National Lung Cancer Audit


NLCA Annual Report Summary

Posted by Neal Navani on Thursday 13 August, 2020


Neal Navani, NLCA senior clinical lead, discusses the newly published annual report data, and looks to the future of the audit.

It has been an immensely challenging year for our healthcare system. The National Lung Cancer Audit (NLCA) team recognise the outstanding work carried out by lung cancer multidisciplinary team (MDT) members, many of who were deployed to the frontline of the response to COVID-19.

As recovery planning from the pandemic continues and COVID-19 becomes an endemic problem, we hope that lung cancer teams will be able to refocus on quality improvement measures for their lung cancer patients.

The NLCA are pleased to provide the publication of two important reports on patients with lung cancer. The first is the annual report on patients diagnosed in 2018. We are also providing the 2019 spotlight report on patients with stage I–IIIa disease and good performance status who did not receive treatment with curative intent. In addition to these reports, we provide a bespoke dashboard for each individual trust, highlighting their results against the national average, as well as showing the trends in performance over the past 5 years. We have also analysed data by clinical commissioning group and hope these data will be utilised by commissioners to support service developments.

As previously, the NLCA report provides 13 key recommendations for improving outcomes for lung cancer patients, but, for the first time, we have also provided a quality improvement toolkit. This is designed to support all organisations in improving services for lung cancer patients and not just those trusts which have been identified as negative outliers for key measures.

Neal Navani, NLCA senior clinical lead

The annual report collates information on 39,754 patients with lung cancer diagnosed in 2018 from trusts in England and Wales. There are several areas of good news:

  1. Early-stage diagnoses have increased to 29% from 26% for 2016 patients.
  2. Late-stage diagnoses have reduced to 49% from 53% for 2016 patients.
  3. 1-year survival in stage III patients has increased to 63% from 45% in 2016 for 2015 patients.

However, the 1-year survival for patients with stage IV disease remains low at 17% and this is unchanged from patients diagnosed in 2015.

While resection rates continue to rise slowly overall, 60 organisations failed to meet the audit standard of 17% (compared with 52 last year). Nine organisations have been notified of their negative outlier status for this metric.

As previously, the NLCA report provides 13 key recommendations for improving outcomes for lung cancer patients, but, for the first time, we have also provided a quality improvement toolkit. This is designed to support all organisations in improving services for lung cancer patients and not just those trusts which have been identified as negative outliers for key measures. This year’s annual report also features examples of quality improvement from four trusts: East Kent Hospitals University NHS Foundation Trust, Portsmouth Hospitals NHS Trust, Northampton General Hospital NHS Trust and Mid Essex Hospital Services NHS Trust. We are very grateful to those trusts for agreeing to share their quality improvement journey and would encourage you to read these when possible.

As many people may know, it has been a period of uncertainty for the NLCA. However, I am pleased to say that a solution has been found and the NLCA has been funded again up until October 2021. We will keep you updated with any further developments. We hope that this will spur MDTs on to continue to provide complete and validated datasets so that the NLCA can publish high-quality data to drive quality improvement.

Finally, I also want to take this opportunity to highlight the immense contribution that Dr Paul Beckett has provided to all aspects of the NLCA. Paul has recently stepped down from having a formal role at the NLCA and will be greatly missed, not just for his IT skills in setting up the NLCA website and dashboards but also his knowledge of quality improvement methods and vision to translate the data into clinically meaningful change in practice. He has been instrumental in taking the NLCA forward for over 10 years and I have personally learnt a lot from working with him. Paul leaves the NLCA in a strong position and with important developments in lung cancer care such as early diagnosis initiatives and measuring the impact of COVID-19, there is an opportunity for the NLCA to continue to be a driving force for improving lung cancer outcomes.

Dr Neal Navani, NLCA senior clinical lead

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