National Lung Cancer Audit Dr Ian Woolhouse University Hospital Birmingham Senior Clinical lead NLCA
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
English National Cancer Registration System New data flows Cancer Waiting Times Pathology full-text reports Radiotherapy Data (RTDS) Data from MDT software systems Chemotherapy Dataset (SACT) COSD Local imaging systems Molecular labs (EGFR) Patient Administration Systems ONS - Cancer and non- cancer deaths English National Cancer Registration System This is a diagram which represents the data feeds that will flow into ENCORE. Green boxes show feeds which will be sent directly to the Registry from each provider trust. These will be from Multi-Disciplinary Team (MDT) cancer tracking systems, full-text reports from Pathology systems, diagnostic and procedural information from Patient Administration Systems (PAS) and data from Radiology systems. The Orange represents national cancer datasets. These are the Radiotherapy Data Set (RTDS), the Systemic Anti-Cancer Therapy (SACT)/Chemotherapy dataset and National Cancer Waiting Times (CWT). Yellow boxes represent other feeds of data – Death information from the Office of National Statistics (ONS) and data from the Cancer Screening Programmes (Breast, Cervical and Bowel). “Cancer death” information will be provided for patients who have a mention of cancer on their death certificate, while “Non-Cancer Death” information is provided on all patients which has previously been flagged with ONS as having had cancer (but have died from another cause). The remaining white boxes show other data flows that will exist in ENCORE which either supplement existing data for COSD (HES, PET-CT and National Audits) or provide extra information that is not part of the COSD. Fully registered lung cancer case
Impact of new data flows Additional 6000 cases identified Older patients Less complete PS and stage Less likely to receive treatment Additional treatments identified Overall treatment rates similar
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
Online reporting portal https://nww.cancerstats.nhs.uk
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
Audit standards INDICATOR STANDARD Seen by CNS > 90% CNS present for diagnosis > 80% Histological confirmation > 75% NSCLC NOS rate < 15% Valid EGFR status recorded (non-squamous) PET before radical treatment > 95% Time from diagnosis to treatment SCLC < 2 weeks
Audit outcome indicators STANDARD % Stage I-II NSCLC receiving radical treatment Review outliers after risk adjustment % Stage IIIB-IV NSCLC PS 0-1 receiving chemotherapy % NSCLC EGFR M+ receiving TKI treatment % SCLC receiving chemotherapy Survival (median and 1 yr)
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
2015 results (preliminary)
2015 results (preliminary)
2015 results (preliminary)
Plan Data flows Online reporting portal Audit standards South West Network 2015 results Quality Improvement
Quality Improvement Two new QI leads Spotlight audits Regional workshops Targeted visits Sharing learning
What’s the end game?
nlca@rcplondon. ac. uk www. rcplondon. ac nlca@rcplondon.ac.uk www.rcplondon.ac.uk/resources/national-lung-cancer-audit