NBOCA's move into the National Cancer Audit Collaborating Centre

How has the contracting of NBOCA changed in 2023?

NBOCA has moved into the National Cancer Audit Collaborating Centre (NATCAN) at the Clinical Effectiveness Unit of the Royal College of Surgeons of England (RCSEng).

NBOCA retains the same core team and now resides within NATCAN. NATCAN includes four established cancer audits and six newly commissioned cancer audits.

NBOCA will continue to focus on robust reporting of data for all patient with bowel cancer, earlier availability in reporting outcomes, and a major ongoing emphasis on implementation of quality improvement initiatives.

What is NATCAN?

The National Cancer Audit Collaborating Centre (NATCAN) is a new national centre of excellence which will shine a spotlight on the care and treatment of patients who are diagnosed with cancer in England and Wales. The Healthcare Quality Improvement Partnership (HQIP), on behalf of NHS England and the Welsh Government, has commissioned the development and establishment of NATCAN, which is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). It aims to:
• Provide regular and timely evidence to cancer services of where patterns of care in England and Wales vary
• Support NHS services to identify the reasons for the variation in care in order to guide quality improvement initiatives
• Stimulate improvements in cancer detection, treatment and outcomes including survival

When did NATCAN start and who funds it?

Work on setting up the new centre began on October 1 2022. NATCAN is funded by NHS England and the Welsh Government.

What is NATCAN doing differently?

• All audits within NATCAN will only use linked national routinely collected datasets for its core outputs. This will make the process of producing relevant and robust performance indicators more efficient.
• Rapid cancer registration data, that allow timely (three months following diagnosis) Quarterly reporting to providers, will be used alongside annual State of the Nation reports based on “gold-standard” cancer registration datasets (data available at least 18 months after diagnosis).
• Each audit in NATCAN will carry out a quality improvement initiative using the rapid cancer registration data at least once in the first three years. The aim is to “close the audit cycle”, following an approach commonly referred to as the “plan-do-study-act” method. This will be a first at national level for cancer audits.

How are patient data being collected in NATCAN?

In order to reduce burden on hospital staff, the audits in NATCAN, similar to the existing audits in prostate and lung cancer, do not ‘collect’ clinical data. The cancer audits utilise the nationally mandated flows of data from hospitals to the National Disease Registration Service (NDRS) in NHSE and the Wales Cancer Network in Public Health Wales. Each NATCAN publishes a minimum dataset [NBOCA Key COSD Data Items 2023/24], comprising relevant data items for each cancer site, which hospitals can check are being completed and submitted to NDRS or the Wales Cancer Network.

NBOCA still encourages clinicians to engage with coders and data administrators to ensure data accuracy, especially on staging information provided to NDRS and the Welsh Cancer Network.

Using this approach, NBOCA will receive clinical information for every patient diagnosed with bowel cancer in England and Wales. Data from Trust/Health Board data submissions are linked to selected items from national datasets to provide information on the diagnosis, management and treatment of all patients newly diagnosed with each cancer type. That includes patient and tumour characteristics, diagnostic tests and imaging, hospitals appointments and admissions, procedures, treatments, interventions and outcomes.

How can hospitals ensure that the data analysed by NBOCA in NATCAN is accurate?

For 2024 reporting onwards (patients diagnosed since April 2022), NBOCA will use cancer registry data which includes multiple data sources submitted by trusts, one of the main ones being the Cancer Outcomes and Services Dataset (COSD). The vast majority of NBOCA data items are COSD items – please refer to NBOCA Key COSD Data Items 2023/24. We therefore ask hospitals to check the data quality of these data items entered into COSD or the Wales Cancer Network, particularly staging data. CancerStats2 provides trust-level data completeness of key COSD items for hospitals in England.

NBOCA will also be using the rapid cancer registry dataset, much of which comes from COSD. It is important that hospitals regularly upload accurate COSD data to NDRS.

Trusts are encouraged to submit all data available on a monthly basis in-line with the COSD reporting timescales. It is expected that the majority of diagnosis and treatment data are submitted within six months of diagnosis. Once the full patient pathway is linked together, the data are provided to the NBOCA team to analyse. Further information about the COSD and reporting timescales can be found at the following link:


For queries regarding data submissions in England, the Data Liaison team within the NDRS has a wealth of knowledge on cancer pathways and processes within NHS Trusts. Contact details for the regional Data Liaison Managers can be found at the following link:

NDRS – Regional Data Liaison Managers