1. National Lung Cancer Audit
Dr Ian Woolhouse
University Hospital Birmingham
Senior Clinical lead NLCA

2. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

3. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

4. English National Cancer Registration System
New data flows
Cancer Waiting Times
Pathology full-text reports
Radiotherapy Data (RTDS)
Data from MDT software systems
Chemotherapy Dataset (SACT)
COSD
Local imaging systems
Molecular labs (EGFR)
Patient Administration Systems
ONS - Cancer and non- cancer deaths
English National Cancer Registration System
This is a diagram which represents the data feeds that will flow into ENCORE.
Green boxes show feeds which will be sent directly to the Registry from each provider trust. These will be from Multi-Disciplinary Team (MDT) cancer tracking systems, full-text reports from Pathology systems, diagnostic and procedural information from Patient Administration Systems (PAS) and data from Radiology systems.
The Orange represents national cancer datasets. These are the Radiotherapy Data Set (RTDS), the Systemic Anti-Cancer Therapy (SACT)/Chemotherapy dataset and National Cancer Waiting Times (CWT).
Yellow boxes represent other feeds of data – Death information from the Office of National Statistics (ONS) and data from the Cancer Screening Programmes (Breast, Cervical and Bowel). “Cancer death” information will be provided for patients who have a mention of cancer on their death certificate, while “Non-Cancer Death” information is provided on all patients which has previously been flagged with ONS as having had cancer (but have died from another cause).
The remaining white boxes show other data flows that will exist in ENCORE which either supplement existing data for COSD (HES, PET-CT and National Audits) or provide extra information that is not part of the COSD.
Fully registered lung cancer case

5. Impact of new data flows
Additional 6000 cases identified
Older patients
Less complete PS and stage
Less likely to receive treatment
Additional treatments identified
Overall treatment rates similar

6. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

7. Online reporting portal

8. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

9. Audit standards INDICATOR STANDARD Seen by CNS > 90%
CNS present for diagnosis
> 80%
Histological confirmation
> 75%
NSCLC NOS rate
< 15%
Valid EGFR status recorded (non-squamous)
PET before radical treatment
> 95%
Time from diagnosis to treatment SCLC < 2 weeks

10. Audit outcome indicators
STANDARD
% Stage I-II NSCLC receiving radical treatment
Review outliers after risk adjustment
% Stage IIIB-IV NSCLC PS 0-1 receiving chemotherapy
% NSCLC EGFR M+ receiving TKI treatment
% SCLC receiving chemotherapy
Survival (median and 1 yr)

11. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

12. 2015 results (preliminary)

13. 2015 results (preliminary)

14. 2015 results (preliminary)

15. Plan Data flows Online reporting portal Audit standards
South West Network 2015 results
Quality Improvement

16. Quality Improvement Two new QI leads Spotlight audits
Regional workshops
Targeted visits
Sharing learning

17. What’s the end game?

19. nlca@rcplondon. ac. uk www. rcplondon. ac