National Lung Cancer Audit (NLCA) reports consistently demonstrate variation in diagnostic pathways, treatment rates and outcomes that are not wholly explained by case-mix. One possible explanation is different access to lung cancer diagnostics, treatment options and specialists. This hypothesis is supported by previous reports, which have demonstrated that patients with lung cancer are 50% more likely to undergo surgical treatment if they are first seen in a thoracic surgical centre, and twice as likely to receive active anticancer treatment if they are seen by a lung cancer clinical nurse specialist (CNS). Little is known about provision of lung cancer services across the UK. To address this, we performed the first ever national lung cancer organisational audit in 2014.