Merseyside & Cheshire Cancer Network Dashboard

Transcription

1 Merseyside & Cheshire Cancer Network Dashboard May If you wish to know more about the Cancer Network Dashboard please contact the Merseyside and Cheshire Cancer Network. Version2.0 Part 2 Cancer Dashboard MCCN 2010

2 Background The National Awareness and Early Detection Initiative-NAEDI- was announced in the Cancer Reform Strategy (CRS) and is being led by Professor Mike Richards, National Cancer Director and Harpel Kumar the Chief Executive of Cancer Research UK. Cancer Networks are well placed to provide leadership for prevention and early diagnosis. Cancer Networks and PCTs are expected to undertake a baseline that will inform Network and PCT Strategic Commissioning Plans to ensure effective progress in this area based on local needs. A Cancer Dashboard The cancer network have developed performance measures that include baseline measures but also add further quality to information that is appropriate for PCTs and GP practices and we want to embed these into a more robust cancer dashboard using and testing measures. We see this as a way of assessing current baselines within PCTs and also practices but will also enable us to analyse performance regularly. The cancer dashboard will be outcome driven; each PCT will be asked to complete a template with the Early Detection and Awareness Strategy lead team. We will agree milestones with PCTs and assist them in supporting the gathering of evidence for the individual measures, including measures by practice. We envisage that action plans will be developed and adopted by PCT boards as appropriate and recommendations will be made to commissioners, these recommendations will be more likely to be considered as they will be evidence based. A key element of the cancer dashboard will be the development of a database that PCTs and practices can access to review performance and to create reports. The cancer dashboard will: Collate primary care equity audits for urgent referrals in the PCT by practice- this will include, review of referring patterns linked to deprivation, number of referrals, cancer yield. This is different than the primary care audits. Capture data within templates for survival, mortality, incidence, screening and staging data and will identify key trends and variations. Provide PCT reporting in a template that will demonstrate compliance with national and local baseline s identified within the Cancer Reform Strategy. Provide information about screening performance at GP practice and PCT level, templates for GP practices will be made available. Capture action plans to enable Commissioners to make decisions on services. Test other performance measures around commissioning such as length of stay analysis and other commissioning priorities. We believe that the cancer dashboard will enhance the PCTs ability to demonstrate their progress on world class commissioning (WCC) and quality, innovation, productivity and prevention (QUIPP) Dr Daniel Seddon- Early detection and prevention lead Paul Mackenzie- Health Inequalities Manager Version 2 Cancer Dashboard MCCN

3 Baseline key metrics and indicators for the Cancer Dashboard. No Performance category Network PCT Practice Trust 1. Proportion of diagnosed cancers reaching a 90% registration status (including staging) with after 90 days 2. TWW activity including did not attend (DNA) and cancellation rates 3. Total number of Urgent 2 week wait referrals by tumour site 4. Urgent 2 week wait cancer referral yield rate by tumour site (Yield = No of Diagnosis Cancers/ Number of Urgent 2 week wait referrals 5. Number of Urgent 2 week wait cancer referrals by tumour site with a cancer diagnosis 6. Coverage rates for national bowel cancer screening programme 7. % variation from national coverage rates for bowel cancer screening programme 8. Number of cancers detected as a result of the bowel cancer screening programme 9. % Never screened for bowel cancer 10. Coverage rates for national cervical screening programme 11. % variation from national coverage rates for the cervical screening programme 12. Number of cancers detected as a result of the cervical screening programme 13. % Never screened for cervical cancer 14. % patients receiving cervical screening results within 2 weeks following screening 15. Lab data 16. Coverage rates for national breast screening programme 17. % variation from national coverage rates for the breast screening programme 18. Number of cancers detected as a result of the breast screening programme 19. % Never screened for breast cancer 20. European Age Standardised Cancer Incidence rates for all cancers compared to the national average and best in Europe (if appropriate) 21. European Age Standardised Cancer Mortality rates for all cancers compared to the national average and best in Europe (if appropriate) 22. % variation in 1 year relative survival rates for all cancers compared to the national average and best in Europe (if appropriate) 23. % variation in 5 year relative survival rates for all cancers compared to the national average and best in Europe (if appropriate) 24. Number of emergency admissions resulting in the first definitive cancer diagnosis

4 1. Public awareness of Cancer The Cancer Awareness Measure has been developed as part of the national awareness and early detection initiative (NAEDI) to help to ensure the delivery of the Cancer Reform Strategy (CRS). The survey has been designed to benchmark the current level of awareness amongst the population. The CAM will serve as a baseline against which we will be able to evaluate awareness raising initiatives within PCTs. The CAM is usually a face to face interview or telephone interview Awareness of cancer signs and symptoms Help-seeking behaviour Awareness of risk factors Awareness of cancer incidence and common cancers Awareness of cancer screening programmes Contribution to cancer Cancer Awareness Measure 1a Has the PCT conducted a CAM to benchmark local awareness? PCT not aware of the level of knowledge in the local population Plans being developed for 2010/11 Some evidence of awareness measurement The PCT can demonstrate baseline measurement of public knowledge of cancer CAM measure or equivalent conducted in the PCT. Further evidence of application to specific groups in society demonstrated.

5 Public awareness 1b Has the PCT engaged the public in cancer awareness activity? PCT cannot identify any cancer awareness initiatives in the PCT Plans being developed for 2010/11 Some evidence of cancer awareness activity in one or two cancer specific areas The PCT can demonstrate strong community engagement with examples of cancer awareness activity The PCT has targeted cancer awareness campaigns or activity and is actively engaged in developing knowledge and understanding in communities. (e.g. Health Communities Cancer Collaborative) There are plans to repeat the CAM to evaluate increased awareness. Local action plan How will the PCT identify cancer awareness knowledge in the population and what awareness campaigns will be targeted? Action to be taken Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

6 2. Screening a. Bowel b. Breast c. Cervical Bowel cancer screening Roll out of the national bowel cancer screening programme has been achieved within Cheshire and Merseyside. This programme invites most men and women aged years. referral was an option during the first phase of roll out. The CRS (2009) second annual report highlights that 4.5 million kits have been sent out resulting in 17,000 polyp removals and 4,000 cancers being diagnosed. The extension of bowel screening to men and women aged from 2010 is a Vital Sign in the NHS Ope Framework (VSA10). There is currently no national target for bowel screening although pilot studies resulted in around a 60% coverage rate. There is considerable variation of uptake amongst those in lower socio economic areas, within different ethnicity and cultures and in those who are no registered with a GP. Breast screening The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK aged 50 and over. Around one-and-a-half million women are screened in the UK each year. Women aged between 50 and 70 are now routinely invited. The NHS Breast Screening Programme will extend the age range of women eligible for breast screening to ages 47 to 73 by The national target for breast screening coverage is 70%. Cervical screening All women between the ages of 25 and 64 are eligible for a free cervical screening test every three to five years. The NHS Cervical Screening Programme now offers screening at different intervals depending on age. This means that women are provided with a more targeted and effective screening programme. The national coverage rate is 80% The new intervals are; Age Duration 25 First invitation yearly yearly 65+ Only screen those who have not been screened since age 50 or have had recent abnormal tests Achieving a 14 day turnaround time for results of cervical screening is a Vital Sign in the NHS Ope Framework (VSA15). This is to be achieved by the end of Version 2 Cancer Dashboard MCCN

7 Operational leadership 2a Does the PCT have a screening operational and strategic lead in place? The PCT does not have an operational screening lead in place The PCT designates this responsibility to a number of people The PCT has an operational and strategic lead The PCT has an operational and strategic lead and they represent the PCT at a variety of screening meetings The PCT has an operational and strategic lead and they represent the PCT at a variety of screening meetings. They are actively engaged in the cancer network and public health network screening groups Implementation plans 2b Does the PCT have an implementation plan for screening in place? No plan in place Plans being developed An operational plan is only available for some of the screening programmes A full operational plan is in place and can be shared for all cancer screening programmes A full operational plan is in place and can be shared for all cancer screening programmes. Action plans and performance is reviewed regularly and shared with the PCT board. Version 2 Cancer Dashboard MCCN

8 Breast screening extension 2c Has the PCT made plans to start the extension of breast cancer screening offered to women aged and from April 2010? No plans in place Plans in place Making good progress on plans Breast extension will begin after April 2010 Breast extension has begun Two week reporting cervical screening 2d Is the PCT reporting the results of cervical screening within two weeks? No plans in place Not able to review data Data reviewed but performance is below expectations 80% 90% of 2 week turnaround 99% of 2 week turnaround Bowel cancer screening coverage 2e How is the PCT achieving the national average coverage rate for bowel screening? How is the PCT improving coverage rates The PCT overall is not achieving level 2 The PCT overall is achieving between at least 50% and 54% coverage with more than a third of ward areas having more than 50% The PCT overall is achieving between 55% and 59% coverage with more than two thirds of ward areas having more than 55% The PCT overall is achieving between 60% and 64% coverage with more than two thirds of ward areas having more than 60% The PCT overall is achieving between 65 and 69% coverage with more than two thirds of ward areas having more than 65% How is the PCT improving screening rates? Version 2 Cancer Dashboard MCCN

9 Breast cancer screening coverage 2f How is the PCT achieving the national average coverage rate breast screening? How is the PCT improving coverage rates The PCT is not achieving level 2 The PCT overall is achieving between 50% and 54% coverage with more than two thirds of practices having more than 50% The PCT overall is achieving between 60% and 64% coverage with more than two thirds practices having more than 60% The PCT overall is achieving between 65% and 69% coverage with more than two thirds of practices having more than 65% All practices in the PCT are achieving 70% coverage or more How is the PCT improving screening rates? Cervical screening coverage 2g How is the PCT achieving the national average coverage rate for cervical screening? How is the PCT improving coverage rates The PCT is not achieving level 2 The PCT overall is achieving between 65% and 69% coverage with more than two thirds of practices having more than 65% The PCT overall is achieving between 70% and 74% coverage with more than two thirds of practices having more than 70% The PCT overall is achieving between 75% and 79% coverage with more than two thirds of practices having more than 75% All practices in the PCT are achieving more than 80% coverage or more Version 2 Cancer Dashboard MCCN

10 Non participants in screening 2h How is the PCT identifying which groups in the community are not participating in screening? The PCT cannot identify the groups The PCT is aware of the different groups who are not taking up screening The PCT identify groups and individuals who do not take up screening The PCT has a system in place to ensure all groups are invited for screening The PCT has a system in place to ensure all groups are invited for screening and can demonstrate performance How will the PCT improve coverage rates for screening? Action to be taken Bowel cancer screening Breast screening Cervical screening Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

11 3. Delays in presentation/ Referral Patient s survival and mortality is likely to be poorer if they present late to primary care with potential cancer symptoms. Community engagement projects such as the Healthy Communities Collaborative and IVAN mobile support and information service can target awareness and prompt earlier presentation to primary care. The national audit of cancer diagnosis in primary care is a tool supported by the Royal College of General Practitioners and the National Cancer Action Team. The tool captures themes in the patient experience from delay presenting to the GP, through referral and diagnostics. This tool is a reflective learning tool; each practice reviews the pathway for each audit. Yearly audits like this have been highlighted as a key recommendation from the All Party Parliamentary Group on Cancer. Primary care audits 3a The PCT can provide evidence of audits that inform the PCT of delays in the patient experience prior to diagnosis using primary care audits No evidence Plans to participate in audits PCT has been involved in network primary care audit initiative The PCT plans involve at least a third of all practices in collecting audits The PCT has developed an agreement to repeat audits in each practice yearly Referral under the urgent two week waits (TWW) 3b The PCT regularly reviews urgent TWW activity including did not attend (DNA) and cancellation rates The PCT is not at level 2 The PCT can demonstrate that it is starting to review TWW data on DNA/ cancellation rates The PCT can extract reports by GP practice to show DNA cancellation rates The PCT can extract reports by GP practice to show DNA cancellation rates and reviews them at cancer action team meetings. A plan has been developed to reduce DNA/ cancellation rates. The PCT can demonstrate a reduction in DNA/ Cancellation rates by PCT The PCT can extract reports by GP practice to show DNA cancellation rates and reviews them at cancer action team meetings. A plan has been developed to reduce DNA/ cancellation rates. The PCT can demonstrate a reduction in DNA/ Cancellation rates by PCT and by those practice with the worst DNA rates Version 2 Cancer Dashboard MCCN

12 3c The PCT regularly reviews TWW activity including yield rates Does not review urgent rates by practice Reviews TWW on a ad hoc basis Reviews TWW and reports findings to PCT Reviews TWW and provides regular reports on efficiency including yield rates Reviews TWW data every quarter and reports on efficiency to PCT, GP and Trust colleagues. Initiatives to improve TWW. Cancer yield rates can be identified (referrals versus actual cancer diagnosis). Equity audits have been completed for the PCT Emergency presentation 3d The PCT can review cancers that have been diagnosed via accident and emergency Unable to identify cancers via this route PCT is exploring ways to gather this data PCTs can identify emergency presentations resulting in a cancer diagnosis PCTs can identify emergency presentations resulting in a cancer diagnosis and this is shared with GP practices PCTs can identify emergency presentations resulting in a cancer diagnosis and this is shared with GP practices. The reasons for emergency presentation are being investigated and performance can be measured on a regular basis How will the PCT improve referrals? Action to be taken Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

13 4. Staging The information for the stage of cancer is essential to help a person choose the best treatment. It also helps them to understand their prognosis. Cancer Registration 4a Bladder How complete is the clinical stage data for cancers 3 months after registration? in collaboration with the cancer network and 4b Bladder How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and Version 2 Cancer Dashboard MCCN

14 4c Prostate How complete is the clinical stage for cancers 3 months after registration? in collaboration with the cancer network and 4d Prostate How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and 4e Colorectal How complete is the clinical stage for cancers 3 months after registration? in collaboration with the cancer network and Version 2 Cancer Dashboard MCCN

15 4f Colorectal How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and 4g Malignant Melanoma How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and 4h Lung How complete is the clinical stage for cancers 3 months after registration? in collaboration with the cancer network and Version 2 Cancer Dashboard MCCN

16 4i Lung How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and 4j Breast How complete is the clinical stage for cancers 3 months after registration? in collaboration with the cancer network and 4k Breast How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and Version 2 Cancer Dashboard MCCN

17 4l Haematology Hodgkin lymphoma How complete is the final stage data for cancers 3 months after registration? in collaboration with the cancer network and MDT performance 4m Is MDT performance improving? No MDT data submitted MDT data being submitted MDT data submitted for all MDTs MDT data submitted for all MDTs and the quality is reviewed. MDTs have self assessed themselves. Annual audits can be demonstrated. Data captured for ethnicity, gender, age and treatment on Somerset Cancer Register or MDT proforma. MDT data submitted for all MDTs and the quality is reviewed. With 90% of data sets completed. MDTs have self assessed themselves. MDT completes annual audits and can demonstrate that it can capture stage, ethnicity, gender, age and treatment How will the PCT improve MDTs? Action to be taken Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

18 5. Cancer incidence, cancer mortality Cancer incidence 5a Does the PCT review cancer incidence? The PCT has not completed baseline cancer incidence data Some evidence of recording cancer incidence emerging, but not for all the main cancers Cancer incidence completed for all the main cancers. National and international benchmarks completed Cancer incidence completed for all the main cancers. National and international benchmarks completed The PCT has reviewed the cancers where the incidence is increasing the most. Cancer incidence completed for all the main cancers. National and international benchmarks completed The PCT has reviewed the cancers where the incidence is increasing the fastest. The PCT analyses cancer incidence rates versus other factors such as survival and mortality. Cancer mortality 5b Does the PCT review cancer mortality? The PCT has not completed baseline cancer mortality data Some evidence of recording cancer mortality emerging, but not for all the main cancers, bowel, lung, breast and prostate Cancer mortality completed for all the main cancers. National and international benchmarks completed. PCT ambitious cancer mortality has been set. Cancer mortality completed for all the main cancers. National and international benchmarks completed. PCT ambitious cancer mortality has been set. The PCT has reviewed the cancers where the cancer mortality is the highest. Cancer mortality completed for all the main cancers. National and international benchmarks completed. PCT ambitious cancer mortality has been set. The PCT has reviewed the cancers where the cancer mortality is the highest. Mortality rates have been scoped for the over 75s Version 2 Cancer Dashboard MCCN

19 How will the PCT reduce cancer mortality? Action to be taken Who will lead on the delivery of this action? Identify milestones 6. Survival Cancer Survival 6a Does the PCT review survival data? No evidence PCT receives regular survival reports for 5 year survival PCT receives regular survival reports for 5 year survival and analyses data PCT analyses some data and collects 1 and 5 year data. The PCT is involved in 1 and 5 year survival discussions network wide for less common cancer types PCT uses data to analyse survival for all cancer. Collects 1 and 5 year survival rates and compares results against international benchmarks. The PCT understands 1 and 5 year survival data for less common cancer types How will the PCT improve cancer survival? Action to be taken Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

20 7. Inequalities Cancer Inequalities 7a Can the PCT identify specific groups where the cancer inequalities are the greatest? No evidence The PCT can identify specific groups were inequalities are the greatest The PCT can provide data that shows inequalities for marginalized groups in respect of cancer mortality, incidence and screening activity The PCT can provide data that shows inequalities for marginalized groups in respect of cancer mortality, incidence and screening activity. Data intelligence can be shared on groups described in the national cancer equality initiative. BME communities, those with disabilities, age related inequalities, young people, socio economic inequalities, people who are disadvantaged because of sexual orientation The PCT can provide data that shows inequalities for marginalized groups in respect of cancer mortality, incidence and screening activity. Data intelligence can be shared on groups described in the national cancer equality initiative. BME communities, those with disabilities, age related inequalities, young people, socio economic inequalities, people who are disadvantaged because of sexual orientation. The PCT demonstrates interventions and outcomes to reduce inequalities. How will the PCT reduce cancer inequalities? Action to be taken Who will lead on the delivery of this action? Identify milestones Version 2 Cancer Dashboard MCCN

21 8. Local Plans: Findings from local awareness and early detection initiative or strategy (LAEDI) a. Summary of event b. Key recommendations Key issues discussed Action to be taken Who will lead on the delivery of this action? 9. Example of local initiatives a. Community engagement b. Service improvement c. Reducing inequalities Examples of local cancer action and initiatives? Name of initiative (Describe the initiative, what was the outcome?) Name of initiative (Describe the initiative, what was the outcome?) Name of initiative (Describe the initiative, what was the outcome?) Name of initiative (Describe the initiative, what was the outcome?) Name of initiative (Describe the initiative, what was the outcome?) Version 2 Cancer Dashboard MCCN

22 10. Commissioning commitments- ope plan and strategic commissioning plans Key cancer commissioning pledges Summary of key cancer priorities Other priorities identified Version 2 Cancer Dashboard MCCN

23 Cancer Performance summary table for xxx PCT Number Measure Level1 Level2 1a Has the PCT conducted a CAM to benchmark local awareness? 1b Has the PCT engaged the public in cancer awareness activity? 2a Does the PCT have a screening operational and strategic lead in place? 2b Does the PCT have an implementation plan for screening in place? 2c Has the PCT made plans to start the extension of breast cancer screening offered to women aged and from April 2010? 2d Is the PCT reporting the results of cervical screening within two weeks? 2e How is the PCT achieving the national average coverage rate for bowel screening? How is the PCT improving coverage rates 2f How is the PCT achieving the national average coverage rate breast screening? How is the PCT improving coverage rates 2g How is the PCT achieving the national average coverage rate for cervical screening? How is the PCT improving coverage rates 2h How is the PCT identifying which groups in the community are not participating in screening? 3a The PCT can provide evidence of audits that inform the PCT of delays in the patient experience prior to diagnosis using primary care audits 3b The PCT regularly reviews urgent TWW activity The PCT regularly reviews urgent TWW activity including did not attend (DNA) and cancellation rates 3c The PCT regularly reviews TWW activity including yield rates 3d The PCT can review cancers that have been diagnosed via accident and emergency 4a How complete is staging data for cancers 3 months after registration? 4b Is MDT performance improving? 5a Does the PCT review cancer incidence? 5b Does the PCT review cancer mortality? 6a Does the PCT review survival data? 7a Can the PCT identify specific groups where the cancer inequalities are the greatest?