Data Quality
- Data Recording Criteria
- Data Submissions
- Exclusions and Adjustments
- Data Completeness
- Data Quality Assurance
The cancer waiting times targets/standards are applicable to adult (over 16 at date of diagnosis) NHSScotland patients with a newly diagnosed primary cancer. To be included, the cancer type must fit into one of the listed cancer types in the Cancer Waiting Times Data and Definitions Manual 
[560kb].
The information to support these targets/standards comes to ISD from NHS Boards in each of the three regional cancer networks - South East Scotland Cancer Network (SCAN), North of Scotland Cancer Network (NOSCAN) and West of Scotland Cancer Network (WOSCAN). Tracking systems are used to provide data for both performance management and official reporting against cancer waiting times targets/standards. Responsibility for collating and submitting the data to ISD lies with the NHS Board that received the patient's initial referral to secondary care. Data are submitted to ISD monthly for quarterly publication.
For some patients in the 31-day cohort, it is possible that an NHS Board other than the one that submits the data is responsible for delivering the target/standard. NHS Boards are required to have mechanisms in place for submitting and signing off the accuracy of data for these patients.
Approximately 1,800 records from all NHS Boards are submitted each month. The dataset contains 21 fields, the majority of which are mandatory. Data is collected by cancer trackers and administrative staff (including medical secretaries) across NHSScotland, and are based on locally available information drawn from sources such as patient administrative systems, laboratory systems, and medical records across the country; which are then recorded onto the NHS Boards' Tracking systems. From this the NCWT submission template is completed, which is based on the previous month of treatment, and submitted to ISD via SWIFT DVL. When in ISD, the data is validated and put on to Business Objects to allow data interrogation and reporting. Further information on submitting and validating data can be found in the Scottish Cancer Waiting Times System (SCWaTS) User Manual Version 3 [1.5mb]. If NHS Boards discover that data submitted is incorrect, or data is missing, further submissions can be made at any time up to the publication submission deadline [30kb] and will be reflected in the publication.
A patient will be excluded from reporting against the Cancer Waiting Times targets/standards for the following reasons:
- The patient chooses to have any part of their pathway out with NHSScotland (if this is before the decision to treat they will be excluded from the 62-day target/standard and if after the decision to treat they will be excluded from both targets/standards)
- The patient died before treatment
- The patient refused all treatment
- The patient was deemed a clinically complex case by the lead cancer clinician of the responsible NHS Board.
As part of a patient's pathway there may be some areas of delay not attributable to NHS Board performance, and in these cases an adjustment can be made to discount periods of patient unavailability. If applicable, the cumulative number of days by which the waiting times pathway can be adjusted (before and/or after the decision to treat) is then subtracted from the total wait (in days) to give an adjusted wait. Adjustments can be made for the following patient-induced delays and medical suspensions:
- Patient did not attend an appointment
- Patient cancelled an appointment
- Patient deferred an appointment
- Temporary co-morbidity
- Other patient-induced suspension
- Medical Suspension
NHS Boards are required to record all adjustments for the patient, and add these together before submitting data for reporting against waiting times targets/standards. Documented evidence is required before an adjustment can be made, which must be made available during quality assurance exercises (please see Data Quality Assurance section). More detailed information on adjustments and adjusted waiting times scenarios can be found in the Cancer Waiting Times Data and Definitions Manual [560kb].
In order for ISD to gauge if data collected for January - March 2010 was robust enough for publication, a 'fitness for publication' (FFP) exercise was carried out for the 62-day target. This exercise showed that completeness of the 62-day target was within an acceptable range and was fit for publication. A similar exercise was carried out to assess the introduction of screened positive patients for the July - September 2010 time period. Various additional FFP exercises have been carried out: details of all FFP exercises can be found here .
ISD and NHS Boards are actively working to resolve any quality issues that impact on data reliability.
Case ascertainment is assessed each quarter for the 31-day target/standard. The latest figures can be found within the 31-day tables in the Publication Report [210kb].
It should be noted that publication reports contain small numbers which may affect comparisons. For example in island NHS Boards there may be a substantial quarter-on-quarter fluctuation in the percentage figures, which may represent the pathway of one or two patients. Due to the effects of small numbers, percentiles have only been calculated where there are 40 or more patients within a population.
NHS Boards may discover, post publication, that data have been recorded incorrectly or not included in the targets/standards in error. If this occurs, any data inaccuracies will be reflected in any related publication table footnotes and then revised and updated in the next publication release.
Click here for information on specific data quality issues for NHS Boards [140kb].
The Data Quality Assurance (DQA) team on behalf of the Cancer Waiting Times team carried out and completed a data quality audit for patients who fell under the 31 and 62-day targets based on quarter 2 2010 (April-June) as at 28 September 2010. The purpose of the audit was to determine:
- If correct codes/dates are being recorded
- If waiting times adjustments are being applied correctly and consistently
- If the rules and guidance are being appropriately applied
Click here for the Project Outline [100kb]
After the audit was carried out discussion of results took place at each NHS Board. Detailed reports were produced for management information/quality assurance purposes only and distributed to all NHS Boards. A high-level Scotland report was also produced and is available here . The audit provides further assurance of data completeness, accuracy and quality. Queries that resulted from the DQA audit can be found within the query log under the DQA Queries worksheet 
[70kb].
In a continuing collaboration between ISD and NHS Boards, recommendations for both NHS Boards and ISD were included within the Scotland level report. A table outlining the progress made by ISD against the appropriate recommendations is available here [130kb]. A summary of progress made by individual NHS Boards can be found here [66kb].
ISD recently carried out a data quality project with regards to Cancer Waiting Times (CWT) data submissions for colorectal screened patients. This was further to the Data Quality Assurance (DQA) Audit of CWT [270kb], published in June 2011, which excluded screening patients as data had not yet been published on these cancer groups at the time of the DQA visits to NHS Boards. A paper highlighting the outcome of this project can be found here [50kb].
All documents on this page can also be found in Guidance section of the website.
