Early cancer diagnosis DES and QOF guidance 2024-25

NCL Wide

Welcome to the NCL Direct Enhanced Service (DES) and Quality and Outcomes Framework (QOF) landing page.

This guidance has been developed with the support of wider stakeholders.

North Central London (NCL) has had the best one-year survival in England for combined cancer sites for the last six years and has the joint highest five-year survival for patients diagnosed in 2016 (latest published data). Our hypothesis is that our good survival outcomes are in part linked to high referral rates for suspected cancer, where NCL is in the top quartile nationally. 

North Central London Cancer Alliance (NCLCA) wants to build on these achievements and this document provides an overview of cancer objectives for 2024/25. Our focus is on delivering activities in line with the QOF and DES for cancer, notably: 

  • Supporting referral practice, focused on primary care’s delivery of the Directed Enhanced Service (DES) contract. 
  • The latest National Cancer Patient Experience Survey (2022) explored patient experience across North Central London, outlining areas where we can make local improvements. At a primary care level, challenges around Cancer Care Reviews were highlighted; only 17.5% of respondents thought they had a Cancer Care Review. This page includes resources on carrying out Cancer Care Reviews within twelve months of diagnosis, as well as offering support discussions three months after a patient’s diagnosis of cancer. 

Key contacts

Practices are encouraged to get in touch if they have any queries or would like any additional advice or support. The NCL Cancer Team would be happy to attend a scheduled peer-to-peer learning event, provide support to identify unwarranted variation via use of the revised dynamic primary care network cancer dashboard, and more.   


Review date: Saturday, 31 May 2025