National Cancer Audit Collaborating Centre

The contract will initially be delivered for NHS-funded care in England and Wales for a period of 3 years, at a maximum total budget of up to £11,145,600 GBP including VAT,

£9,288,000 GBP excluding VAT. Bids exceeding this limit will be rejected. There is potential to extend the contract for up to two additional years at a potential value of

£3,715,200 GBP per year including VAT, £3,096,000 GBP per year excluding VAT.

All pricing submissions must be in regard to this 'core' value, and not inclusive of any extension costs or aspirational intent costs, i.e. Please only submit a cost schedule up to the maximum core value of £11,145,600 GBP including VAT, £9,288,000 GBP excluding VAT.

The maximum budget ‘core’ value excludes the potential two year extension and aspirational intent as described in section 14.4 of Annex A - Service Specification.

Please note, there is no commitment by the Authority at this stage to include any aspirational intent measures. Taking the total of this aspirational intent into account, as well as the possibility that a contract extension may be offered for an additional two years, the potential ceiling value is £28,029,455 GBP including VAT, £23,357,879 GBP excluding VAT

There is also a potential that the contract price will be subject to discretionary inflationary uplifts.

Cancer is a leading cause of mortality, but it is also a leading cause of avoidable mortality in England and Wales. Cancer mortality rates in the UK are much higher than in other, comparable countries and vary greatly between different areas of the country. As part of the effort to improve treatment and outcomes and reduce variation, the National Cancer Audit Collaborating Centre (NATCAN) was established and funded by NHS England and the Welsh Government in 2022. The aim was to develop a national centre of expertise which would host the NHS national cancer audits. The audits provide regular and timely evidence to NHS services about where and how patterns of care vary between patients and between hospitals and to support local quality improvement.

The Centre hosts ten audits, some of which are very well established and others which have been added to the portfolio since NATCAN was established. The audits are for primary breast cancer, metastatic breast cancer, bowel cancer, kidney cancer, lung cancer, non-Hodgkin lymphoma, oesophago-gastric cancer, ovarian cancer, pancreatic cancer and prostate cancer.

The funders have decided to recommission the national centre following the initial contract for an additional contract period. The anticipated continued benefits of a national centre for cancer audit delivery include:

•Consistency and standardisation across audits

•Flexibility to develop and share specialised resources between audit topics (such as statisticians and data analysts, and patient and public involvement expertise)

•Enhanced subcontracting power across topics (such as for data visualisation platforms)

•Consistency and alignment of communications strategies

Further details of the current work can be found at www.natcan.org.uk ↗.

The role of national clinical audit is to stimulate healthcare quality 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. Outcomes are benchmarked against available national guidance and standards e.g. quality standards from the National Institute for Health and Care Excellence (NICE), and those from other established professional and patient sources. Successful national audits are those where the individuals who are engaging with and using the audit results are also in a position to improve the system, and where there is a shared understanding of what good care looks like.

National clinical audits are expected to:

a.Develop a robust, high-quality audit designed around key quality metrics likely to best support local and national healthcare quality improvement

b.Detect, describe and help reduce unwarranted clinical variation by systematically benchmarking performance, identifying outliers, and supporting services to understand variation in outcomes, processes and experience

c.Achieve, articulate and maintain close alignment with relevant NICE national guidance and quality standards throughout the audit, as appropriate

d.Enable healthcare quality improvement through the provision of timely, high-quality data that compares providers of healthcare, and comprises an integrated mixture of named Trust or Health Board, regional Cancer Alliance, Integrated Care System (ICS), commissioner, multidisciplinary team (MDT), possibly consultant or clinical team level and other levels of reporting

e.Engage patients, carers and the public in a meaningful way, achieving a strong patient voice which informs and contributes to the design, functioning, outputs and direction of the audit

f.Consider the value and feasibility of linking data at an individual patient level to other relevant national datasets either from the outset or in the future, and plan for these linkages from the inception of the contract

g.Ensure robust methodological and statistical input at all stages of the audit

h.Identify from the outset the full range of audiences for the reports and other audit outputs, and plan and tailor them accordingly

i.Provide audit results in a timely, accessible and meaningful manner to support healthcare quality improvement, minimising the reporting time lag and providing continual access to data at relevant reporting levels

j.Utilise strong and effective project and programme management to deliver audit outputs on time and within budget

k.Develop and maintain strong engagement with local clinicians, networks, commissioners, patients and their families and carers, and charity and community support groups to drive improvements in services

At the time of writing the specification, requirements include the following (please also refer to the potential future aspirational intent section listed in section 14.4 of Annex A – Service Specification):

1.Delivery of the ten audits already underway with a focus on treatment variation. The funder and commissioner may decide to stand down current topics and add different topics and / or vary the number of reporting metrics to accommodate the inclusion of different or additional/revised topics.

2.Conduct a review of all reported NATCAN metrics in order to identify clearly the following:

•The clinical and operational relevance of each metric, with a focus on the audits’ core objectives and on enhancing system impact and identifying areas of unwarranted treatment variation (this includes identifying areas of new unwarranted variation)

•How to avoid duplication with metrics reported by NHSE/DHSC and other bodies, cancer waiting times and cancer patient survey data*

•The optimal source of data for each metric

•The optimal frequency of publication

•How to reduce and minimise the reporting time lag for each metric

•For England: How to engage with and link to relevant actions identified in the National Cancer Plan for England

3.Periodically monitor longitudinal data trajectories to determine whether a metric remains relevant or should be stood down.

4.Regularly review the source of data for each metric, striking a clinically and operationally relevant balance between publishing timely data, and data that is more complete and validated.

5.Work collaboratively with NHS organisations and teams, e.g. cancer alliances, DHSC/NHSE teams, the National Disease Registration Service (NDRS), Welsh Government, and health boards. This will include consulting on metric selection, data sources and frequency of publication of metric results as above.

6.Implement technical solutions to support system leaders and local healthcare providers to be able to identify and visualise outputs from the various NATCAN audits in one display, thereby enabling understanding of themes and priority issues across the NATCAN audits.

7.Maximise consistency and harmonisation across the NATCAN portfolio of topics, e.g. consistency of output focus, remit and formats, including the scopes, dashboards and state of the nation reports to make them easier for users to use and cross-refer.

8.Revisit the Scoping Document for each audit, updating to ensure relevance to new standards and guidance and that they add maximum value, and use these documents to proactively monitor that each audit remains focused on its core objectives.

*Unless the funders and commissioner explicitly request and sign off any such metrics.

Further details of the existing audit can be found at: www.natcan.org.uk ↗