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Informatics

Informatics requirements for 2012/13

As part of the implementation of the London Cancer Programme Model of Care, all London commissioners have been asked to include certain enhancements to measuring acute cancer activity in their contracts for 2012-13.

This web page sets out the requirements so that trusts can be prepared to collect the necessary information from the start of the financial year. Trusts have also been notified of these requirements by letter and by commissioners.

There are 4 specific elements:

1. Metrics

A list of generic cancer and tumour-specific metrics has been developed in collaboration with a wide group of clinicians, following the aims of the cancer programme to improve patients’ experiences and outcomes along the whole of the cancer pathway.

Draft commissioning metrics                SHORTLIST technical guidance

2.    Staging of tumours

a)    A cancer CQUIN has been proposed for 2012-13 which will reward an improvement in the level of staging data collected. Discussions about this in 2012-13 contracts are on-going. The proposed CQUIN can be viewed below

CQUIN recorded stage for 2012 v0 5 (231211)

b)    NWL commissioners have decided to enforce data collection through the relevant clause in the national contract. This is the same information as covered by the CQUIN.

 3.    Output specifications

A central part of the Model of Care is the achievement of best practice pathways for all cancer patients across London. Output specifications which define best practice for breast, colorectal and brain cancers have been approved by the Cancer Implementation Board and shared with the ICSs’ Joint Development Groups.

A cover note is provided to further explain how the output specifications are to be used in 2012/13

4.    Finance data collection

The Model of Care proposes that best practice be incentivised by an alternative method of payment between commissioners and providers. Two alternatives will be modelled during 2012-13 with a view to implementing one from April 2013. In order to make this happen, providers need to submit information to commissioners on a regular basis. Some of this information is already due to be reported to the Cancer Registry and the rest is planned to be collected in future through ENCORE, the new national Cancer Registry data collection tool. The full list was referred to in the London Commissioning Intentions and is set out in detail below. Commissioners have requested that LHP then use the information to measure the actual activity and cost of cancer treatment during 2012-13 and model potential changes in cost using the two alternative payment methodologies.

Informing commissioners for new patients

• The date a patient is diagnosed with cancer
• The cancer that they have been diagnosed with
• The stage on diagnosis
• Their NHS number or an agreed pseudonymised alternative

Informing commissioners for existing patients

• The date the stage of the cancer is diagnosed as having changed
• The new stage

Informing commissioners for all patients

• The date a patient reaches the end of planned active treatment, defined by the issuing of an ‘end-of-treatment’ summary or out of hospital follow-up plan.
• The reason for that (e.g. death/move away/patient chooses to stop having active treatment etc.

Notes

Agreement about the NHS number or pseudonymised alternative is to be reached in conjunction with IG specialists, the technical sub-group, commissioners and providers.

It is acknowledged that further work will be required with providers to collect change in staging data during treatment.

The date the patient reaches the end of planned active treatment was originally listed as the point the MDT ceases to have overall responsibility for the care of the patient. The wording was changed following discussions with clinicians and is being tested with providers. Discussions about the implementation of an ‘end-of-treatment’ summary are being held in London Cancer (North and East), and North West London commissioners are drafting their cancer CQUIN to include this.