Ajay Aggarwal, Clinical Director of the National Cancer Audit Collaborating Centre (NATCAN) and Consultant Clinical Oncologist at Guy’s and St Thomas’ NHS Foundation Trust, shared a post on LinkedIn:
“After serving as Clinical Director of the NHS Cancer Audit Programme (National Cancer Audit Collaborating Centre (NATCAN)) – the largest national cancer quality assurance and improvement programme of its kind internationally – I’m stepping down, and I want to reflect on what we’ve achieved.
During my term, we fully integrated six new cancer audits (we have 10 in total), introduced quarterly reporting, and launched dashboards enabling hospital-level and regional analysis across a range of indicators and cancers. We also embedded patient and public involvement within every audit, alongside a dedicated cross-cutting patient group across NATCAN as a whole.
What I’m most proud of is the shift in culture around quality improvement in cancer care. Oncology remains a speciality rightly focused on developing new treatments and pathways – but our audits have exposed substantial variation in quality across the NHS that is amenable to improvement at scale. Too many people still don’t receive the right treatment, at the right time, in the right place, to the highest standard. Crucially, we’ve shown these gaps can be closed at scale.
To drive this, we introduced quality improvement interventions for each audit – the first programme of this scale anywhere – designed to feed data back more effectively and change behaviour on the ground. Our partnerships with Macmillan Cancer Support, THIS Institute (The Healthcare Improvement Studies Institute), University of Leeds and professional societies such as The Royal College of Radiologists, are supporting the development of further QI programmes to accelerate impact across the NHS.
Much remains to be done. We still focus too heavily on the reputation of individual hospitals, which obscures the high performance across the NHS that we could be learning from. We need clinical leadership at every level to bring that disconnect into sharper focus – alongside investment to ensure QI becomes a high-value priority rather than a tick-box exercise. Done well, it can help our system deliver a more equitable, sustainable, and higher-quality service by eradicating variation in care and raising the bar for everyone.
I’m delighted to hand over to Tom Roques, who will no doubt deliver continued growth and impact of the audit programme. He inherits a professional, committed, and hugely talented team at NATCAN- data scientists, methodologists, project managers, clinical fellows, clinical audit leads, as well as patient groups – who represent a prized resource in the NHS. I can’t thank them enough for their support during my tenure.
In the future I hope to see the audits expand to additional cancers, and a continued commitment to the most innovative QI approaches – translatable across the NHS and beyond, to deliver meaningful impact to improving the outcomes and experience of care for patients.
My sincere thanks to everyone who supported my work at NATCAN.”
Title: The National Cancer Audit Collaborating Centre (NATCAN): improving the quality of National Health Service cancer care in England and Wales
Authors: Ajay Aggarwal, David Cromwell, Julie Nossiter, Jan van der Meulen, Kate Walker
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