Transcript National Prostate Cancer Audit: Review of the Organisational Audit Dr Ajay Aggarwal Oncology Coordinator NPCA Honorary Consultant Clinical Oncologist www.npca.org.uk [email protected].

National Prostate Cancer Audit:
Review of the Organisational Audit
Dr Ajay Aggarwal
Oncology Coordinator NPCA
Honorary Consultant Clinical Oncologist
www.npca.org.uk
[email protected]
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
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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
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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
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Availability of diagnostic & staging
investigations
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Availability of Radical interventions
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Availability of Personal Support Services
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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
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Single HDR
Brachytherapy
Centre
HDR Centre
covering >1
NHS area
team
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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.
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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.
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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
http://www.npca.org.uk
• Prospective audit will assess patient ACCESS to different
technologies given current inequity and impact on outcomes
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[email protected]