The cancer strategy for Scotland Cancer in Scotland: Action for Change¹ emphasises the central role of Regional Cancer Advisory Groups and Managed Clinical Networks (MCNs) in providing a multidisciplinary and regional approach to improving cancer services for specific cancer sites. An important role of MCNs is to provide the framework for monitoring the quality of cancer services in Scotland. Key to their ability to carry out this task is the availability of timely, comprehensive, and nationally comparable data. ISD has an important role in facilitating national prospective audit with regional networks (SCAN, NOSCAN, WOSCAN).

ISD supports NHSScotland in carrying out prospective audit in a number of ways.

Data definitions

In 1999 ISD (as SCTN) published data definitions to accompany four national datasets (breast, colorectal, lung, and ovarian) and has since provided support and advice on the interpretation and application of these definitions.

All files open in a new window and are in Adobe PDF  format. File sizes are shown in brackets.

Cancer	Date revised
Blood [1859KB]	1 December 2007
Breast [764KB]	1 December 2007
Colorectal [578KB]	1 October 2009
Cancer genetics [275KB]	1 January 2006
Head & neck [539KB]	1 July 2005
Lung [499KB]	1 December 2009
Neuro-oncology [950KB]	1 July 2008
Ovarian [594KB]	1 July 2005
Sarcoma [630KB]	1 December 2007
Skin (melanoma)  [343KB]	1 July 2005
Skin (squamous cell carcinoma)  [633KB]	1 December 2006
Upper GI [987KB]	1 December 2007
Urology [954KB]	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.
 

Communication and sharing of expertise

ISD has facilitated communication nationally between staff involved in prospective cancer audit through establishing and supporting the National Prospective Cancer Audit Working Group (NPCAWG). This group comprises a representative of each health board area, as well as representatives of NHS QIS (including SIGN), and ISD itself.

The group meets on a quarterly basis and provides a valuable forum for developing a common approach to collection of data at a practical level. Issues covered have included revisions to data definitions and datasets; common methods of analysis of data; and measurement of waiting times.
 

Training

ISD provides training in a variety of forms: tailored courses, workshops and one-to-one coaching. Areas covered include cancer information, confidentiality and statistical advice.

An e-group linked to the NPCAWG, open to any interested clinical, clerical, or audit staff, has also been set up for circulation of information about prospective audit.
 

Quality Assurance

ISD has developed and implemented a national system for quality assurance of data. Data collected for the national datasets are regularly assessed and verbal and written feedback provided.

Links with other groups: SIGN and NHS QIS

ISD has developed close working relationships with two key groups providing the framework for quality monitoring: the Scottish Intercollegiate Guidelines Network (SIGN) and NHS QIS.
 

Reports

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.

Further information

Further information on prospective audit, including copies of data definitions, information about the National Prospective Cancer Audit Working Group, and registration with the related e-group, can be obtained from Kathy Clarke, National Cancer Information Coordinator.

¹ June 2001 The Scottish Executive: Cancer in Scotland: Action for Change