Project Name: UCLH Breast Cancer – Innovation and data strategy to improve the patient pathway and flow within the service.

Project Summary:

Female breast cancer is the most commonly diagnosed cancer, with an estimated 2.3 million new cases globally1.

In the United Kingdom, there are around 55,900 new breast cancer cases every year and it is the most common cancer, accounting for 15% of all new cancer cases2.

The increasing incidence of breast cancer and the most recent advances in breast oncology have led to significant expansion of the clinical practice. The implementation of new treatments requires more complex pathways and substantially higher clinic capacity with frequent review to monitor toxicity and ensure safe delivery. 

The potential to derive benefit from routinely collected data is a major challenge for NHS. The NHS could learn from every patient interaction to continually improve services, better understand health and care needs, develop new treatments, support advances in data-driven technology and AI, and enable more efficient and patient-centered care3. 

Over the last few years UCLH breast unit has faced unprecedented pressure particularly in outpatients, with patients receiving more treatments, with increased intensity and need for monitoring than ever before. This is demonstrated when viewing the rise in the increase in patient “follow-up” appointments which captures patients receiving treatment or on surveillance.

Overall, there has been an increase in the ratio of new to follow-up appointments from 1:10 to 1:17 which means that more outpatient appointments and treatment attendances must be accommodated within the existing clinic space and staffing resource. It is essential to capture this activity; there is much focus on the number of new patients diagnosed each year, but this only tells part of the story and suggests a much lower burden on the service. This increase in “on-treat burden” is set to continue and UCLH need to be able to analyse and interrogate data so that UCLH can identify new ways of efficient working and optimise patient care further. 

The increasing clinical demand and the complexity of new treatment pathways highlights the need to optimise UCLH’s patients’ flow, review pathways and improve the quality of oncology care for breast cancer patients. In addition, creating ways to optimise the curation and linkage of clinical activity will enable better decision-making for direct care, commissioning, monitoring, evaluation and improvement of NHS services, policymaking, and research. 

This project is designed to provide the link between the current clinical service to high-quality, timely data for service improvement, research, and innovation.

The CWP will achieve these aims through:

  1. The recruitment and utilisation of one full time equivalent (FTE) Clinical Fellow (ST3+) by UCLH for fifteen months.
  2. The Clinical Fellow will be supported by the recruitment and utilisation of a Business Intelligence Analyst (Band 8a) by UCLH for two days per week for fifteen months (0.4 FTE). 

Planned Milestones:

  1. Project Kick off and initiation of recruitment of ST3+ clinical research fellow and Band 8a Business intelligence analyst.

  2. Completion of recruitment of Band 8a Business intelligence analyst and Shortlisting of candidates for ST3+ Clinical Fellow

  3. Completion of recruitment of ST3+ Clinical Fellow

  4. Initiation of EPIC and clinical database development and configuration. 

  5. Collection of baseline data, implementation of new Breast Cancer patient management protocols, completion of initial EPIC and clinical database configuration, initiation of clinical activity.

  6. Data readout of 3 months clinical activity.

  7. Data readout of 6 months clinical activity.

  8. Data readout of 9 months clinical activity.

  9. Data readout of 12 months Clinical activity.

  10. Completion of ST3+ substantive role feasibility assessment and completion of project write up.

Expected Benefits:

Anticipated benefits for patients

This project will improve clinical data quality, thereby assisting the oncology department team:

  • To enable patients to be screened earlier
  • Increase patient access to the full treatment/ management pathway by improving identification of candidates for innovative therapies, genomic profiling or clinical trials (where appropriate)
  • Enable more efficient patient progress through assessment and treatment; reducing time to progress through pathway- via securing an up-to-date patient pathway.
  • To enhance pathway mapping and highlight opportunities to:
    • Enhance patient experience via improvements to patient flow.
    • Reduce and minimise of delays patients experience when transitioning from one treatment line to the next when there is disease progression.
    • Improve patients’ outcomes- Through increased clinic capacity related to improved pathway efficiency and effectiveness.

Anticipated benefits for the CW Partner 

  • Development of data capture tool to accurately capture quantitative and qualitative patients’ clinical data.
  • Optimisation of clinical documentation with the use of a shared tool will streamline clinical handover between different clinics lead by different lead UCLH clinicians.
  • Improved segmentation of the UCLH patient population to support improved clarity on the eligibility for innovative therapies, genomic profiling and appropriate clinical research as defined by protocols.
  • Increase in clinic capacity for service provision.
  • Increase in Breast Cancer service efficiency in transitioning patients through treatment and management pathways.
  • Improved data to support future analysis and research projects.

Anticipated Benefits for Novartis

  • This project will support Novartis’ reputation and vision to make an impact in patients’ life by enhancing productivity and efficiency within the NHS.
  • Ethical, professional, and transparent relationship between Novartis and the NHS.
  • Better understanding of overall customers’ and patients’ needs
  • Optimal use of NICE approved medicines (including Novartis medicines) in appropriate patients

Start Date & Duration: October 2023 for 23 months. 

References: 

  1. Sung H et all, CA CANCER J CLIN 2021;71:209–249
  2. UK, C. R. BREAST CANCER STATISTICS, <https://www.cancerresearchuk.org/health-professional/cancer-statistics/…;
  3. https://www.health.org.uk/publications/long-reads/how-better-use-of-dat…

UK | October 2023 | 734690

Project Name: UCLH Breast Cancer – Innovation and data strategy to improve the patient pathway and flow within the service.

Partner Organisation(s): University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU

Completion Date: Date when the final milestone was delivered – 29.09.25

Outcome Summary: 

  • Development of clinical database for early and metastatic breast cancer UCLH patients. This dataset enabled peer-reviewed publications to be drafted.
  • Improved treatment mapping pathway for the breast medical oncology service at UCLH, providing greater transparency on patient numbers across the service.

Key Project Outcomes Data: 

Through the development and implementation of a new EPIC workflow and database operations:

  • Staging and receptor status dataset was completed for 100% of patients (neoadjuvant, early and metastatic breast cancer cohorts) within one month of assessment in the oncology clinic.
  • There was a 90% increase of patients on an active SACT plan with treatment pathway completely mapped compared to baseline, with a total of 750 patients expected to benefit from the treatment pathway mapping implemented as part of this project (200 neoadjuvant, 200 adjuvant, 350 metastatic)

By increasing clinic capacity with inclusion of a Clinical Fellow:

  • An additional 240 patients were reviewed as part of this project. Significant admin and research activity was carried out as part of the clinical activity.

 

The project also enabled identification of patients for clinical trials:

  • a 60% increase in patients identified for clinical trials.

 

Transparency and service intelligence 

  • Improved visibility of real-time patient numbers across neoadjuvant, adjuvant, and metastatic cohorts, supporting service planning and audit.

 

Research and publication output 

  • Creation of a robust dataset that enabled abstracts and peer-reviewed publications with focus on real world data, raising the profile of UCLH breast oncology research.
  • The clinical database serves as a foundational predictive tool for forecasting research capacity. By analysing real-world patient cohorts, the clinical trial portfolio was proactively designed to align with available populations. This data-driven approach ensures strategic resource allocation, reduces feasibility risks, and significantly improves UCLH’s clinical research performance.

Outcomes: 

This project improved clinical data quality, thereby assisting the oncology department team to deliver the following: 

Outcomes for patients

  1. The establishment of a clinical database enables patients to be screened earlier.
  • It increases patient access to the full treatment/ management pathway by improving identification of candidates for innovative therapies, genomic profiling or clinical trials (where appropriate).
  • It enables more efficient patient progress through assessment and treatment; reducing time to progress through pathway- via securing an up-to-date patient pathway.
  1. The project enhanced pathway mapping and highlighted opportunities to:
  • Enhance patient experience via improvements to patient flow.
  • Service evaluation and improvement are facilitated.
  • Reduce and minimise delays patients experience when transitioning from one treatment line to the next when there is disease progression.
  • Improve patients’ outcomes - Through increased clinic capacity related to improved pathway efficiency and effectiveness. 

 

Outcomes for the CW Partner 

  • Development of data capture tool to accurately capture quantitative and qualitative patients’ clinical data.
  • Optimisation of clinical documentation with the use of a shared tool to streamline clinical handover between different clinics lead by different lead UCLH clinicians.
  • Improved segmentation of the UCLH patient population to support improved clarity on the eligibility for innovative therapies, genomic profiling and appropriate clinical research as defined by protocols.
  • Increase in clinic capacity for service provision.
  • Increase service efficiency in transitioning patients through treatment and management pathways.
  • Improved data to support future analysis and research projects.
  • Improved feasibility studies, design of research strategy and optimisation of research performance. 

 

Outcomes for Novartis

  • This project supported Novartis’ reputation and vision to make an impact in patients’ lives by enhancing productivity and efficiency within the NHS.
  • Ethical, professional, and transparent relationship between Novartis and the NHS.
  • Better understanding of overall customers’ and patients’ needs
  • Optimal use of NICE approved medicines (including Novartis medicines) in appropriate patients

Quote from Partner: 

“This collaborative working project Novartis and our Trust is the perfect example of meaningful collaboration between pharma and the NHS. This strategic partnership enabled a Clinical Research Fellow and a part-time Data Analyst to develop a proprietary clinical database for our unit. This project directly enhanced our clinical capacity by embedding the Fellow within our clinics. The project's outcomes were transformative: we streamlined patient pathways, created models to forecast business and research activity, and implemented a cycle of continuous service evaluation and improvement. Furthermore, we curated with the view to publish novel real-world data, enhancing our academic profile. Critically, the project's legacy is secure; the infrastructure developed ensures robust prospective data collection will continue, driving innovation and service improvement long after the fellowship has concluded."

"This project aimed to ensures the collection of high-quality, real-world data that is crucial for regulatory approval and demonstrating the true value of new medicines within the NHS.” - Elsavet Papadimitraki, Consultant Medical Oncologist specialising in breast cancer.

Conclusion:

The collaborative working project was a catalyst for long-term change. By resourcing a clinical research fellow and a data analyst, the Trust did more than just temporarily increase capacity; they built a future-proof engine for improvement. The fellow enhanced clinic throughput and with the help of the data analyst they developed a sophisticated clinical database. This asset allowed the team to streamline pathways, forecast activity, and improve services based on evidence. Most importantly, it established a long-term tool for curating and publishing real-world data ensuring that the project's benefits—prospective data collection, research, and service innovation.

Additional Content: 

The first submitted manuscript is under review and two others are being worked on. The initial project investment has created a powerful, sustainable asset: a permanent framework for prospective data collection and a core clinical database. To fully capitalise on this investment and future-proof the clinical and research performance, the research fellow role is pivotal.

FA-11539118-1 | October 2025