Visioning the Q uality P erformance I ndicator ( QPI ) Reporting Programme

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

3. Development of QPIs. Commence with Renal and Prostate in 2010. Cancer standards. NHS QIS Standards in place for Breast, Lung, Colorectal and Ovarian cancers. Current Position

4. 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. Current Position

5. 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. Current Position

6. 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. Current Position

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

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

9. Reporting Processes: One Option Scottish Cancer Taskforce NHS QIS: Quality Assurance Local Board Governance Structures • RCAGs: • Receive annual performance reports • Agree & monitor Network action plans • Submit annual report to Regional Planning Group • Submit regional reports, as required to NHS QIS • Regional Cancer Networks, MCNs/TSGs: • Analyse & report performance against agreed quality performance indicators (QPIs). • Agree action plans & submit to RCAG. Implement actions Rolling programme of National QPI development & review Robust quality assurance programme in place Rolling programme of QPI and dataset review • 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

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?