1. EUROCHIP Pilot Study Dr. Finian Bannon Dr. Anna Gavin N. Ireland Cancer Registry Waiting Times & Compliance with Guidelines UK

2. EUROCHIP 2 Talk outline 1.Background UK Waiting Times Initiative UK National Cancer Audit 2.EUROCHIP Pilot Study in UK 3.Issues for Clarification

3. EUROCHIP 3 1. Background Waiting Times a political issue - Mr Andy Kerr, Scottish Minister of Health, reported in May 2006: "Cancer waiting times performance across the NHS isn't good enough”. Targets exist and they are monitored

4. 62 days for all cancers from urgent GP referral. GP referral for suspected cancer First Treatment for all cancers Scottish Cancer Waits Targets First treatment: Breast cancer, acute leukaemia, and children's cancer 31 days

5. 62 days for all cancers from urgent GP referral. 31 days for all cancers GP referral for suspected cancer Diagnostic phase (CT, MRI, endoscopy, biopsy, etc) and MDT Decision to Treat made First Treatment Welsh Cancer Waits Targets

6. 62 days for all cancers from urgent GP referral. 31 days for all cancers GP referral for suspected cancer First seen for suspected cancers Diagnostic phase (CT, MRI, endoscopy, biopsy, etc) and MDT Decision to Treat made First Treatment 14 days English Cancer Waits Targets Strict Monitoring!

7. EUROCHIP 7 1. Waiting Times Northern Ireland Health Minister is advocating a monitoring system Has adopted some of the English Waiting Times targets, e.g. max. 2 week wait Currently civil servants looking at –definitional issues –data capture e.g. electronic at hospital multi-disciplinary team meetings (MDT) Registry has 5 yearly retrospective timelines for major cancer sites

8. EUROCHIP 8 Cancer Services Audit 1996 & 2001 www.qub.ac.uk/nicr

9. EUROCHIP 9 2. National Cancer Audit Compliance with guidelines Scotland prospective cancer audits Northern Ireland 5 yearly retrospective audits and beginning prospective MDT data collection England no national audit of cancer services, but regional initiatives NYCRIS, and site specific e.g. BASO (breast), BAUS (urology). Wales no national audit of cancer services but some site specific audits, e.g.NBOCAP

10. EUROCHIP Progress to date

11. EUROCHIP 11 EUROCHIP-Progress to date Sent out the protocol to all UK registry’s 9 of 11 have responded to date Responses represent 66% of UK population Feedback has been helpful

12. EUROCHIP 12 Population and Sample 68.6 % positive response (registries in red)

13. Clarification issues

14. EUROCHIP 14 1.What do options for SOURCE mean? 2.What does active/passive mean? 3.What sampling level is required? 3 clarification issues

15. EUROCHIP 15 1. Meaning of Source Options ‘Yes’ interpretations? Yes 1.We collect it routinely 2.It generally exists in this source, but may not be routinely collected by cancer registry 3.For this sampled patient, we found a record of it in this source

16. EUROCHIP 16 1. Meaning of Source Options ‘No’ interpretations? 1.We do not collect it routinely, but it may exist in this source. If it doesn’t exist in this source, then ‘NA’. 2.For ‘X’ sampled patient, we could not find a record of this information in this source. ‘NA’ means it never exists in this source.

17. EUROCHIP 17 1. Meaning of Source options Questionnaire completion 1. Are we assessing routine registry sources? Registries recorded ‘Yes’ if that source provided data for the registry, i.e. some rows empty? Or 2. Are we assessing all the data sources irrespective of what registries routinely receive ? i.e. a tick in each row?

18. EUROCHIP 18 2. Definition of Active and Passive? Is passive where data comes in automatically, creates records, and populates fields in the registry database. Does active involve any human intervention, even, for instance, reading a pathology report that comes into registry on a file.

19. EUROCHIP 19 3. Sample Size Difficult to assess the local sources of information with 3-20 cases

20. EUROCHIP 20 Summary Monitoring Waiting Times is high on agenda for UK We feel the we have undertaken pre-pilot of the Pilot Study Need Clarification 1.Interpretations of ‘Yes’, ‘No’, and ‘NA’ 2.Definition of active/passive 3.Sample Size