Frequently asked questions for Professionals

What is the National Lung Cancer Audit (NLCA)?

This is a national clinical audit assessing the quality of services and care provided to individuals with lung cancer in England and Wales. The National Lung Cancer Audit collects clinical information about the treatment of all patients newly diagnosed with lung cancer in England and Wales and information about their outcomes.

The NLCA determines whether the care received by patients is consistent with current recommended practise, such as those outlined in the National Institute for Health and Care Excellence (NICE) Guidelines and Quality Standards as well as to provide information to support healthcare providers, commissioners and regulators in helping improve care for patients.

The audit began collecting data nationally in 2005, and since then has become as exemplar of national cancer audit. The audit was previously run by the Royal College of Physicians. From 1 February 2022, the NLCA will be delivered by the Royal College of Surgeons of England.

Who is running the NLCA?

The NLCA is run by the Clinical Effectiveness Unit (CEU) of The Royal College of Surgeons of England (RCSeng). The audit is also delivered in partnership with the Society for Cardiothoracic Surgery, the Roy Castle Lung Cancer Foundation representing lung cancer patients and their carers, the Wales Cancer Network, the Lung Cancer Nursing UK and the British Thoracic Oncology Group. We are commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme. The day to day running of the NLCA is based at the RCSeng and is managed by a project team including clinicians, audit experts and cancer information specialists.

Which patients are included in the NLCA?

All patients with an ICD-10 diagnostic codes of C34-39 (lung cancer). The following patients are excluded: patients identified with lung cancer through death certificate only, patients with non-lung cancer-related pathology codes and patients who cannot be assigned a trust of diagnosis.

How are patient data being collected?

The NLCA’s data collection partner in England is the National Cancer Registration and Analysis Service (NCRAS), which collects patient-level data from all NHS acute providers and from a range of national data-feeds. This includes the Cancer Outcomes and Services Dataset (COSD), which specifies the data items to be submitted routinely by service providers via MDT electronic data collection systems to the National Cancer Data Repository (NCDR) on a monthly basis. Clinical sign-off of data submitted to NCRAS is not currently mandated in England.

The Wales Cancer Network (WCN), Public Health Wales is the NLCA’s data collection partner in Wales however the data collection process in Wales differs from England. The NLCA dataset is captured through a national system, Cancer Information System for Wales (CaNISC), after identification by hospital cancer services and uploaded via electronic MDT data collection systems. Prior to submission of NLCA data to the WCN each patient record is validated, frequently by an MDT coordinator, and signed off by a designated clinician. Patient records are signed off when all key data items have been completed.

Who can take part in the audit?

All NHS Trusts in England and Health Boards in Wales that provide lung cancer services.

Does my hospital have to participate in the NLCA?

Yes, all NHS healthcare providers are expected to participate in relevant HQIP-funded projects within the National Clinical Audit and Patient Outcomes Programme. The NLCA is one of these projects.

Details of the statutory and mandatory requirements for clinical audit are available on the HQIP website .

Is the NLCA included in the reporting for annual Quality Accounts?

Yes, the NLCA is included in the Quality Accounts lists for 21/22 and 22/23

I have a question that is not answered in the FAQs

For all queries related to the NLCA, please contact us.