The Cancer Alliance Data, Evaluation and Analysis Service (CADEAS)

CADEAS is funded by the NHS National Cancer Programme, and is a collaboration between NHS England and NHS Improvement, and Public Health England.

 

 

Our purpose and work programmes

The aim of CADEAS is to support Cancer Alliances to take a data-driven, and evidence-based approach in:

  • Recovering Cancer services following the Covid-19 pandemic;
  • Meeting and sustaining operational performance; and
  • Transforming Cancer services to meet the ambitions in the Long Term Plan.

Our core offer to Cancer Alliances is to:

  • Provide access to timely and reliable data held nationally on operational performance and cancer activities, outputs and outcomes to track progress and to identify areas for action;
  • Provide products such as tools, models and analysis to give greater depth and insights into key priority areas;
  • Offer advice and guidance to support robust local evaluations; and
  • Synthesise emerging evidence and disseminate evaluation findings to understand what works and how.

Our work programme (2021/22) is developed in consultation with Cancer Alliances, the National Cancer Programme and the National Cancer Registration and Analysis Service (NCRAS) in PHE. See our previous work programmes: 2020/21 , 2019/20 and 2018/19.

 

We would like to thank patients and clinicians who provide the information that is collected by the NHS as part of patients' cancer care.  

 

Supporting the recovery of Cancer services from the Covid pandemic

COVID-19 Cancer Equity Data Pack: Urgent referral and first treatment activity

CADEAS and NCRAS have produced two equity data packs. These present the latest national and regional activity data on both the number of:

  • Urgent suspected Two-Week Wait referrals. 
  • First definitive treatments.

The data is further broken down by tumour type and patient factors: deprivation, age, sex and ethnicity. The figures present the working day adjusted proportion compared to pre-pandemic levels. A national summary of the data is included in each pack.

These data are being used to directly inform activity in the restoration and recovery of cancer services, including targeted messaging in the national Help Us Help You (HUHY) campaign to support people coming forward with symptoms indicative of cancer to their GP. The data and findings are also being shared with Cancer Alliances and regional teams to support the targeting of local campaign messages. These data will be monitored, updated and published monthly.

The COVID-19 Cancer Equity Data Packs will be published alongside the regular NHS Performance Statistics publications scheduled for the 2nd Thursday of each month. 

 

Link to data: COVID-19 Cancer Equity Data Pack: Urgent referral activity to June 2021

 

Link to data: COVID-19 Cancer Equity Data Pack: First treatment activity to June 2021

A correction has been applied to last month’s equity packs. PHE have now updated the ethnicity data based on the latest hospital data. This update resulted in a reduction in the percentage of patients allocated to the ‘unknown’ or ‘other’ ethnicity groups, and in turn influenced the size of the recovery gaps between ethnic groups. For example, in last month’s May 2021 data a 6 percentage point (pp) gap in urgent referrals between White British and Asian groups (111% and 105% respectively) in England was reported, whereas the updated May 2021 data now indicates an equivalent 3pp gap (White British 113% and Asian 110%).

 

Operational performance

Analysis of 62-day pathways using 2017-2018 Cancer Waiting Times data for colorectal, lung and prostate cancers

CADEAS have produced reports which aim to provide Cancer Alliances with analysis of pathways with a 62-day Cancer Waiting Times (CWT) record for colorectal, lung and prostate cancers. This will enable Cancer Alliances to support:

  • Implementation of the best practice times pathways. 
  • Meeting 62-day CWT operational standards.
  • The work is also aimed at helping Cancer Alliances understand where variations are occurring across Alliances, as well as understanding pathway variation between cancer types.

This National Report has been segmented by Cancer Alliance.

Cancer Alliance reports segmented by CCG are available below.  Click on 'show' below to see the full list of CCG data packs:

Cancer Alliance reports by CCG

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This Guidance Document has been provided to help interpreting the results.

 

System intelligence

Cancer Alliance, STP and CCG summary grid of key indicators

CADEAS publish summary indicator grids each month, containing cancer metrics by Cancer Alliance, Sustainability and Transformation Partnership (STP) and Clinical Commissioning Group (CCG).  By colour coding values based on comparisons with the national benchmark, expected values or operational standards, Alliances and their key stakeholders can identify areas of success and potential areas for improvement. Data in the grids should be considered alongside other sources of information for contextual and richer interpretation. This work was put on hold during the Covid period and will be restarted on a quarterly basis in 2021/22.

CADEAS Cancer Alliance summary indicator grids April 2020 (1.12MB)

CADEAS Cancer Alliance summary indicator grids March 2020 (1.1MB)

CADEAS Previous summary indicator grids

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Median Pathways

CADEAS have created the Median Pathways tool to report on the analysis of median pathway length for patients diagnosed with fifteen cancers (2013-2018). The tool aims to further Cancer Alliances’ understanding of variation in median days taken for different segments of the patient pathway from referral to first treatment, by socio-demographic factors, cancer stage, routes to diagnosis and geography, and to help enable Cancer Alliances to:

  • Investigate whether the variations are justified.
  • Discuss implementation of local strategies to reduce variation and address health inequalities.
  • Identify and share best practice for faster diagnosis and improving patient experience.  

Link to the Median Pathway tool here

 

 

Evaluation of key interventions

Evaluation is crucial for developing evidence and best practice that can be shared across all Cancer Alliances and with the National Cancer Programme to support evidence-based decision making. The CADEAS Evaluation team is supporting the evaluations of a number of key projects within the Cancer Programme:

 

Rapid Diagnostic Centres

Rapid Diagnostic Centres are an ambitious five-year programme, started in 2019, to transform Cancer Diagnostic Pathways. RDCs are a flagship programme of NHS England & Improvement and support the broader strategy outlined in the Long Term Plan to deliver faster and earlier cancer diagnosis (75% of all cancers diagnosed at stage 1 or 2) and improved patient experience. In time RDCs will provide:

  • A coordinated access to a diagnostic pathway for all patients with symptoms that could indicate cancer.
  • A personalised, accurate and rapid diagnosis of symptoms by integrating existing diagnostic provision and networked clinical expertise.

RDCs are being created for patients with non-specific symptoms (NSS) of cancer, and for cancer pathways that already exist where RDC principles will be applied. The new non-specific symptom pathways are for patients who display symptoms that could indicate cancer that don’t align to current specific symptom diagnostic pathways, such as unexplained weight loss, fatigue or vague abdominal pain. These new pathways compliment current cancer diagnostic pathways as well as providing components that can be applied to existing pathways where improvements are needed.

Evaluation of the RDC programme:

NHS England & Improvement have commissioned an independent partner (Ipsos MORI in partnership with Midlands and Lancashire Commissioning Strategy Unit and York Health Economic Consortium) to comprehensively evaluate the national RDC programme. The aim of the evaluation is to carry out a full process, impact and economic evaluation in order to:

  • Understand the optimal approach to delivering national pathways for specified cohorts of patients.
  • Understand what works, in what context(s).
  • Understand what impacts can be achieved both in terms of patient outcomes and experience as well as impacts on the health and care system.

This evaluation will cover the full lifetime of the programme (due to end in March 2024) and aims to provide rapid ongoing feedback to inform the delivery of RDCs and to inform the strategic direction of RDCs in the last five years of the Long Term Plan.

Further information can be found here

 

Targeted Lung Health Check

The Targeted Lung Health Check (TLHC) programme is a key part of the response to ambitions set out in the Long-term Plan to improve early diagnosis and survival for those diagnosed with cancer.  Promising evidence about the efficacy of targeted lung screening has been produced in trials and pilot projects around England (which themselves build on the international evidence base). 

The TLHC evaluation aims to test these early findings at a much wider scale, and in numerous different locations and contexts, in order to inform potential wider scaling.  There are ten original projects sites and 7 additional onboarded project sites across England taking part. Ipsos MORI, in partnership with the Strategy Unit from the Midlands and Lancashire Commissioning Support Unit, have were appointed in 2020 to conduct the full process, impact and economic evaluation.

The CADEAS evaluation team will:

  • Support the Cancer Programme Team with managing this contract, ensuring the effective delivery of the evaluation for this programme.
  • Review and sign off all draft and final reports written by the external Evaluator.
  • Support the quality assurance processes of the Monthly Management Information collated from sites.
  • Monitor progress against agreed milestones and help troubleshoot arising issues.
  • Provide oversight of this work.

More information about TLHCs can be found here

 

Colon Capsule Endoscopy

NHS England and NHS Improvement’s Cancer Programme have allocated funding to support Cancer Alliances to establish pilot CCE clinics to test and develop the evidence base for this technology, and to support restoration of endoscopy services during the COVID-19 pandemic. The hospitals participating in this pilot will collect a minimum dataset to inform the CCE service evaluation delivered by the National Cancer Programme Team (NCPT).

NHS England and NHS Improvement has appointed York Teaching Hospital NHS Foundation Trust (YTHNFT) to lead a clinical evaluation of this service, whilst CADEAS will lead a service evaluation, to provide context and allow staff views to be considered.  An assessment of patient experience will also be undertaken.

The CADEAS evaluation team will:

  • Support the management of the clinical evaluation.
  • Design and deliver site interviews with staff.
  • Manage the procurement of an external evaluator to assess patient experience.

 

Cytosponge

The NHS England and NHS Improvement’s Cancer Programme (NHS Cancer Programme) has prioritised the implementation of Cytosponge within the secondary care diagnostic pathway for patients with low-risk (but not no-risk) reflux symptoms from the endoscopy waiting list. This implementation will form a key part of the recovery plan to restore services disrupted as a result of Covid-19 and contribute to the NHS Long Term Plan ambitions for cancer. The programme is taking a two-phased approach to implementation across 19 Cancer Alliances. Five Cancer Alliances will be trained as part of phase 1 from March 2021 to April 2021. The remaining 14 Cancer Alliances will start training from April 2021 to June 2021. Once training is completed, sites will commence delivery of Cytosponge until March 2022.

The NHS Cancer Programme will appoint an external Evaluator by June 2021 to conduct a service evaluation to generate evidence to understand the impact of Cytosponge on endoscopy service delivery and patient outcomes in secondary care. The full evaluation will include a comprehensive assessment of the implementation processes, patient experience, health and service outcomes, and the economic value of the programme.

The CADEAS evaluation team will:

  • Lead preliminary evaluation scoping and development of the Evaluation Data Set and reporting requirements.
  • Manage the procurement of an external Evaluator to conduct the service evaluation.
  • Review and sign-off all draft and final reports written by the external Evaluator.
  • Monitor progress against agreed milestones and help troubleshoot arising issues.
  • Provide oversight of work. 

 

Local evaluation resources 2020/21

As set out in the 2019/20 NHS Planning Guidance, all Cancer Alliances will be required to undertake local evaluations in prescribed areas, specifically;

  • approaches to increase screening uptake.
  • each additional project where the intervention is novel, and the evidence is less established e.g. personalised (stratified) follow up care beyond breast, colorectal, and prostate pathways.

Evaluation is crucial for developing evidence and best practice that can be shared across all Cancer Alliances and with the National Cancer Programme to support evidence-based decision making, thus occupying a central role in the policy cycle. 

To support Cancer Alliances in carrying out local evaluations in the prescribed areas, as reflected above, CADEAS has developed a suite of evaluation resources. The resources listed below are designed to serve as a guide and support Cancer Alliances throughout the evaluation process.

  1. Evaluation how to guide: practical steps to undertaking evaluation.
  2. Evaluation framework: evaluation questions, data collection methods and sources.
  3. Introduction to approaches to evaluation and data collection reference guide.
  4. Blank logic model and evaluation templates.
  5. Commissioning an evaluation reference guide.

These resources are intended to complement each other and should be read together to guide the establishment and delivery of local evaluation.

 

Contact

We welcome contact from Cancer Alliances at england.CADEAS at nhs dot net link

Local Intelligence

Local Cancer Intelligence

CADEAS

 

Region specific work

East of England

London

 NCRAS - TCST Partnership