Comparative indicators for cancer network management in England: availability, characteristics and presentation

Abstract

Background: In 2000, the national cancer plan for England created 34 cancer networks, new organisational structures to coordinate services across populations varying between a half and three million people. We investigated the availability of data sets reflecting measures of structure, process and outcome that could be used to support network management.

Methods: We investigated the properties of national data sets relating to four common cancers - breast, colorectal, lung and prostate. We reviewed the availability and completeness of these data sets, identified leading items within each set and put them into tables of the 34 cancer networks. We also investigated methods of presentation.

Results: The Acute Hospitals Portfolio and the Cancer Standards Peer Review recorded structural characteristics at hospital and cancer service level. Process measures included Hospital Episode Statistics, recording admissions, and Hospital Waiting-List data. Patient outcome measures included the National Survey of Patient Satisfaction for cancer, and cancer survival, drawn from cancer registration. Data were drawn together to provide an exemplar indicator set a single network, and methods of graphical presentation were considered.

Conclusion: While not as yet used together in practice, comparative indicators are available within the National Health Service in England for use in performance assessment by cancer networks.

Figure 1

Percentage of patients reporting 'a problem with amount of respect and dignity' in the National Cancer Patient Survey. Values for trusts in one network

Figure 2

Breast cancer, age standardised five-year % relative survival (with CIs and national and regional averages) by cancer networks in England, grouped by NHS regions, of women with breast cancer diagnosed 1996–2001, followed up to 31 December 2003

Figure 3

Spider-chart ranking of one network for one dimension in each of five data sets for breast cancer (each dimension: 0 = most favourable, 10 = least favourable). A: 1-year relative survival. B: Satisfaction survey 'respect and dignity'. C: Compliance with cancer standards. D: % GP urgent referrals seen within 2 weeks. E: Inhospital mortality.

Figure 4

Moving average control chart. Percentage GP urgent referrals for lung cancer seen within 2 weeks, single NHS hospital, data for consecutive year quarters 2001/2 – 2003/4. % seen within 2 weeks. Moving average. Control limits for moving average