1. South West Public Health Observatory South West Regional Public Health Group Opportunities for future analysis by SWPHO Sean McPhail South West Public Health Observatory sean.mcphail@swpho.nhs.uk

2. South West Public Health Observatory South West Regional Public Health Group Introduction Changes in SWCIS audit function Prospective data collection vs electronic datasets In this talk: Overview of Head and Neck cancer in the South West Examples of type of work that is possible Recent work on combining datasets

3. South West Public Health Observatory South West Regional Public Health Group Electronic data sources Cancer Registry databases ONS Mortality Hospital Episode Statistics (HES) data Cancer Waiting Time data RES Radiotherapy data

4. South West Public Health Observatory South West Regional Public Health Group Types of analysis By Trust, Network, or defined group of patients: Numbers, rates, age-standardised rates Crude and relative survival Geographic Information Systems (GIS) Patient follow-up Histopathology and grade

5. South West Public Health Observatory South West Regional Public Health Group Incidence trends – counts and age-standardised rates

6. South West Public Health Observatory South West Regional Public Health Group

7. South West Public Health Observatory South West Regional Public Health Group

8. South West Public Health Observatory South West Regional Public Health Group Mortality trends

9. South West Public Health Observatory South West Regional Public Health Group

10. South West Public Health Observatory South West Regional Public Health Group Analysis of surgical care HES data: inpatient and daycases only Define –Resections (61 procedure types) –Harvesting (64 procedure types) –Reconstruction (38 procedure types) Look for all procedures of these types on patients with a diagnosis of Head & Neck cancer

11. South West Public Health Observatory South West Regional Public Health Group Analysis of surgical care (2004 HES data) ReconstructionHarvestResection Trust A281550 Trust B9103 Trust C161777 Trust D124181131 Trust E1061561 Total283238322 Count number of procedures of different types by Trust

12. South West Public Health Observatory South West Regional Public Health Group Inter-trust transfers (2004 combined HES and cancer registry data) Count number of referrals between Trusts

13. South West Public Health Observatory South West Regional Public Health Group GIS analysis – travel times

14. South West Public Health Observatory South West Regional Public Health Group Analysis by socio-economic deprivation 18 Lung cancer mortality rate 0 20 40 60 80 100 12345 Deprivation quintile (income) Rate per 100,000 More deprivedLess deprived

15. South West Public Health Observatory South West Regional Public Health Group Patient pathway analysis Patient cohort defined as people as diagnosed with prostate or bladder cancer in 2000 in the SW GOR (as recorded on the SWPHO cancer registry). 2862 Prostate cancer patients 925 Bladder cancer patients

16. South West Public Health Observatory South West Regional Public Health Group Number of bed-days for prostate and bladder cancer relative to diagnosis Time in months

17. South West Public Health Observatory South West Regional Public Health Group Number of episodes for prostate cancer relative to diagnosis, by broad type Time in months

18. South West Public Health Observatory South West Regional Public Health Group Number of episodes leading up to death, prostate and bladder cancer Time in months

19. South West Public Health Observatory South West Regional Public Health Group Number of episodes leading up to death, prostate cancer, by admission type Time in months

20. South West Public Health Observatory South West Regional Public Health Group Number of episodes leading up to death, bladder cancer, by admission type Time in months

21. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty Time in months

22. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty – emergency only Time in months

23. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty – elective only Time in months

24. South West Public Health Observatory South West Regional Public Health Group Summary & conclusions Some analyses / audits can be performed more efficiently with electronic data collection: –Waiting times –Provision of surgery –Patterns of referral Some do require prospective data collection Use of electronic databases allows new types of audit/analysis A combination of the two provides greater flexibility

25. South West Public Health Observatory South West Regional Public Health Group Thank you sean.mcphail@swpho.nhs.uk