The role of inequalities in cancer care experience in mediating inequalities in cancer treatment receipt and time-to-treatment.

The Data will be used for the purpose of a research project: The role of inequalities in cancer care experience in mediating inequalities in cancer treatment receipt and time-to-treatment.

The Data will be used to answer the following question:

1. Do marginalised groups report differences in cancer care experience and, if so, to what extent do these differences mediate inequalities in treatment receipt and time-to-treatment?

The objectives are to:

1. To identify which marginalised groups, known to experience inequalities in cancer survival, report differences in cancer care experience.

2. To assess whether differences in cancer care experience mediate inequalities in treatment receipt and time-to-treatment.

No data will flow to NHS England for the purposes of this Data Sharing Agreement (DSA).

NHS England will provide the relevant records from the NDRS CPES and NDRS Cancer Registrations datasets to University of Surrey. The Data will contain no direct identifying data items but will contain a unique person ID which can be used to link the Data with other record level data provided in this agreement.

The Data will not be transferred to any other location.

The Data will be stored on servers at University of Surrey

University of Surrey will back-up data on their own servers.

The Data will be accessed by authorised personnel via remote access.

The University of Surrey must confirm and provide evidence upon audit by NHS England that access via any remote device complies with the data security obligations within this DSA and the Data Sharing Framework Contract.

For remote access:

- Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA;

- Access controls granting users the minimum level of access required are in place;

- Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data;

- Multifactor authentication (MFA) is required for remote access;

- Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access;

- All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this DSA) and complies with the organisation’s remote access policy.

The above applies in addition to any condition set out elsewhere within the DSA (e.g. who may carry out processing, and for what purpose).

No other organisation is permitted to access the Data.

The Data will not be linked with any other data outside of this agreement.

The expected outputs of the processing will be:

1. Submissions to peer reviewed journals: Two manuscripts will be published. The manuscripts will be prepared and submitted for publication within one year receipt of the data (i.e. 01/01/2027). This will provide one year for further data analysis, should reviewers request any revisions.

2. Presentations at the Cancer in Primary Care Research Conference (October 2027, October 2028) and Cancer Research UK’s Early Data-driven Research Conference (April 2027, April 2028).

3. Creation animated videos for patients and the public (April 2028)

4. Publishing of the syntax (but not the data) publicly available for others to replicate, validate or adapt for their use (April 2028)

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:

- Open access manuscripts, published in peer-reviewed journals (e.g. British Journal of Cancer)

- Oral presentations at scientific conferences (e.g. Cancer Research UK Early Diagnosis Conference)

- Animated videos co-produced with cancer patients and members of the public (uploaded to YouTube, LinkedIn, X, Facebook and University websites)

- Summaries, sent to policy makers and practitioners, via contacts within Department of Health and Social Care, NHS England, Cancer Research UK.

The University of Surrey is one of five academic partners that make up the NIHR Policy Research Unit for Cancer Awareness, Screening and Early Diagnosis. As such, it has strong links to the Department of Health and Social Care and NHS England, who can support the cascading of information to relevant stakeholders and policy makers.

The research will improve the understanding of where inequalities in cancer care experience arise, and how these inequalities mediate wider inequalities in cancer treatment and time-to-treatment. This information can be used to create an evidence base, essential to decision making for policy to reduce inequalities in cancer care.

In addition to improving cancer care for patients, policies designed to tackle inequalities in cancer care may result in more equitable treatment and time to treatment for patients, which, in turn, may lead to improved cancer survival.

The research team will work with their professional and social networks to promote the research. For example, the findings will be shared with the University of Surrey (host institution) and Cancer Research UK (funder) media teams, who may decide to issue a press release to coincide with the publication.

The University of Surrey is one of five academic partners that make up the NIHR Policy Research Unit for Cancer Awareness, Screening and Early Diagnosis. As such, it has strong links to the Department of Health and Social Care and NHS England, who can support the cascading of information to relevant stakeholders and policy makers.

Yielded Benefits is not a requirement for new applications.