1. Visioning the Quality Performance Indicator (QPI) Reporting Programme Dr Bob Masterton Chair National Cancer Quality Steering Group

2. Elements of a National Cancer Quality Programme National Cancer Quality Programme Development of QPI’s Review of National Minimum Core Datasets Quality Assurance of Audit Data Data Collection & Completeness Technology to Support Analysis National Reporting of QPI’s Review of QPI’s

3. Current Position Development of QPIs. –Commence with Renal and Prostate in 2010. Cancer standards. –NHS QIS Standards in place for Breast, Lung, Colorectal and Ovarian cancers. National Cancer Quality Programme Developme nt of QPI’s Review of National Minimum Core Datasets Quality Assurance of Audit Data Data Collection & Completen ess Technology to Support Analysis National Reporting of QPI’s Review of QPI’s

4. Current Position Review of existing national minimum core datasets. –Lung dataset reviewed. Breast dataset review commenced Nov 09. Quality assurance of data. –No formal national programme of whole record Quality Assurance of existing national minimum core datasets. National Cancer Quality Programme Developme nt of QPI’s Review of National Minimum Core Datasets Quality Assurance of Audit Data Data Collection & Completen ess Technology to Support Analysis National Reporting of QPI’s Review of QPI’s

5. Current Position Data collection & completeness. –Complete datasets reported as being collected, in all constituent Health Boards, for 8 tumour types in SCAN, 11 tumour types in WoSCAN and 10 in NOSCAN. Technology to support data capture & reporting. –No single system in place across Scotland. eCASE developed to support data capture for all tumour types. Implemented in WoSCAN and being implemented in NOSCAN. Alternative systems in place in SCAN. National Cancer Quality Programme Developme nt of QPI’s Review of National Minimum Core Datasets Quality Assurance of Audit Data Data Collection & Completen ess Technology to Support Analysis National Reporting of QPI’s Review of QPI’s

6. Current Position National reporting of QPIs. –ISD support national reporting for Lung and Colorectal cancers. –Regional Networks support national reporting of Breast and HPB cancers. Review of existing NHS QIS standards. –Review of Breast, Lung, Colorectal and Ovarian standards completed end 2008. National Cancer Quality Programme Developme nt of QPI’s Review of National Minimum Core Datasets Quality Assurance of Audit Data Data Collection & Completen ess Technology to Support Analysis National Reporting of QPI’s Review of QPI’s

7. Level of Reporting Key purposes Example product Adapted from: Department of Health (2008) ‘High Care Quality for All, Measuring for Quality Improvement: The Approach’ Small core set of quality performance indicators National Quality Report National comparative reporting Regional quality measures Regional Comparative Reporting Clinical Team quality measure Local audit report Local clinical ownership of indicators Local Regional National Six Dimensions of Quality Co-production at all levels of the system Individual Patient Experience Improvement against national priorities Public accountability National and International benchmarking Improvement in quality within the region and progress against the national and regional vision Enable benchmarking Service improvement Board accountability Organisational benchmarking Team benchmarking for improvement

8. Patients, Carers and Family Defined QPI’s Agreed Measurability Reporting Timetable Performance assessment & reporting Information Governance Framework Local Action Plans & Regional Priorities Incremental Service Improvement Network Accreditation MDTs Guidelines & Protocols Based on ‘Best Practice’ Prospective Clinical Audit Closing the Quality Loop

9. Reporting Processes: One Option NHS Boards: Submit clinical audit data/results to Regional Cancer Network or ISD in line with agreed programme for regional & national reporting Agree, implement & monitor local action plans Rolling programme of National QPI development & reviewRobust quality assurance programme in placeRolling programme of QPI and dataset reviewRegional Cancer Networks, MCNs/TSGs: Analyse & report performance against agreed quality performance indicators (QPIs). Agree action plans & submit to RCAG. Implement actions NHS QIS: Quality AssuranceRCAGs: Receive annual performance reports  Agree & monitor Network action plans  Submit annual report to Regional Planning Group  Submit regional reports, as required to NHS QIS Local Board Governance StructuresScottish Cancer Taskforce

10. Questions for Consideration Reporting of Quality Performance Indicators (QPIs) –At what level: international, national, regional, local unit, MDT? –By whom: Networks, ISD, local Boards? –How often: annually, bi-annually, less frequently? Role of national meetings? Role of SCT, Networks, NHS QIS, ISD? Governance framework: what does it look like? How best to effect change?