Insights & Quality Improvement

The NCDA has a strong quality improvement (QI) component and encourages practices to use the audit results to inform targeted QI activity. National cycles of the NCDA provide all participating GPs with a tailored feedback report on their practice’s data to support QI planning.

The report:

• Highlights examples of good practice
• Identifies potential areas for further review
• Helps decide where to focus quality improvement activity
• Identifies variations at practice level
• Provides comparative information, as well as criteria and standards for benchmarking
• Suggests next steps and signposts to support and relevant QI resources

Many GPs undertake quality improvement activities based on insights from their NCDA report, as well as learning gained while auditing individual cases. Most often, these activities focus on improving referral behaviours, safety netting and cancer screening uptake.  

In England, the NCDA can also support PCN-level work on early cancer diagnosis.

The most recent findings available from the audit, looking at new cancer diagnoses in 2014, showed:

• Co-morbidity burden is high among patients diagnosed with cancer
• The majority of patients first present at the GP surgery (or have a home visit)
• Many patients have primary care-led investigations, such as blood tests and imaging, before they are referred
• Many patients are still diagnosed through routes other than an urgent suspected cancer referral / two week wait pathway
• Patients with vague symptoms are more likely to be diagnosed as an emergency and with a late stage cancer
• Use and recording of safety netting varies by practice and by cancer type
• For more than one in five patients, GPs in the audit considered there to have been an avoidable delay in the patient receiving their diagnosis
• Patients with non-specific but concerning symptoms are more likely to experience an avoidable delay

National findings from the previous cycle of NCDA have been presented in academic papers (see publications in the accordion below and at conferences. These will act as a baseline to monitor implementation and impact of NICE NG12 cancer referral guidelines when analysed alongside findings from the most recent cycle of NCDA, which looked at cancers diagnosed in 2018.