# Raise the share of UK patients who receive any active treatment, and publish it by trust

Source: https://onco.cc/ideas/idea-pdac-uk-active-treatment-rate-audit-and-target/  
OnCo record `idea-pdac-uk-active-treatment-rate-audit-and-target` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In England and Wales a national audit now reports each year what share of people diagnosed with pancreatic cancer receive any treatment aimed at the cancer, how many are discussed by a specialist team and how many see a specialist nurse. The proposal is a national target for the treatment rate, published by hospital, so the trusts furthest behind are visible.

## Summary

The National Pancreatic Cancer Audit, run by the National Cancer Audit Collaborating Centre, has published three State of the Nation reports (2024, covering patients diagnosed 2020 to 2021 in England and 2022 in Wales; 2025; and 2026, covering 2022 to 2023 in England and 2023 to 2024 in Wales), each with five recommendations, and reports performance indicators including multidisciplinary team discussion, clinical nurse specialist involvement, enzyme replacement prescribing and receipt of active treatment, with a data viewer for individual organisations. This is a placeholder for the gaps the UK and NHS page names in detail: the proportion receiving no active treatment, variation between trusts, the time from diagnosis to treatment, and the treatment rate in older and less fit patients. The idea is to attach a national target to the active treatment indicator, publish trust-level results with case-mix adjustment, and fund the multidisciplinary capacity (surgeons, oncologists, specialist nurses, dietitians) in the trusts below it. Pancreatic Cancer UK's campaigns (Don't Write Me Off; Unite Diagnose Save Lives 2025) make the same case.

## Fields

- Kind: Idea
- Last checked: 2026-09-24
- Tags: pancreatic-evidence
- Hypothesis: Publishing case-mix-adjusted active treatment rates by trust with a national target raises the national rate by 10 percentage points within three years and narrows the interquartile range between trusts by half.
- Rationale: Audit-driven publication has moved treatment rates in other UK cancers; the indicators, the data flow and the organisational comparisons already exist in the audit.
- Proposed test: Before-and-after comparison of the audit's active treatment indicator and its between-trust variation across the years following publication of a target, with case-mix adjustment; qualitative review of what the lowest trusts changed.
- Maturity: speculative
- Actor: policy

## Sources

- NPaCA State of the Nation Report 2026: https://www.natcan.org.uk/reports/npaca-state-of-the-nation-report-2026/
- NPaCA State of the Nation Report 2025: https://www.natcan.org.uk/reports/npaca-state-of-the-nation-report-2025/
- NPaCA State of the Nation Report 2024: https://www.natcan.org.uk/reports/npaca-state-of-the-nation-report-2024/
- Pancreatic Cancer UK: Don't Write Me Off campaign: https://www.pancreaticcancer.org.uk/get-involved/make-a-difference/join-our-campaigns/dont-write-me-off-impact/

## Connected records

- ideas: [A fast-track pathway from suspicion to treatment for pancreatic cancer in the NHS, measured from first scan to first treatment](https://onco.cc/ideas/idea-pdac-uk-fast-track-diagnosis-to-treatment-pathway/), [Pancreatic enzyme replacement by default: prescribe at diagnosis, audit the rate, and run the trial that settles survival](https://onco.cc/ideas/idea-pdac-enzyme-replacement-prescribing-by-default/)
- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Knowledge reaches practice too slowly](https://onco.cc/bottlenecks/b-knowledge-diffusion/), [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/)
- key papers: [Enzyme replacement improves survival among patients with pancreatic cancer: Results of a population based study](https://onco.cc/key-papers/paper-roberts-pert-survival-pancreatic-cancer-pancreatology-2019/)
- roadmaps: [Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question](https://onco.cc/roadmaps/pancreatic-roadmap/)

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