Introduction Late diagnosis of cancer increases morbidity and mortality, and the overall cost of care. Camden Clinical Commissioning Group (CCG) improved the percentage of patients diagnosed at stage I and II cancer, from 39% in 2012 to 47% in 2015;there remained a need to identify the issues leading to late diagnosis.

Method Camden CCG adapted the Royal College of General Practitioners’ cancer significant event analysis (SEA) tool to be used by general practitioner (GP) surgeries to identify the causes of delayed cancer diagnoses and to find ways to increase early diagnosis. The effective collection of findings through an online portal, comprehensive communication of these to GPs and clear display of these to commissioners ensured the necessary information to transform systems to facilitate early diagnosis. GPs were encouraged to complete a SEA through financial incentivisation, clinical leadership and Cancer Research UK (CRUK) Facilitator input.

Results 49 root cause analyses were completed and the findings led to changes in behaviour to improve early diagnosis of cancer.

Conclusion Results show that for SEA to be successfully used across a borough to change individual clinician’s behaviour and to induce system transformation, multiple approaches are required: involvement of all stakeholders from the start, clinical leadership, support from CRUK Facilitators, education and financial incentivisation.