Bowel Cancer Framework for Scotland

BOWEL CANCER FRAMEWORK FOR SCOTLAND

06. CONTINUOUS QUALITY IMPROVEMENT

Continuous quality improvement is essential for the delivery of the best quality of treatment and care possible and is the raison d'être of NHS QIS. Regional cancer networks have a responsibility for ensuring continuous quality improvement is at the heart of their day-to-day working as set out in NHS HDL (2002) 69 and NHS HDL (2001) 71. To be able to assess services against evidence based clinical standards and guidelines, all services should have in place robust arrangements for clinical audit, including data collection and analysis and agreed reporting arrangements to NHS Boards/operating divisions. All cancer networks are required to publish annual reports of their activities and performance (NHS HDL (2001) 71) and Cancer in Scotland: Action for Change confirmed that "prospective audit is the platform on which monitoring will be based and is the key for local (MCN) continuous assessment".

The Scottish Executive, RCAGs and NHS QIS are working together to establish a Quality Assurance/Accreditation Framework for cancer services.

Each of the three regional cancer network organisations will seek accreditation during the summer of 2004.

Cancer in Scotland recognised the pressing need to harness the power of information technology and provide better information to patients and to improve communication between clinician and patients. To take this forward a National Cancer IM&T Plan was published in December 2002 whose basic foundation was to exploit ECCI and SCI to support the patient journey. Since then the Cancer eHealth Sub-Group has been piloting the plan in four areas across Scotland and in February 2004 hosted a national workshop to review outcomes from the pilot, share examples of good practice and to reach consensus on a way forward.

Scotland's Health White Paper Partnership for Care further recognised the urgent need for an eHealth culture driven by clinical leaders and set the goal to deliver an integrated care record. To drive this forward the eHealth Programme Board was established under the chairmanship of the Minister for Health and Community Care and has produced a National eHealth Strategy.

In line with the National eHealth Strategy move forward with a national procurement of a generic patient pathway system using cancer as a demonstration project.

Cancer in Scotland recognised that there is significant evidence that outcomes are improved for those patients treated in environments where research is the norm or for those patients who are involved in cancer trials. Throughout this framework research implications are noted but we need to bear in mind that as of 1 May 2004, cancer research involving a clinical intervention with medicinal products will require to be carried out under the EU Clinical Trials Directive. While the Directive aims to protect the rights, safety and well-being of those participating in clinical trials, it is appreciated that the organisation and management of cancer clinical trials will be more challenging, particularly in the transitional phase.

CONTINUOUS QUALITY IMPROVEMENT

Basic Elements

• Uniform, comprehensive, independent data collection based on agreed minimum core dataset and definitions

• National comparative data reporting

• NHS QIS Framework for Quality Assurance/Accreditation of cancer networks

• IM+T