Cancer Waiting Times release history

Additional Columns in FDS General Previews

Following user feedback, it was identified that in the 28 Day FDS Reports, the addition of Patient Pathway Identifier (PPI); Breach Indicator; Pathway End Date; Decision To Treat Date; Source of Referral for Out Patients and Cancer Referral to Treatment Period Start Date columns will be highly beneficial and match the report column profiles of the 31 and 62 Day reports. These columns will be added in this release.

Goals

To add the following columns to the 28 Day preview CSV:

• Source of Referral for Out patients
• Patient Pathway Identifier (PPI)
• Breach Indicator
• Clock Stop Date

New columns to match the profile of columns for the 31 Day and 62 Day Preview Reports where appropriate.

New columns to reflect for historic data as well.

New column profile for 28 Day:

*Indicates a new column

Decision To Treat Date is Cancer Treatment Period Start Date (as in 31 and 62 day previews)

Benefits

The inclusion of these columns reduces the burden for users who currently cannot view this information without using the old Individual Standard Reports.

Removing the use of the old Individual Standard reports enables them to be decommissioned and reduce the burden and cost of maintaining them in the CWT system.

'PPI' (Patient Pathway Identifier) helps in back tracing of the patient record for easy amendments if needed.

'Breach indicator' indicates if the record has breached a standard, in this case FDS.

'Pathway End Date' provides the FDS end date, which is important information for the 28 Day standard.

'Decision To Treat Date' which is Cancer treatment period start date indicates start of treatment period.

'Source of Referral for Out Patients' is again an important information to trace the referral.

'Cancer Referral to Treatment Period Start Date' similar to Activity Date.

Additional updates

Other updates on the system since the last main release are:

• Included in this release – Optimisation of the patient data table to improve speeds and robustness
• 2.2.76 – 3 October 2024 - Maintenance update
• 2.2.75 – 17 September 2024 - Fix for organisation types (PH and PP) that were not fully supported
• 2.2.74 – 10 September 2024 - Deployment of system updates to improve reliability and robustness of the system
• 2.2.73 – 29 August 2024 - Fix for issue with IPT discrepancy for a trust
• 2.2.72 – 27 August 2024 - Fix for blank Preview reports
• 2.2.71 – 6 August 2024 - Fix for discrepancies in ‘Accountable Total Over Target’ column
• 2.2.70 – 5 August 2024 - Fix for crashing Transaction Monitor component
• 2.2.69 – 15 July 2024 - Deployment to fix an issue with IPT Reports (26.1,26.4,28.1,28.4) not being listed correctly
• 2.2.67 and 2.2.68 – 10 June-15 July 2024 Windows Server Upgrades to the latest version to improve future-proofing and reliability
• 2.2.59 – 2.2.66 – 4 April-30th May 2024 Deployments to cover live issues and bug fixes
• 2.2.57 and 2.2.58 – 12 March- 21 March 2024 Certificate Renewals for servers

Contact us

If you experience any issues with using the system or have any feedback on the changes, then please contact the National Service Desk at [email protected].

You can also use our Workspace on FutureNHS to start a conversation with any of your fellow Cancer Waiting Times system users.

As part of the Clinical Review of Standards outcomes, an additional change has been identified to remove two of the validation rules for the Cancer Care Spell Delay Reason First Seen.

An update will be required to the validation rules within the CWT system to remove the two rules that are the subject of this change.

Goals

Remove the CR19 cross-reference validation rule for the field – CancerCareSpellDelayReasonFirstSeen

• if the Priority Type Code is ‘3’ and the calculated period between Cancer Referral to Treatment Period Start Date and Date First Seen is greater than 14 days (after adjustments have been taken into account), then Cancer Care Spell Delay Reason (First Seen) must not be blank

Remove the CR91 cross-reference validation rule for the field – CancerCareSpellDelayReasonFirstSeenComment

Benefits

• removal of redundant validation for first seen standard type
• reduces the number of validations the system has to perform

Additional updates

No additional updates have taken place on the system since the previous version 2.2.55

31 day Combined Standard Subsequent Treatment Modalities update

Summary

The system will be updated in the compliance rules to accommodate changes to treatment modalities as part of the Clinical Review of Standards changes to meet Dataset Guidance v12. The change requires 31 day subsequent treatment to accept all treatment modalities except for subsequent active monitoring and palliative care for the 31 day. The changes are to be made primarily in the combined standard calculator within the system.

Regeneration of October, November and December Combined Standard Reports

As part of the release the October, November and December Combined Standard Reports will be regenerated with the change in place. From after this release, the Combined Standard Reports will display the correct Treatment Modalities groupings.

Individual Standard reports will not be regenerated and therefore only show the changes for new submissions. Therefore individual treatment group counts and performance may not match with the combined standards treatment group counts until new individual reports are generated from 5 March 2024. New generation of reports for individual standards from January data onwards and the final revision reports from October data onwards will include the changed treatment modalities groupings, and will then match with the combined standards outputs for the relevant treatment groupings (i.e. drug, radiotherapy, and surgery).

Development released

Update the Treatment groups for few Modalities - 08 from Palliative Treatments to Active Monitoring, 09 from Other Treatments to Palliative Treatments and 16 from Drug Treatments to Other Treatments (new field values highlighted below):

Updating treatment groups will reflect changes immediately in the below CRS reports:

• 25.2 - 31 Day General Treatment Standard (Treatment Group) report
• 25.5 - 31 Day General Treatment Standard (Treatment Group) Report with GP registered
• 27.2 - 31 Day General Treatment Standard (Treatment Group)
• 27.5 - 31 Day General Treatment Standard (Treatment Group) with Provider

Note: Individual 31 day and 62 day reports will reflect these changes in future in reports generated from 5 March 2024:

• 2.2 - 31 Day First Treatment (Treatment Group) Report
• 2.5 - 31 Day First Treatment (Treatment Group) Report with GP registered
• 3.2 - Cancer Plan 62-Day Standard (Treatment Group) Report
• 3.5 - Cancer Plan 62-Day Standard (Treatment Group) Report with GP registered
• 4.2 – CRS 62-Day Screening Standard (Treatment Group) Report
• 4.5 - CRS 62-Day Screening Standard (Treatment Group) Report with GP registered
• 5.2 - CRS 62-Day Upgrade Standard (Treatment Group) Report
• 5.5 - CRS 62-Day Upgrade Standard (Treatment Group) Report with GP registered
• 7.2 - 31 Day First Treatment (Treatment Group)
• 7.5 - 31 Day First Treatment (Treatment Group) with Provider
• 8.2 - Cancer Plan 62 Day Standard (Treatment Group)
• 8.5 - Cancer Plan 62 Day Standard (Treatment Group) Report with Provider
• 9.2 - CRS 62 Day Screening Standard (Treatment Group)
• 9.5 - CRS 62 Day Screening Standard (Treatment Group) Report with Provider
• 10.2 - CRS 62 Day Upgrade Standard (Treatment Group)
• 10.5 - CRS 62 Day Upgrade Standard (Treatment Group) Report with Provider
• 15.2 - 62-Day From Symptomatic Breast Referral (Treatment Group) Report
• 15.5 - 62-Day From Symptomatic Breast Referral (Treatment Group) Report with GP registered
• 16.2 - Commissioner Based 62-Day From Symptomatic Breast Referral (Treatment Group)
• 16.5 - Commissioner Based 62-Day From Symptomatic Breast Referral (Treatment Group) Report With Provider

31 day CRS reports to include all treatment modalities for subsequent treatments with exception of subsequent active monitoring and palliative care, and ‘all treatments declined’

• 07, 08, 09, and 98 will be excluded from the list of modalities (link to the data dictionary).

31 day status indicator on Manual Entry screen to use 31 day combined standard calculator:

31 day previews and reports to use 31 day combined standard calculator replacing the individual calculators:

• Primary Diagnosis <> BLANK
• Cancer Treatment Modality <> 98
• Cancer Treatment Event Type IN (01, 07, 12) OR (Cancer Treatment Event Type IN (02, 03, 04, 05, 06, 08, 09, 10, 11) AND Cancer Treatment Modality <> 07, 08, 09)
• Cancer Treatment Period Start Date <> BLANK 
• Treatment Start Date for Cancer <> BLANK

Below are the reports that get affected by the new combined 31 day standard:

→ 25.1 - 31 Day General Treatment Standard (Tumour) report

→ 25.2 - 31 Day General Treatment Standard (Treatment Group) report

→ 25.3 - 31 Day General Treatment Standard (Treatment) report

→ 25.4- 31 Day General Treatment Standard (Tumour) Report with GP registered

→ 25.5 - 31 Day General Treatment Standard (Treatment Group) Report with GP registered

→ 25.6 - 31 Day General Treatment Standard (Treatment) Report with GP Registered

→27.1 - 31 Day General Treatment Standard (Tumour)

→27.2 - 31 Day General Treatment Standard (Treatment Group)

→27.3 - 31 Day General Treatment Standard (Treatment)

→27.4 - 31 Day General Treatment Standard (Tumour) with Provider

→27.5 - 31 Day General Treatment Standard (Treatment Group) with Provider

→27.6 - 31 Day General Treatment Standard (Treatment) with Provider

• 31-day combined standard reports and previews to have 6 splits by treatment modality – Drug, Radiotherapy, Surgery, Palliative, Active Monitoring and Other.
• The changes in 31 day combined CRS reports must be reflected from October data onwards. This will need existing data in those reports to be deleted and reports will be regenerated

Additional updates

Before these releases, the following changes were also made to the Cancer Waiting Times system:

• CWT 2.2.51 – 11 January 2024. A change to the URL within the system for the Corporate Reference API
• CWT 2.2.52 – 18 January 2024. An update to the timeout configuration in the Portal API within the system
• CWT 2.2.53 – 26 January 2024. Update to the submission deadlines within the system
• CWT 2.2.54 – 12 February 2024. Update to security certificates within the system

31 day Combined Standard Subsequent Treatment Modalities update

The system will be updated in the compliance rules to accommodate changes to treatment modalities as part of the Clinical Review of Standards changes to meet Dataset Guidance v12. The change requires 31 day subsequent treatment to accept all treatment modalities except for subsequent active monitoring and palliative care for the 31 day. The changes are to be made primarily in the combined standard calculator within the system.

Regeneration of October, November and December Combined Standard Reports

As part of the release the October, November and December Combined Standard Reports will be regenerated with the change in place. From after this release, the Combined Standard Reports will display the correct Treatment Modalities groupings.

Individual Standard reports will not be regenerated and therefore only show the changes for new submissions. Therefore individual treatment group counts and performance may not match with the combined standards treatment group counts until new individual reports are generated from 5 March 2024. New generation of reports for individual standards from January data onwards and the final revision reports from October data onwards will include the changed treatment modalities groupings, and will then match with the combined standards outputs for the relevant treatment groupings (i.e. drug, radiotherapy, and surgery).

Development released

Update the Treatment groups for few Modalities - 08 from Palliative Treatments to Active Monitoring, 09 from Other Treatments to Palliative Treatments and 16 from Drug Treatments to Other Treatments (new field values highlighted below):

Updating treatment groups will reflect changes immediately in the below CRS reports:

• 25.2 - 31 Day General Treatment Standard (Treatment Group) report
• 25.5 - 31 Day General Treatment Standard (Treatment Group) Report with GP registered
• 27.2 - 31 Day General Treatment Standard (Treatment Group)
• 27.5 - 31 Day General Treatment Standard (Treatment Group) with Provider

2.2.42 – 20 November 2023 at 3pm - Toggle on CRS Report/Extract, reports which have split by first and subsequent for 31 days standard and referral type split for 62 days standard. Also, implementation of lower tumour granularities on extract.

2.2.43 – 27 November 2023 at 5pm - NSS data correction for Patient data submitted in month of July having DatefirstSeen or CancerFasterDiagnosisPathwayEndDate or TreatmentStarteDateCancer between 01-Apr-2023 to 30-Jun-2023.

2.2.44 – 27 November 2023 at 5pm - Replace 'Lower Granularity' in Extract filename as 'LG'.

2.2.45 – 30 November 2023 at 2pm - Extension of submission window for revised, monthly snapshot for month of October and report generation date due to data not showing on previews/slow processing of derivation service.

2.2.46 – 1 December 2023 at 8am - Extension on CRS reports toggle ON functionality as report generation date is moving forward.

2.2.47 – 6 December 2023 at 6pm - Code changes in the derivation service to derive the PrimaryDiagnosisCategory values from DSS table (ICD10Lookup) based on TreatmentStratdateCancer. In existing Derivation service, it derives these values based on CancerTreatmentPeriodStartDate or ConsultanatUpgradeDate or DateFirstSeen.

2.2.48 – 7 December 2023 at 10:30am - Rerun of affected records from October months to correct the DerivedData_PrimaryDiagnosisCategoryOne and DerivedData_PrimaryDiagnosisCategoryTwo value in PPRV table in CwtReportingApi_B database. Code changes to fix the 'Standard Breached' column in old granularity extract files to display values and Stored procedure changes (Generate62DaysBreachExtract) in Reporting database to have values for Lower Granularities (for Lower Granularity extracts).

2.2.49 – 8 December 2023 at 10am - regenerating the extracts for the month of October after data correction using rerun to reflect the correct set of granularity data in Lower Granularity extracts.

2.2.50 - 8 December 2023 at 10am - regenerating the Reports for the month of October after data correction using rerun to reflect the correct set of granularity data in Lower Granularity Reports.

Fix for Single Record Input API live issues

The manual entry screen was throwing an error when users created/updated single/manual entry records. This release fixed the live issue in the system.

CRS toggle ON for preview and downloads

The release included a combination of changes to implement the CRS changes to accommodate the new guidance v.12. These included within the system:

• 62 day CRS reports to stop using 31-day rare cancer referral to first treatment standard(s) - discarding rare cancer standard types (100, 110 and 120) from 62 days CRS reports
• 31-day combined standard reports and previews to have split by first and subsequent treatment replacing the admitted and non-admitted care type splits
• 31-day combined standard reports to be split by treatment modality with Tumor Granularity available across both 31-day reports for ICB and provider
• 62-day combined standard reports and previews to have split by referral types – GP referred, National screening and Consultant upgrade replacing the admitted/non-admitted and/or treatment modality splits
• preparation of the 'Downloads' section of the CWT system to accommodate new tumour granularities on the UI screens
• updating 'Extracts' to reflect new tumour granularities in an additional flavour of extracts alongside the existing ones
• making the release of the changes configured by a date, and not via a development toggle
• CRS Report Outcomes Update for TWW toggle
• index changes for performance tuning of the download of individual patient record query

Before these releases, the following changes were also made to the Cancer Waiting Times system:

CWT 2.2.39 – 12 October 2023 - ES Decommission, CRS Changes (Toggled Off) , SRI Api Audit Enabling – this change removed redundant system technology called EventStore and introduced some CRS prepratory changes above for v2.2.40, but behind a system toggle and not visible to users.

CWT 2.2.38 – 28 September 2023 - CWT Certificate Update – the system’s SSL certificates were updated.

CWT 2.2.37- 5 September 2023 – this release was a system uopdate in response to a major incident where reports were displaying blank data.

CWT 2.2.36 – 10 August 2023 – this release was in response to a live issue whereby a bug was affecting the compliance calculations for:

• All Cancer 2WW Standard Applies (exclude breast)
• 62-day Classic
• 28 Day Faster Diagnosis - Two Week Wait Urgent 2WW GP Referral

The below changes are scheduled for release at 5pm on Tuesday 8 August 2023. There may be a short period of system downtime while the changes are applied.

Fix for a discrepancy in the number of records between the Preview in-app and the downloaded file

Users were seeing a discrepancy between the number of records in the Preview against when downloaded. This is due to an earlier fix on the Preview logic in v2.2.11 to remove duplicate records that had not been applied to the downloaded file from Preview. A fix has been put in place to resolve this issue and Previews and the downloaded files now match in record count.

Multiple small updates have been made to the interface in response to recent accessibility compliance testing results.

These updates include:

• updated error messages and use of colours, to be in line with Government Digital Service Standards
• improved keyboard navigation through the system, including use of the tab key and arrows to navigate

Previously the system limited downloads to either monthly or quarterly date ranges. If users required a larger date range than this, multiple files are required to be downloaded and combined, creating a cumbersome overhead to the work.

In addition, if a smaller or more precise range was required, this resulted in additional manipulation.

To reduce this burden, the download page now has options to pick a custom date range, in addition to the previous options to select by month or by quarter:

The downloads page also now removes any duplicate records within the generated files. Though these were rare to occur, multiple month downloads (such as the quarterly and now the date range options), in addition to selecting multiple Events to filter by carried a risk of including duplicates of the same record.

These duplicates are now removed at the point of generation, removing the risk of double- counting in any further analysis.

Additional updates

Any dropdown box to select an organisation within the Cancer Waiting Times system has been updated to be in a uniform standard, reducing risk of confusion while using the system. The format is now [organisation code] followed by [organisation name], separated by a ‘-‘ delimiter, for example: RLT - Leeds Teaching Hospital.

The extract page now displays a more suitable error message if there is no extract selected when opting to download an extract.

Removal of  'IPT data is under development…’ message displayed on Audit page for IPT.

Fields detailing the IPT transfer have been added to the preview reports. This should result in a significant reduction in time and burden for users to find the relevant information and avoid additional steps by presenting the IPT details in an easily accessible format. This includes avoiding the need to switch between screens and applications, and using processes that result in being timed out of the system and requiring logging in again. 

For users who have commissioner-level reporting enables (typically CCG and Cancer Alliance users), a new feature to consolidate exports has been enabled.

The first element that has been added is a select/delesect All Organisations button:

In addition, a ‘consolidate’ option will be provided:

This will provide the Commissioner-level users the selected Organisations compiled into one Excel file, rather than split into organisations by folders.

Additional updates

The limit on the number of records that can be submitted within one file has now increased from 8,500 to 10,000.

A responsibility assignment issue has been fixed, so the system will now correctly assign breach responsibility instead of 50/50, as the logic did not handle wait time adjustment correctly.

A missing IPT calculation for Consultant Upgrade records has been fixed, by adding a new cross reference validation rule (CR96). This rule will check that "Consultant Upgrade Date" must not be blank if "Organisation Site Identifier Of Provider Consultant Upgrade" is provided.

The following 62 day breast symptomatic reports accessible to Cancer Alliance users:

• 15.1 - 62-Day from Symptomatic Breast Referral (Tumour) Report 
• 15.2 - 62-Day from Symptomatic Breast Referral (Treatment Group) Report 
• 15.3 - 62-Day from Symptomatic Breast Referral (Treatment) Report

If you experience any issues with using the system or have any feedback on the changes, then please contact the National Service Desk at [email protected].

You can also use our Workspace on FutureNHS to start a conversation with any of your fellow Cancer Waiting Times system users.