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Quality Standards for Melanoma
11th October 2012
James Larkin FRCP PhD
Consultant Medical Oncologist
Royal Marsden Hospital /
Institute of Cancer Research
London
Overview
• What are quality standards?
• How does this fit in to NICE?
• The Melanoma Taskforce
• Melanoma Pathway Expert Working Group
• Quality statements
• Conclusions and next steps
What are quality standards?
• ‘NICE quality standards are a concise set of statements
designed to drive and measure priority quality
improvements within a particular area of care’
• Evidence-based; NHS and social care
• 22 at present; 19 in development
• E.g. breast , colorectal, lung, ovarian cancer; hip
fracture, COPD, glaucoma, heart failure
• 100+ are in ‘topic library’ for future development
http://www.nice.org.uk/aboutnice/qualitystandards/qualitystandards.jsp
Purpose of NICE quality standards
• Patients, carers and the public can use NICE quality standards
to provide information about the quality of care they should expect
• Health and social care professionals and public health
practitioners can use the quality standards in clinical audit and
governance reports or in professional development and validation
• Provider organisations can use the quality standards to provide
high quality services for patient care and monitor quality
improvements or to show successful performance in a national audit
or inspection
• Commissioners may use the quality standards to ensure that high
quality care is being commissioned through the contracting process
or to incentivise provider performance by using the indicators in
association with incentive payments such as Commissioning for
Quality Improvement (CQUIN)
http://www.nice.org.uk/guidance/qualitystandards/moreinfoaboutnicequalitystandards.jsp
Purpose of NICE quality standards
• Patients, carers and the public can use NICE quality standards
to provide information about the quality of care they should expect
• Health and social care professionals and public health
practitioners can use the quality standards in clinical audit and
governance reports or in professional development and validation
• Provider organisations can use the quality standards to provide
high quality services for patient care and monitor quality
improvements or to show successful performance in a national audit
or inspection
• Commissioners may use the quality standards to ensure that high
quality care is being commissioned through the contracting process
or to incentivise provider performance by using the indicators in
association with incentive payments such as Commissioning for
Quality Improvement (CQUIN)
http://www.nice.org.uk/guidance/qualitystandards/moreinfoaboutnicequalitystandards.jsp
Cancer quality standards
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Breast cancer (P)
Colorectal cancer (P)
Lung cancer (P)
Ovarian cancer (P)
Prostate cancer
Cancer chemotherapy
Haematological malignancies
Head and neck cancer
Sarcoma
Skin cancer (including melanoma)
Children and young people with cancer
Metastatic spinal cord compression
Referral for suspected cancer
Radiotherapy services
Bladder Cancer
Published
In ‘topic
library’
http://www.nice.org.uk/aboutnice/qualitystandards/qualitystandards.jsp
Other types of NICE guidance
Clinical guidelines
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Guidance on the appropriate treatment and care of people with specific diseases and conditions.
Public health guidance
•
NICE public health guidance makes recommendations to the NHS local authorities and other organisations in the
public, private, voluntary and community sectors on how to improve people's health and prevent illness and disease.
Technology appraisal guidance
•
NICE technology appraisal guidance makes recommendations on when and how new and existing medicines and
treatments should be used in the NHS.
Interventional procedures guidance
•
NICE interventional procedures guidance advises the NHS on whether new interventional procedures are safe and
effective enough to be used routinely.
Medical technologies guidance
•
NICE Medical technologies guidance is designed to help the NHS adopt efficient and cost effective medical devices
and diagnostics more rapidly and consistently.
Diagnostic guidance
•
NICE diagnostic guidance makes recommendations to the NHS on the efficacy and cost effectiveness of new
diagnostic technologies.
Cancer service guidance
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NICE cancer service guidance supports the implementation of The NHS Cancer Plan for England, and the NHS Plan
for Wales Improving Health in Wales.
Quality standards
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NICE Quality standards define the standard of healthcare that people can expect by indicating when a clinical
treatment (or a set of clinical procedures) is highly effective cost effective and safe, and is viewed a a positive
experience by patients
http://www.nice.org.uk/guidance/index.jsp?action=byTopic&o=7165
Other types of NICE guidance
Clinical guidelines
•
Guidance on the appropriate treatment and care of people with specific diseases and conditions.
Public health guidance
•
NICE public health guidance makes recommendations to the NHS local authorities and other organisations in the
public, private, voluntary and community sectors on how to improve people's health and prevent illness and disease.
Technology appraisal guidance
•
NICE technology appraisal guidance makes recommendations on when and how new and existing medicines and
treatments should be used in the NHS.
Interventional procedures guidance
•
NICE interventional procedures guidance advises the NHS on whether new interventional procedures are safe and
effective enough to be used routinely.
Medical technologies guidance
•
NICE Medical technologies guidance is designed to help the NHS adopt efficient and cost effective medical devices
and diagnostics more rapidly and consistently.
Diagnostic guidance
•
NICE diagnostic guidance makes recommendations to the NHS on the efficacy and cost effectiveness of new
diagnostic technologies.
Cancer service guidance
•
NICE cancer service guidance supports the implementation of The NHS Cancer Plan for England, and the NHS Plan
for Wales Improving Health in Wales.
Quality standards
•
NICE Quality standards define the standard of healthcare that people can expect by indicating when a clinical
treatment (or a set of clinical procedures) is highly effective cost effective and safe, and is viewed a a positive
experience by patients
http://www.nice.org.uk/guidance/index.jsp?action=byTopic&o=7165
What about clinical guidelines?
• 159 clinical guidelines on diverse topics including breast,
lung, colorectal, prostate and ovarian cancers
• 61 in development including bladder cancer and
melanoma (projected publication date June 2015)
• Lung cancer clinical guideline is 200 pages long!
• No planned guidance on oesophageal, stomach,
pancreatic cancers or NHL (consider incidence and
mortality)
• Hopefully melanoma quality standard will be developed
alongside melanoma clinical guideline
The Melanoma Taskforce
The Melanoma Taskforce
The Melanoma Taskforce
‘Quality in
Melanoma Care’
commissioned late
in 2011
Melanoma Pathway Expert
Working Group
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Simon Davies, Chief Executive Teenage Cancer Trust and Chair, Cancer52
Stephen Kownacki, Executive Chair, PCDS
Charlotte Fionda, Development Director, Skcin
Paul Lorigan, Medical Oncologist
Jerry Marsden, Dermatologist and Chair, MSG
Julia Newton-Bishop, Dermatologist and Chair, Skin Site Specific Clinical
Reference Group, NCIN
Gill Nuttall, Founder Factor50
Veronique Poirier, Principal Cancer Intelligence Analyst, SWPHO
Barry Powell, Plastic Surgeon and National Clinical Advisor in Skin Cancer
Saskia Reeken, Skin Cancer CNS and Chair, BDNG
Daffyd Roberts, Dermatologist
Neil Shroff, GPwSI Skin Cancer, Committee Member PCDS
Meirion Thomas, Surgical Oncologist
Jacky Turner, Principal Oncology Pharmacist, GSTT
Catherine Wheelhouse, Skin Cancer CNS and Chair, British Association of
Skin Cancer Specialist Nurses
Melanoma Pathway Expert
Working Group
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Simon Davies, Chief Executive Teenage Cancer Trust and Chair, Cancer52
Stephen Kownacki, Executive Chair, PCDS
Charlotte Fionda, Development Director, Skcin
Paul Lorigan, Medical Oncologist
Jerry Marsden, Dermatologist and Chair, MSG
Julia Newton-Bishop, Dermatologist and Chair, Skin Site Specific Clinical
Reference Group, NCIN
Gill Nuttall, Founder Factor50
Veronique Poirier, Principal Cancer Intelligence Analyst, SWPHO
Barry Powell, Plastic Surgeon and National Clinical Advisor in Skin Cancer
Saskia Reeken, Skin Cancer CNS and Chair, BDNG
Daffyd Roberts, Dermatologist
Neil Shroff, GPwSI Skin Cancer, Committee Member PCDS
Meirion Thomas, Surgical Oncologist
Jacky Turner, Principal Oncology Pharmacist, GSTT
Catherine Wheelhouse, Skin Cancer CNS and Chair, British Association of
Skin Cancer Specialist Nurses
Melanoma Pathway Expert
Working Group: Process
• Meetings in February and May 2012
• Other work outside meetings
• 5 core teams (primary care, dermatology, surgery,
oncology and survivorship/end of life care)
• Cross-cutting group reviewed work of teams
• Developed 16 quality statements and other
recommendations; they describe the…
Quality Statements
Quality Statements
Quality Statements
Quality Statements
Conclusions and next steps
• Positive that clinical guideline and quality
standard planned for melanoma
• Hopefully the quality statements we have
developed will be taken into account by the
group working on these
• Whether there is any scope for this to inform
quality of care before 2015 is unclear
• There may be disagreement about some of the
statements but unity as a community is vital
• Comments and suggestions gratefully received
Acknowledgements
Sian James MP
Expert Working Group
Secretariat, particularly Daniel
Cambers and Katie Russell
Thank you
How are quality standards developed?
http://www.nice.org.uk/guidance/qualitystandards/moreinfoaboutnicequalitystandards.jsp#How are topics selected?
How are quality standards developed?
http://www.nice.org.uk/guidance/qualitystandards/moreinfoaboutnicequalitystandards.jsp#How are topics selected?
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