Cancer Registrations- necessary to understand patient characteristics
• NDRS National Radiotherapy Dataset (RTDS)- necessary to understand treatment pathways
• NDRS Systemic Anti-Cancer Therapy (SACT) Dataset- necessary to understand treatment pathways
• NDRS Linked Cancer Waiting Times (CWT)- necessary to understand waiting times and cancer care pathways
• NDRS Cancer Patient Experience Survey (CPES)- to better understand patient experience and incorporate this into measures of care quality
• NDRS Somatic Molecular Testing Dataset- to better understand the use of molecular testing within the disease areas covered by NATCAN
• Hospital Episode Statistics (HES)- Admitted Patient Care (APC), Outpatient (OP) and Accident & Emergency (A&E) subsets- necessary to build a more comprehensive view of patient pathways and outcomes.
• Emergency Care Dataset (ECDS)
• Diagnostic Imaging Dataset (DIDs)- necessary to understand the imaging pathways employed.
• Medicines Dispensed in Primary Care- for breast and pancreatic cancer only to enable the audits to determine whether the care (treatments) received is in line with national guidance. Specifically the audit will use the data to highlight patient safety in relation to national prescribing guidelines, i.e. those patients who may be at risk where guidelines don’t appear to be followed; and indicate medication effectiveness for those patients who are receiving treatments in line with national prescribing guidelines, which aligns with the directions for which the data are permitted to be accessed and used.
The following will be received on an annual basis linked to the NDRS Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• NDRS CPES
• NDRS Somatic Molecular Testing Data
• HES APC, HES OP
• ECDS
• Medicines Dispensed in Primary Care
• DIDS
Of which the following will be received on a quarterly basis linked to the NDRS Rapid Cancer Registration Data (inc. items from COSD):
• NDRS RTDS
• NDRS SACT
• NDRS CWT
• HES APC, HES OP
• ECDS
The level of the Data will be Pseudonymised.
The Data will be minimised as follows:
• Limited to a study cohort identified as having been diagnosed with one (or more) of the following (each being defined by specific ICD codes): Breast Cancer, Ovarian Cancer, Pancreatic Cancer, Non-Hodgkin Lymphoma, Kidney Cancer between 01.01.2015 to the Latest Available Cancer Registrations.
• All datasets will be limited to the point of diagnosis to the latest available information for each individual patient unless otherwise stated. Appropriate measures will be put in place to account for imperfections in diagnosis date recording.
• HES APC which will be limited to all admissions up to 24 months prior to diagnosis to the latest available information.
• NDRS Rapid Cancer Registration Data is limited to records from 01.01.2018 onwards.
• The Medicines Dispensed in Primary Care Dataset will be limited to patients diagnosed with Breast and/or Pancreatic Cancer.
Once in receipt of the requested data The Royal College of Surgeons of England (RCSEng), who act as Processor under this Agreement, will further minimise the data ensuring that each individual audit only has access to information that is relevant to the disease area of said audit.
NATCAN is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NHS England and HQIP are the joint controllers for the data, as together both organisations determine the purposes and means of processing.
HQIP and NHS England both rely on Article 6(1)(e) of the GDPR as the lawful basis of processing - "processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller". This is justified through commissioning arrangements which link back to NHS England with statutory responsibilities to improve the quality of health care services.
HQIP rely on Article 9(2)(i) as the legal basis for processing under GDPR - "processing is necessary for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety of health care and of medicinal products or medical devices, on the basis of Union or Member State law which provides for suitable and specific measures to safeguard the rights and freedoms of the data subject, in particular, professional secrecy". This is justified as all projects aim to drive improvements in the quality and safety of care and to improve outcomes for patients. The processing meets Schedule 1 Part 1 condition 3 of the Data Protection Act 2018 as the processing is carried out by the Royal College of Surgeons on behalf of NHS England.
NHS England relies on Article 9(2)(h) of the GDPR as the legal basis for processing. "Processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to a contract with a health professional and subject to the conditions and safeguards referred to in paragraph 3". NHS England is responsible for the provision of health and social care, and the management of systems and compliance.
The funding is provided by NHS England via the intermediary of HQIP. The funding is specifically for the audit described. Funding is in place until 30/09/2025.
The funder will have no ability to suppress or otherwise limit the publication of findings.
The RCSEng is a processor acting under the instructions of the Controllers. The RCSEng are required to fulfil the contracted deliverables to HQIP and NHS England.
NATCAN has an organisational structure with a high-level overarching management body (NATCAN Executive Team). The individual Audit teams report into this Executive team. This set-up aims to provide a transparent and responsive management structure allowing each Audit to cater for the individual attributes of the different cancer types, while also providing an integrated and consistent approach across the Audits. More information on the structure can be accessed via https://www.natcan.org.uk/resources/2675/
An over-arching NATCAN Board provides top-level governance with overall responsibility for the operational and strategic management of the centre. The NATCAN Board provides project governance and oversees the delivery of the contract, and includes members of leading professional bodies, patient representatives, the commissioning body (HQIP), and the commissioned organisation (RCSeng). The NATCAN Executive Team reports to the NATCAN Board, providing formal accountability for the delivery of the centre and the individual Audits.
The Audit teams within NATCAN are supported by a Technical Advisory Group (which advises on national cancer data collection, statistical methodology, development of relevant and robust performance indicators to stimulate QI, and communication to practitioners and lay audiences) and a Quality Improvement (QI) Team of external experts with extensive experience in QI and implementation science (which directs the QI work of the Audits including the design and delivery of QI initiatives for each Audit).
Each Audit has a Clinical Reference Group (CRG) that supports and shapes the implementation of the audit aims. The CRGs include representation of patients and stakeholder organisations and act as consultative groups to the Audit Teams on clinical issues as well as issues related to methodology, quality improvement and the dissemination of audit results/recommendations.
The stakeholder organisations or specialities involved in the Audit Clinical Reference Groups include patient charities, patients, professional organisations, multi-disciplinary experts in the relevant area of cancer care, data providers, commissioners/regulators of care, and policymakers. Each Audit will also have a standalone Patient and Public Involvement Forum to ensure the patient voice is central to the work of the Audit, guiding the development of the Audit QI goals and activities.
These groups serve in an advisory capacity only. The controllers listed within this Agreement maintain overall responsibility for determining the purpose and means of processing. Only those substantively employed by RCSEng, or those with an honorary contract with RCSEng, are permitted to process the data covered under this Agreement.
Patients and Patient Charities have already been involved in the scoping exercises for each individual audit covered under NATCAN. Going forward each individual audit will have its own Patient and Public Involvement Group (PPIG), patients and relevant charities will be involved in the development of the Terms of Reference for each of these Groups.
The composition of the PPIG for each disease area will vary. NATCAN have given careful consideration to the nature of each disease area when determining if and when it is appropriate to invite patients to join the PPIG; taking into consideration survival rates, the toll of treatment and whether it is more appropriate to invite a family member in place of the patient.
In line with the National data opt-out policy, opt-outs are not applied because the data is not Confidential Patient Information as defined in sections 251(10) and (11) of the National Health Service Act 2006
Where individuals have opted out of disease registration by the National Disease Registration Service (NDRS), their data has been permanently removed from the registry and therefore will not be disseminated under this Data Sharing Agreement (DSA). https://digital.nhs.uk/ndrs/patients/opting-out
Expected output
The expected outputs of the processing will be:
• ‘State of the Nation’ (SotN) reports for each individual Audit will be made publicly available. Publication will begin ~September 2024 and will occur annually from that point forward. The Audit teams will also produce a ‘lay-friendly’ version of the SotN report each year.
• Where appropriate, outputs of the audits that reflect key findings or methodological developments will be submitted to peer-reviewed journals.
• Presentations at appropriate conferences
• Publication of dashboards on the NATCAN website from early 2024 onwards
The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived.
The outputs will be communicated to relevant recipients through the following dissemination channels:
• Journals
• Social media
• Public reports
• Industry newsletters
• Press/media engagement
• Reports aimed at Clinicians, Commissioners and Policy Makers
• Reports aimed at Patients and the General Public
Outputs will begin to be disseminated from early 2024, dissemination of outputs will continue until the end of RCSEng's contract with HQIP.
Benefits reported
Yielded Benefits is not a requirement for new applications.
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.
-
December 2023 —
first listed. 1 version: DARS-NIC-709865-W9X6H-v0.9
-
June 2024
1 version added: DARS-NIC-709865-W9X6H-v1.4
-
May 2025
1 version added: DARS-NIC-709865-W9X6H-v2.4
-
October 2025
Renamed Data controllers: NHS England (Quarry House) now named NHS England. Not counted as a change.
-
December 2025
1 version added: DARS-NIC-709865-W9X6H-v3.4
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-709865-W9X6H, “National Cancer Audit Collaborating Centre (NATCAN)”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-709865-w9x6h/ (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-709865-W9X6H to see the original rows.