Quality Improvement

What is Quality Improvement?

The clue is in the name! Quality improvement means using a variety of tools and methods in a systematic way, in order to improve the quality of care for patients on a constant basis, and create better outcomes.

Kate Walker, Senior Methodologist for NATCAN

What role do national cancer audits play?

A priority for each audit in NATCAN is the development of explicit quality improvement (QI) goals. The aim is to improve the results of all forms of cancer care, as well as the experience that patients have during diagnosis and treatment. The QI goals are developed in collaboration with a wide range of stakeholders including professional bodies, patient charities and patients themselves.

Where available, national evidence-based standards of care, such as those published by the National Institute of Clinical Excellence (NICE), underpin the improvement goals of each cancer audit. NATCAN and the audit teams review clinical performance against these goals and shine a light on areas where improvements are needed.

What are the quality improvement plans for the audits?

The Quality Improvement (QI) Plans published in September 2024 describe the approach taken across the NATCAN cancer audits to develop the key quality improvement goals and performance indicators, aiming for these to be measurable, actionable and improvable. In addition, the QI plans set out the improvement methods and activities that will support implementation of the plans, including strategies for reporting and disseminating results, in addition to describing the approaches to evaluation.

The QI Plans were developed in consultation with key stakeholders, including people with lived experience of cancer, and define ten performance indicators, and how they map to key quality improvement goals, national guidelines, and standards. These performance indicators will be used by the audits to monitor progress towards its improvement goals and to provide a better understanding of the determinants of variation in the treatment of people with cancer and the outcomes they experience.

The Quality Improvement Plans for the audits can be found below:

‘New’ audits:
• National Kidney cancer Audit (NKCA)
• National Audit of Metastatic Breast Cancer (NAoMe)
• National Ovarian Cancer Audit (NOCA)
• National Non-Hodgkin Lymphoma Cancer Audit (NNHLA)
• National Pancreatic Cancer Audit (NPaCA)
• National Audit of Primary Breast Cancer (NAoPri)

‘Established’ audits:
• National Bowel Cancer Audit
• National Oesophago-Gastric Cancer Audit
• National Prostate Cancer Audit
• National Lung Cancer Audit

NB: The QI goals for the NLCA were published in January 2025.

Summary of the NATCAN QI goals and performance indicators (605kB pdf)

How can it help?

Results will be reported back frequently, and as soon after diagnosis as possible, alongside tools and methods which guide the way we evaluate cancer care. That means changes to cancer services, where needed, can be made as quickly and effectively as possible. In addition, the impact of these changes can be measured, and the lessons learnt can be shared, to help reduce costs.

The objective is that we will always be building and refining the way we do things, in order to improve them. There is no resting on our laurels. It involves the continuous testing and measuring of the way care is delivered, and ensuring that frontline teams of doctors and nurses are empowered to work effectively.

David Cromwell, Director of the CEU

When this is done in a systematic way, we can make the best use of stretched resources and reduce the chances of mistakes being made. It adds up to better care for patients, and better treatment outcomes.

Links to organisations providing more detailed information on Quality Improvement:

Quality Improvement Methods and Tools

Links to useful Quality Improvement methods and tools including templates

National Quality Improvement programmes

National programmes working to improve the quality of care and use the findings from the NATCAN audits to underpin their work