Cancer Audit
Prospective Audit: supporting the improvement of cancer services in Scotland
Regional Cancer Advisory Groups and Managed Clinical Networks (MCNs) are central to providing a multidisciplinary and regional approach to improving cancer services in Scotland. An important role of MCNs is to provide the framework for monitoring the quality of services being provided for patients diagnosed with cancer, which takes account of the whole patient journey through diagnosis to post-treatment. This role was initially outlined in Cancer in Scotland: Action for Change and reinforced in the policy document Better Cancer Care in 2008. Key to their ability to carry out this task is the availability of prospective cancer audit data, which requires to be timely, comprehensive, and nationally comparable.
ISD has an important role in facilitating national prospective audit in collaboration with Scotland's three regional cancer networks (NOSCAN, SCAN, WOSCAN) by providing support in three main areas: dataset development and support; the quality assurance of National Cancer Audit Datasets; and analysis and reporting. Delivering these services fosters communication between key groups involved in patient care and provides the foundation for monitoring and improving the quality of care available. In addition ISD has facilitated various training to support cancer audit and works closely with other key stakeholders, including Scottish Intercollegiate Guidelines Network (SIGN) and NHS Quality Improvement Scotland (NHSQIS).
Data Definitions
In order to compare different aspects of patient care between geographical areas, a systematic and consistent method of data collection is required. The development of a set of cancer specific National Data Definitions aids audit staff responsible for collating this information to maintain consistency throughout Scotland.
In 1999 ISD first published data definitions to accompany four national datasets (breast, colorectal, lung, and ovarian) and subsequently developed datasets for additional cancer sites. ISD continues to provided support and advice on the interpretation and application of these definitions.
The current definitions for collection of prospective audit data are available by selecting the specific cancer below. All files open in a new window and are in Adobe PDF format. File sizes are shown in brackets.
| Cancer | Date revised |
 Blood [1284KB] |
1 December 2007 |
| Breast [592KB] |
1 December 2010 |
| Colorectal [578KB] |
1 October 2009 |
| Cancer genetics [275KB] |
1 January 2006 |
| Head & neck [539KB] |
1 July 2005 |
| Lung [569KB] |
1 October 2010 |
| Neuro-oncology [950KB] |
1 July 2008 |
| Ovarian [594KB] |
1 July 2005 |
| Renal [690KB] |
1 January 20012 |
| Sarcoma [2,037KB] |
1 December 2011 |
| Skin (melanoma) [343KB] |
1 July 2005 |
| Skin (squamous cell carcinoma) [633KB] |
1 December 2006 |
| Upper GI [987KB] |
1 December 2007 |
| Urology [965KB] |
1 July 2005 |
In the light of experience across Scotland ISD has worked with clinicians and audit staff to prepare and implement revisions to definitions and datasets, aiming to preserve as far as possible their stability and continuity. Previous definitions are available on request by contacting NSS.isdCANCERAUDIT@nhs.net.
Quality Assurance
ISD has developed a national system for quality assurance of data. This highlights difficulties or misinterpretations with the national data definitions. Information on the accuracy of data collected is fed back to hospitals with the aim of assisting NHS hospitals, boards, clinicians, and other relevant staff in monitoring and improving the quality of data.
By providing a guide to the quality of data available, MCNs are better able to interpret information resulting from analysis of these data, and to target improvements in data collection that provides the necessary information regarding patient care.
Analysis
Analysis of prospective audit data allows MCNs to monitor the quality of services being provided to cancer patients. By using audit to review performance against national standards, based on clinical guidelines, and peer reviewing this performance at a national level, MCNs can identify areas for targeting improvements.
Currently there are clinical standards set for breast, lung, colorectal and ovarian cancers. ISD supports the analysis and reporting of data pertaining to these standards, with results currently being fed back directly to MCNs via national clinical forums.
A new strategy for the implementation of Quality Performance Indictors is currently being developed by the National Cancer Quality Steering Group of the Scottish Cancer Taskforce.
Further Information
Further information for those involved in prospective audit data collection and reporting, including access to shared online resources and copies of data definitions, is available from NSS.isdCANCERAUDIT@nhs.net.
Previous Publications
Scottish Audit of Gastric and Oesophageal Cancer (SAGOC) report
SAGOC was established in 1997 and collected data for 2 years, with a subsequent follow-up for a minimum of 1 year. Patient characteristics and details of presentation, treatment, and outcome were collected from all hospitals in Scotland (cross-checking with pathology and discharges found that data were available on 98% of all patients discharged within the study period). The audit was funded by CRAG.
Main Contact
Brian Murray
National Cancer Information Coordinator
NSS.isdCANCERAUDIT@nhs.net
