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Anna Murray BSc Cancer Information Analyst Anna.Murray@mccn.nhs.uk

Skin Cancer Network Group Audit of Clinical Performance Indicators: Data quality and treatment quality. Anna Murray BSc Cancer Information Analyst Anna.Murray@mccn.nhs.uk. Standards for Better Health. Clinical performance indicators Measurable and comparative data

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Anna Murray BSc Cancer Information Analyst Anna.Murray@mccn.nhs.uk

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  1. Skin Cancer Network GroupAudit of Clinical Performance Indicators:Data quality and treatment quality Anna Murray BSc Cancer Information Analyst Anna.Murray@mccn.nhs.uk

  2. Standards for Better Health • Clinical performance indicators • Measurable and comparative data • Progress assessment locally and at network level • Merseyside and Cheshire CNG: • Access to services • Consistency of service provision • Compliance with national targets

  3. Clinical Performance Indicators • The number of newly diagnosed patients referred by trust and ICD-10 code: • 31 day first definitive treatment • 62 day standard • Performance of radiotherapy: • Number of patients being treated • Waiting times for treatment

  4. Clinical Performance Indicators • Clinical trial activity • Accrual by MDT in to clinical trials • Sentinel lymph node biopsy • Number of patients referred by Breslow score • Number of procedures performed • Primary care excisions • Number of primary care excisions taking place

  5. The number of newly diagnosed patients referred by trust and ICD-10 code:

  6. The number of newly diagnosed patients referred by trust and ICD-10 code:

  7. Data discrepancies • Apparent between CWT data and local trust data • Suggests issues across the network for data uploads • Are performance figures inaccurate? • Somerset Cancer Register should address this • Must make sure that trusts are uploading all of their data • Good quality data is the key Comparison of total numbers of patients first seen for Malignant Melanoma in Merseyside and Cheshire Cancer network by trust (January to December 2008)

  8. Primary care excisions • Research and audit: • ‘…the planned treatment of low-risk BCCs should be restricted to approved doctors…, usually a GPwSI…or the LSMDT/SSMDT. All other skin cancers should be referred to the LSMDT in the first instance (National Institute for Clinical Excellence, 2006).’ • If the lesion is not a BCC, then the patient should be urgently referred (National Institute for Health and Clinical Excellence, 2006) • Abnormal growths/inflammations to be treated by GPs unless there is doubt with regards to diagnosis(National Institute for Health and Clinical Excellence, 2006)

  9. Primary care excisions • Malignant melanoma – 4.6% • Squamous cell carcinoma – 7.2% • Combined – 6.4%

  10. Primary care excisions • Findings: • Not all patients diagnosed with either malignant melanoma or squamous cell carcinoma are urgently referred via 2 week wait • What are the reasons for this? • Can such cases be avoided in the future? • Poorer patient experience?

  11. What next? • Clinical Performance Indicators • Audit of excision completeness in primary care • Monitoring uptake in to clinical trials • Audit of patients referred for SLNB • Breach analysis in CWT data

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