1. Carlos Rocha Registry Manager National Cancer Registration Service (South West) West Dean Registration Improvement of Non-Melanoma skin cancer

2. Background

3. North West London West Midlands South West Northern & Yorkshire East Midlands Eastern Oxford Prior to 2013 8 Regional Offices 8 independent systems

4. North West London West Midlands South West Northern & Yorkshire East Midlands Eastern Oxford 2013 - 2015 Encore

5. Radiotherapy Pathology PAS CWT Chemo Radiology COSD / MDT Open Exeter Encore Audit NHS Acute Trust Regional Office ONS Oxford Death Cert

6. Pathology

7. What do we record at the moment? First occurrence of a BCC First occurrence of an SCC Link all subsequent data to the first occurrence e.g. Pathology Surgery Treatment e.g. radiotherapy

8. Why do we do it this way? Resource 2009 South West skin project: 5,385 SCC’s (1,520 extra cases) 25,981 BCC’s (11,960 extra cases) To process all NMSC cases manually for the whole of England the NCRS would need to employ an extra c.20 WTE registration officers. But…not very efficient and we don’t really know the gap between what we receive and what we should be receiving!

9. Project Aims

10. What? Identify how many BCC + SCC reports we are receiving from each trust Liaise with trusts to determine whether we are receiving all reports, if not, how can we resolve this? Which histopathologists are/are not using proforma reporting? Why are some histopathologists not using proforma reporting and how do we encourage them to do so? How many BCC + SCC records are submitted in COSD submissions? How does the NCRS then identify proforma reports, provide initial feedback on pathology + COSD and then process them more efficiently in ENCORE?

11. Who? Michael Eden – Histopathologist (Cambridge University Hospitals NHS Foundation Trust Karen Graham – Head of Data Improvement (NCRS) Carlos Rocha – Registry Manager (NCRS South West) Josie Horne – Data Quality Manager (NCRS South West) Reporting to: Dr Jem Rashbass – Director, Disease Registration, PHE

12. Where do we want to be? Complete and consistent SNOMED coding on all Pathology reports. Trust Pathology extract criteria identifies all non melanoma skins. Proforma reporting on all non melanoma skin cancers (COSD xml pathology extracts will help with this). NCRS record each and every occurrence of BCC + SCC by processing the majority of pathology reports and COSD data automatically. Using the COSD reporting process to provide feedback on the completeness of the data (both submitted and processed). Detailed reports purely for NMSC.

13. How many BCC & SCC reports are we receiving?

14. BCC and SCC pathology reports received by the NCRS June ‘14 to May ‘15 North West London West Midlands South West Northern & Yorkshire East Midlands Eastern Oxford Encore SCC: 3,055 BCC: 13,716 SCC: BCC: SCC: 6,258 BCC: 22,370 SCC: 5,463 BCC: 17,447 SCC: 1,717 BCC: 6,099 SCC: 3,688 BCC: 13,441 SCC: 3,840 BCC: 14,387 SCC: 5,115 BCC: 20,854

15. Thank you! Any further questions: carlos.rocha@phe.gov.uk