Median pathways 2013-2018

The Cancer Alliance Data, Evidence and Analysis Service (CADEAS) have calculated the median time taken, in days, for patients to be seen for their first treatment following a referral, stratified by four intervals of the patient pathway.

These are:

• Referral to first seen in secondary care
• First seen in secondary care to diagnosis
• Diagnosis to first multidisciplinary team (MDT) meeting
• MDT meeting to treatment start date

This analysis is broken down by socio-demographic factors, stage at diagnosis, route to diagnosis, and geography, for patients diagnosed with one of fifteen cancers in the diagnosis years 2013 to 2018.

Acknowledgements

This work is produced by CADEAS, a partnership between NHS England and NHS Improvement & Public Health England. It builds on work previously carried out by the NCRAS-TCST (National Cancer Registration and Analysis Service - Transforming Cancer Services Team for London) Partnership.

Data for this project is based on patient-level information collected by the NHS, as part of the care and support of cancer patients. The data is collated, maintained and quality assured by the National Cancer Registration and Analysis Service, which is part of Public Health England (PHE).

The Cancer Alliance Data, Evidence and Analysis Service (CADEAS) are to provide Cancer Alliances with in-depth analysis of the median time taken for different intervals of the patient pathway (referral, first seen in secondary care, diagnosis, first multi disciplinary team (MDT) meeting and treatment start).

What does it tell a Cancer Alliance?

The analysis informs Cancer Alliances of variation in time from referral to first treatment by socio-demographic factors, routes to diagnosis and geography for patients diagnosed with one of 15 cancers (2013-2018). Cancer Alliances are provided with pathway data for England, all 21 Cancer Alliances, and for their respective CCGs.

How should a Cancer Alliance use the data?

Cancer Alliances can use the data to identify variation, investigate differences as appropriate and develop local strategies to address health inequalities. Cancer Alliances can also use the analysis to identify best practice that can be shared for faster diagnosis and to improve patient experience. Analysis from this project should be considered in conjunction with other related analyses including:

• Secondary Care Diagnostic Interval
• Routes To Diagnosis
• Provider by Tumour Dashboard
• 62-day Cancer Waiting Times Data - Pathway length reports

Link to strategic priorities in cancer programme

This work supports the strategic priorities outlined in the NHS Long Term Plan (3.51-3.65) of faster diagnosis and reducing health inequalities.

Related work

This is one of two strategic projects CADEAS has undertaken on pathway lengths. The first project 'Analysis of 62-day pathways using 2017/2018 Cancer Waiting Times data for colorectal, lung and prostate cancers' was published in December 2018. Both projects look at the time taken from referral to first treatment for those diagnosed with colorectal, lung and prostate cancers. The first project used the Cancer Waiting Times data set only. This project covers all incidence of cancer and provides granular demographic data by linking the Cancer Waiting Times data set to the Cancer Registry. The data are therefore more comprehensive but less timely and includes cases diagnosed up to 31 Dec 2018.

This website has been split up into three sections:

1. Overview - Provides a high-level summary of the variation in the median time taken for patients to be seen for their first treatment following a referral.
2. Demographic Factors - Provides analysis on the variation in the median time taken for patients to be seen for their first treatment following a referral, broken down by socio-demographic factors, cancer stage and routes to diagnosis, at Cancer Alliance level.
3. Geography - Provides analysis on the variation in the median time taken for patients to be seen for their first treatment following a referral, broken down by Cancer Alliance, STP and CCG.

The Overview tool provides a high-level summary of the median time taken for different intervals of the patient pathway (referral, first seen in secondary care, diagnosis, first multidisciplinary team (MDT) meeting and treatment start). Breakdowns in this section are available by cancer type, Cancer Alliance and diagnosis year. This tool comprises of the following tabs:

Data Completeness

This tab provides information on the total number of patients that form a selected cohort, the completeness in the data for each defined point in time in the patient pathway, and how these volumes have changed over time. The variables for which data completeness has been carried out for are:

* Diagnosis date - The registry diagnosis date is based on European Network of Cancer Registries rules and is derived from the diagnosis date from the following events in order of prioritisation: first histological/ cytological confirmation of the malignancy, the first admission to hospital because of the malignancy, and when a patient is evaluated in outpatient clinic.

Median Days by Cancer Type

The Median Days by Cancer Type tab displays a breakdown of all cancer types as defined in this cohort for a selected Cancer Alliance, detailing the absolute median days taken from referral to treatment for all patients diagnosed in a selected year.

Median Days by Cancer Alliance

The Median Days by Cancer Alliance tab displays a breakdown of all Cancer Alliances for a selected cancer type, detailing the median days taken from referral to treatment for all patients diagnosed in a selected year

Median Days Trend

The Median Days Trend tab displays an overview for a selected Cancer Alliance and cancer type, detailing the median days taken from referral to treatment for all patients diagnosed from 2013 to 2018.

Summary Data

The Summary Data tab displays the data found in the charts in a tabulated format for a selected Cancer Alliance

Menu Selection

There are three dropdown menus in the Overview tool:

Cancer Type

Use this menu to view the charts and data for the cancer type of interest. The cancers that can be selected are as below. Please note, this menu is non-functional in the Median Days by Cancer Type tab as this tab displays the charts for all cancers for a selected Cancer Alliance and diagnosis year.

Cancer Alliance

Use this menu to view the charts and data for the Cancer Alliance of interest. The Cancer Alliances are as below. Please note, this menu is non-functional in the Median Days by Cancer Alliance tab as this tab displays the charts for all Cancer Alliances for a selected cancer and diagnosis year.

Diagnosis Year

Use this menu to view the charts and data for the diagnosis year of interest (2013-2018). Please note, this menu is non-functional in the Median Days Trend tab as this tab displays the charts for all diagnosis years for a selected cancer and Cancer Alliance.

[email protected] - This email address can be used for general enquiries to NDRS NCRAS, please do not include sensitive or patient identifiable information.