Renal Cancer Clinical Quality Performance Indicators: Engagement Document

This document is being circulated for comment and feedback in order to ensure wide

engagement with professional groups, health service staff, voluntary organisations, patients affected by renal cancer and the wider public.

Appendix 1: QPI Development Process

Preparatory Work and Scoping

The preparatory work involved the development of a structured briefing paper by Healthcare Improvement Scotland (formerly NHS Quality Improvement Scotland). This paper took account of existing, high quality, clinical guidance and provided a basis for the development of QPIs.

The scope for development of renal cancer QPIs and a search narrative were defined and agreed by the Renal Cancer QPI Development Group. The table below shows the final search criteria.



Renal cell carcinoma, clear cell and other cell carcinoma, renal parenchyma renal cortical lesions

Adults only (over 16 years of age)

Topics: Prevention and palliative/end of life care related cancers such as bladder and urethra, pelvis tumours, Wilms tumours nephroblastoma.

Date: 2000 or later

Language: All

Topics: Referral, diagnosis, staging, management of non-metastatic (organ confined or locally advanced) and metastatic (advanced) disease, follow up, management of genetic risk.

Table 1 - Renal Cancer Search Criteria

A systematic search was carried out by Healthcare Improvement Scotland using selected websites and two primary medical databases to identify national and international guidelines.

Nineteen guidelines were appraised for quality using the AGREE II instrument [3] . This tool assesses the methodological rigour and precision used when developing a guideline. Six of the guidelines were not recommended for use, of the remaining 13 guidelines, 5 were recommended for use and 8 recommended for use with modifications.

Indicator Development

The Renal Cancer QPI Development Group defined evidence based, measurable indicators with a clear focus on improving the quality and outcome of care provided.

The group developed QPIs using the clinical recommendations set out in the briefing paper as a base, ensuring all indicators met the following criteria:

  • Overall importance - does the indicator address an area of clinical importance that would significantly impact on the quality and outcome of care delivered?
  • Evidence based - is the indicator based on high quality clinical evidence?
  • Measurability - is the indicator measurable i.e. are there explicit requirements for data measurement and are the required data items accessible and available for collection?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in 2011 where the Renal Cancer QPIs, along with the accompanying draft minimum core dataset and measurability specifications, were made available of the Scottish Government website.

During the engagement period clinical and management colleagues from across NHSScotland, patients affected by renal cancer and the wider public were given the opportunity to influence the development of renal cancer QPIs.

Following the engagement period all comments and responses received were reviewed by the Renal Cancer QPI Development Group and used to produce and refine the final indicators.


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