The TACTIC study (Timeliness of Access to Cancer Treatment – Improving Care) is a 3.5-year NIHR funded project which will investigate how to improve timeliness of curative surgery or radiotherapy for people with cancer.
The TACTIC study explores why some people experience delays between cancer diagnosis and starting treatments such as surgery or radiotherapy, and how these delays can be reduced. It focuses on cancers of the bowel, breast, lung, and esophagus. This national study will use the findings to develop practical solutions that help people attending all NHS hospitals to have more timely cancer treatment. The project is highly collaborative and fully involves health professionals and patients.
The time it takes for people to get the treatment they need after receiving a diagnosis of cancer varies widely across the NHS in England. Some people wait a long time, even though NHS England has set a benchmark for 96% of people to begin their treatment within 31 days of a decision to treat.
NHS England data for October 2023 to March 2024 suggests that while the target is generally met for chemotherapy (98.7%), the proportion is much lower for curative surgery (83.2%) and radiotherapy (89.0%), even though they are the two main curative methods used to care for solid tumours.
Delays in getting treatment can make the outcomes for people with cancer worse and can widen health inequalities. But the reasons for delays in treatment need to be better understood so the right solutions can be designed and implemented. Some delays might be because of how the healthcare system works, how care pathways are currently organised, and the different patients interact with services. A more coordinated and evidence-based approach is needed to identify, co-design and evaluate more effective ways to target treatment delays after a cancer diagnosis.
This research, which is led by the London School of Hygiene and Tropical Medicine in collaboration with the National Cancer Audit Collaborating Centre , will bring together patients, clinicians, data experts, and policymakers to address an urgent national priority for cancer care.
We’ll be focusing on four major types of cancer: bowel, breast, lung, and oesophageal. This is because national guidelines recommend surgery or radiotherapy as the main treatments in the early stages of these cancers – and surgery and radiotherapy are most prone to delay.
To organise the research, we’ll be using an innovative cancer learning system model that will integrate multiple research methods – qualitative, quantitative, and co-design – over a period of 3.5 years to investigate ways how to improve timeliness of curative surgery or radiotherapy for people with cancer.
The learning model will support understanding problems, developing solutions, and evaluating them, by combining three key components: high quality data, innovative co-design techniques and an inclusive online community. We’ll keep a strong focus on equity, diversity, and inclusion, throughout, and will keep patients and the public at the heart of the project. Patients, public contributors, and stakeholders will shape priorities and guide all stages of the project.
In bringing together national networks of clinicians with data scientists, healthcare improvement researchers and people with lived experience of cancer, the project will not only help improve the timeliness of cancer treatment but also create a long-lasting resource for improving cancer care.
CanDo is an online community bringing people together to improve the quality of cancer care.
Led by The Healthcare Improvement Studies Institute (THIS Institute), the CanDo community brings together NHS staff, policymakers, patients, and other stakeholders to share insights. It has been developed in collaboration with the London School of Hygiene and Tropical Medicine and the National Cancer Audit Collaborating Centre.
CanDo is designed to connect NHS professionals in a practical, supportive online space – so participants can share learning, test ideas, and take forward quality improvement projects together. On it, you can:
- Share experiences and learning.
- Bring fresh thinking, turning frontline insight into levers for change.
- Help shape and test new approaches.
- Take part in large-scale, well-coordinated improvement projects that can make a real difference.
The first project we are launching on the community is TACTIC – Timeliness in Access to Cancer Treatment- Improving Care.
Join the CanDo community of practice to tackle challenges of treatment timeliness – a dynamic, peer-led network where members learn from each other. https://cancer.thiscovery.org/
What is PPI?
PPI means ‘Patient and Public Involvement’ and is a core component of our research. It helps us to ensure that our researchers are asking the right questions and using the right methods, so that our studies will provide answers that will make a real difference to people’s lives. You can read more about patient and public involvement in research on the NIHR People In Research website.
What is the TACTIC study and what does it aim to do?
The TACTIC study (Timeliness of Access to Cancer Treatment – Improving Care) explores why some people experience delays between cancer diagnosis and starting treatment, and how these delays can be reduced. It focuses on cancers of the bowel, breast, lung, and oesophagus. The study will use the findings to develop practical solutions that help more people start treatment sooner. A key feature of the project is its highly collaborative approach, involving staff and patients at every stage.
This is a 3.5-year study which started in summer 2025 and is funded by the National Institute for Health Research (NIHR).
Why is this study needed?
Once cancer has been diagnosed, getting treatment quickly is a key priority for everyone, especially for patients. The NHS expects people to begin treatment within a month of the decision to treat. But that doesn’t always happen, particularly for surgery and radiotherapy. Waiting times vary between different hospitals, across different types of cancers, and different treatments. Delays also affect some groups more than others, including those worse-off socio-economically and those from minority ethnic communities.
These delays matter. They can lead to poorer patient experience and can impact outcomes. We urgently need to understand why some cancer patients are not getting their treatment at the right time and to find solutions. That’s where TACTIC comes in.
Our project will ask:
- Which types of cancer are likely to have worse outcomes if treatment is delayed?
- Why do delays happen?
- What can we learn from hospitals that are doing better?
- How can treatment pathways and care systems be improved?
How will the research be done?
We will analyse anonymous data already collected by the NHS as part of patient care, and we’ll work with NHS staff and patients to identify possible solutions and test them. Some of this work will take place through an online community called CanDo, which will support people to share information, learning and views.
We want to learn from good practice, so we’ll will be studying what happens in hospitals with different levels of performance to see what enables some hospitals to have better timeliness than others. Once we’ve identified what appear to be good possible solutions, we’ll co-design them with the community and patients, and then test them. We’ll use routinely collected data to evaluate the impact.
No patient will have their treatment changed as a result of our study, but we hope that some may benefit from improved timeliness.
Are patients and the public involved?
Involving people with lived experience of cancer in our research project is essential. We do this through both membership of the study team and as contributors to the research process and sharing of findings. The original research proposal was supported by 3 people with experience of cancer as either patients or carers for loved one. These PPI representatives and a Community Engagement Officer from the Centre for Ethnic Health Research have worked with the project PPI Lead to bring together a diverse panel of people to ensure we’re listening to the views and priorities of cancer patients and their carers. This PPI Panel will meet regularly throughout the project to give us feedback on project activities as well as big picture issues, such as whether particular changes to services are likely to be acceptable to patients. Panel members will also have access to a dedicated space on our online community platform, where they will be able to follow project progress, join in discussions, and connect with the other panel members.
Can I still get involved?
If you are interested to contribute to our research as a member of our PPI panel, please contact the PPI Lead, Yuki Alencar ([email protected]).
LSHTM
- Richard Grieve
- Ajay Aggarwal
- David Cromwell
- Kate Walker
- Bernard Rachet
- Ruth Keogh
- Yuki Alencar
- Sarah Cook
- Jen Turner
- Thea Hope-Johnson
- Iain Timmins
- Tabitha Pring
THIS.Institute
National Cancer Audit Collaborating Centre, NATCAN
Gloucester Hospitals NHS Foundation Trust
- Douglas West - Consultant Thoracic Surgeon
Norfolk and Norwich University Hospitals NHS Foundation Trust
- Thomas Roques - Consultant Oncology
Guy’s and St Thomas’ NHS Foundation Trust
- Kate Haire - Clinical Chair of South East London Cancer Alliance and a Consultant in Public Health Medicine
- Angela Francis - Head of Radiotherapy Services, Trust Professional Lead for Therapeutic Radiography
PPIE Co-applicants
- Paul Charlton