Gera Cancer Pathway Pressure Index — Methodology

Data source

Source

NHS England Cancer Waiting Times (CWT CRS) — ICB Sub-Location extract

Reference period

April 2026

Published

June 2026

Publisher

NHS England

Licence

Open Government Licence v3.0

ICB mapping

NHS Organisation Data Service (ODS), spineservices.nhs.uk

Index formula

England baseline (April 2026)

Step-by-step computation

1. 1

   Obtain NHS England CWT data

   Download the monthly ICB Sub-Location data extract from the NHS England Cancer Waiting Times statistics page (https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/). The file contains columns: PERIOD, YEAR, MONTH, STANDARD, ICB SUB LOCATION (code), SUB-CATEGORY, TOTAL, WITHIN STANDARD, BREACHES.

2. 2

   Map sub-location codes to parent ICBs

   The extract uses ONS ICB sub-location codes (e.g. 00L, 00T). Map each code to its parent Integrated Care Board using the NHS Organisation Data Service (ODS) API (directory.spineservices.nhs.uk), filtering for PrimaryRoleId=RO98 (CLINICAL COMMISSIONING GROUP). Each code's "Name" field embeds the parent ICB.

3. 3

   Sum 62-day Combined rows per parent ICB

   Filter to rows where STANDARD = "62-day Combined". For each parent ICB, sum TOTAL across all sub-locations (total62) and sum WITHIN STANDARD (within62). Compute pct62 = within62 / total62 × 100. This aggregates all four 62-day sub-pathways: Urgent Suspected Cancer, Screening, Consultant Upgrade, and Breast Symptomatic.

4. 4

   Sum 28-day FDS rows per parent ICB for referral volume

   Filter to rows where STANDARD = "28-day FDS". For each parent ICB, sum TOTAL across all sub-locations (refVol). This is the Faster Diagnosis Standard referral volume — the most upstream measure of cancer pathway demand. Also compute pct28 = FDS within-standard / refVol × 100.

5. 5

   Compute raw pathway pressure

   For each ICB: raw_pressure = (1 − pct62 / 100) × refVol. This captures both the magnitude of 62-day target failure and the volume of patients affected. An ICB that misses the target by 30 percentage points with 10,000 referrals has higher raw pressure than one that misses by 30 pp with 1,000 referrals.

6. 6

   Normalise to 0–100 (GCPPI)

   gcppi = (raw_pressure − min_raw) / (max_raw − min_raw) × 100, rounded to one decimal place. The ICB with the lowest raw pressure scores 0; the ICB with the highest raw pressure scores 100. All other ICBs are linearly interpolated between these bounds. The index is re-computed monthly when new NHS England data is published.

NHS cancer standards context

Caveats and limitations

• The GCPPI is a relative index: it ranks ICBs within theApril 2026 cohort. The raw pressure values and therefore the normalised index will change each month as new data is published.
• Sub-location codes in the CWT extract are mapped to parent ICBs using March 2026 organisational mappings (as referenced by NHS England). ICBs created or reorganised after this date may not be correctly reflected until NHS England updates the extract.
• The 28-day FDS referral volume is used as the demand proxy because it is the most upstream measure available in the monthly ICB extract. It may differ from the total diagnostic referral volume if some pathways fall outside the FDS scope.
• Figures with fewer than 5 patients are suppressed by NHS England for disclosure risk. Where all sub-location rows for a pathway are suppressed, that pathway will show 0/0 and is excluded from ICB totals.
• The GCPPI is not a measure of cancer outcomes or clinical quality — it measures pathway timeliness pressure against a single administrative standard. It should not be used as the sole basis for clinical decisions.