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National Prostate Cancer Audit: Review of the Organisational Audit Dr Ajay Aggarwal Oncology Coordinator NPCA Honorary.

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Presentation on theme: "National Prostate Cancer Audit: Review of the Organisational Audit Dr Ajay Aggarwal Oncology Coordinator NPCA Honorary."— Presentation transcript:

1 National Prostate Cancer Audit: Review of the Organisational Audit Dr Ajay Aggarwal Oncology Coordinator NPCA Honorary Consultant Clinical Oncologist

2 NPCA – Audit timeline Year 1: – National survey of service delivery (“organisational Audit”) – Analysis of existing data, provide comparative data for prospective audit – “Develop” a National Minimum Dataset (MDS) for the prospective audit Year 2: – Prospective data collection on all newly diagnosed men – Development of tool to collect PREM/PROMs

3 Organisational Audit National survey of all NHS Trusts and Specialist MDTs How are prostate cancer services organised? – Diagnostic and staging investigations – Radical and palliative therapeutic options (e.g. new radiation technologies) – Accessory prostate cancer services (e.g. specialist continence services) In addition, highlight efficient processes of care

4 Organisational Audit: Methods Two questionnaires developed and distributed via Survey Monkey in October 2013 to the Prostate cancer lead for each Trust and Specialist MDT 100% response rate and completion rate in England – 143 NHS trusts – 48 SMDTs – 55 Radiotherapy Centres 100% response and completion rate from all six health boards in Wales

5 Availability of diagnostic & staging investigations

6 Availability of Radical interventions

7 Availability of Personal Support Services

8 Results:- HDR Brachytherapy 11 Radiotherapy Centres provide HDR Brachtherapy in England Of the 48 prostate cancer Specialist MDTs in England, 20 (42%) provide HDR Brachytherapy There is significant variation in availability amongst NHS area teams in England

9 Single HDR Brachytherapy Centre HDR Centre covering >1 NHS area team

10 Further results 54% of specialist MDTs in England and 50% in Wales offer joint specialist clinics Almost all specialist MDTs in England have consultant-led follow-up clinics after radical treatment The corresponding figures for Wales are lower (post-surgery, 75% and post-radiotherapy 50%). 33% of specialist MDTs in England expects to follow up patients with low-risk localised disease longer than 5 years duration after a radical treatment.

11 Conclusions Overall, NHS providers in England and Wales are following guidelines for the management of prostate cancer services The Organisational audit demonstrates that for a number of providers the delivery of specialist services can be improved further: – multiparametric MRI – robot-assisted prostatectomy – HDR Brachytherapy The consequent inequity may impact on access to these evidence based technologies for the management of prostate cancer patients.

12 Next Steps Aim to feedback results to individual NHS providers in England and Wales by February 2015 Survey results to be publically available on NPCA website Prospective audit will assess patient ACCESS to different technologies given current inequity and impact on outcomes


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